Workers Compensation: What You Should Know

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Under the workers’ compensation laws of California, employers are required to have workers’ compensation coverage for all employees. Reverent Employer Consultants can work with you to find brokers who have the greatest interest in your business’s success. Avoid common pitfalls and misguidance by under-reporting and misclassification of workforce. We will also provide expert medical review of your open claims to work with you, your insurance carrier, and defense attorneys if any to help identify avenues of more rapid claim resolution. 

Workers Compensation California

California has a compensation system that benefits both employers and employees. Workers are not allowed to sue their employers in court in the same way as those cases involving personal injury seeking damages for pain and suffering. In agreement with this stipulation, employees don’t have to prove that their employer was at fault for the injury. They just need to show that the injury was work-related. The California workers’ compensation system, which is paid for by the employers, provides the coverage that is needed for injured workers.

Workers have the right to medical treatment costs, temporary disability payments, permanent disability payments, life pension payments, vocational retraining costs, and death benefits.

Workers are also covered if their injury happens while traveling on business, performing work-related errands, or a business-related social function. As long as the injury is connected to the job, it can be covered by workers’ compensation.

California Workers Compensation Rights

Base rates vary from state to state, but the process used to calculate these rates are similar. Each type of occupation is assigned a risk classification. This can be determined by the frequency of the on-the-job injury, as well as the severity of the injury. Severity looks at both medical payments and indemnity benefits. In California, roofers have the highest occupational risk classification, and office clerks have the lowest. Reverent Employer Consultants will guide businesses through compliance requirements.

Employees cannot typically sue their employers in court over a work-related injury. Under some limited circumstances, an employer could be sued for intentionally hurting you or for not having the legally required workers’ comp insurance.

Workers Compensation Audit

The end-of-the-year audit is one of the most important times of the year as it is when insurance carriers complete audits to determine the accurate amount of workers comp premium owed on a policy term. They will audit the insured’s payroll records for the expired policy term. It is very important to consult with someone like Reverent Employer Consultants to have this issue addressed and to work with you to find brokers to get you the best pricing possible. Companies can expect to show proof of:

  • Experience Rating Worksheet
  • Tax Forms
  • Payroll records
  • Job Descriptions of all employees
  • Payments for services performed by subcontractors and independent contractors
  • Certificates of Insurance from the subcontractors

Can Work-Related Compensation Injuries Be Denied?

Just about any work-related injury can be covered under workers’ comp. However, there are certain circumstances that can prevent a worker from filing workers’ comp. If an employee is intoxicated or using illegal drugs, any injuries may not be covered. Coverage can also be denied for the following:

  • Injuries that are self-inflicted
  • Injuries suffered while a worker was committing a serious crime
  • Injuries suffered while an employee was not on the job
  • Conduct was in violation of company policy

Medical Bills and Workers Comp Premiums

Workers can expect to have their hospital and medical expenses taken care of as long as they are related to the injury. Workers will also be compensated with disability wages while the worker is unable to work. Typically, two-thirds of the regular salary is covered. Other comp benefits may include the payment for rehabilitation, retraining, and more.

Is The State of California Workers Comp Mandatory?

Workers’ compensation insurance is mandatory in the State of California. It is counter intuitive and against the law to avoid workers’ compensation coverage for any employee. Improperly categorizing workers to avoid paying for workers’ compensation in full as you are required to, will not provide you with protection just because you pay for workers’ compensation in general for a lesser number of employees. Don’t find out the hard way when a claim is filed. Talk to us today for guidance and education regarding his issue. 

NOTICE: Making a false or fraudulent workers’ compensation claim is a felony subject to up to 5 years in prison or a fine of up to $50,000 or double the value of the fraud, whichever is greater, or by both imprisonment and fine.

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