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Did You Know?
WORKER'S COMPENSATION BASICS

1.
Your insurer should provide you with a breakdown of reported injuries and costs called a loss run. Some insurers will break this report down by job classification and provide a comparison to the previous year.
2.
Your Experience Modification (ex-mod) uses your past loss experience as a predictor of future losses and is one of the factors used to determine your premium. Loss experience is evaluated 18 months from the effective date of your policy, then 12 months later and a third time 12 months after that. The three are then averaged to determine your ex-mod.
3.
Approximately 30% of work injuries occur among employees who have been employed for less than a year.
4.
It is the employer’s responsibility to provide a claim form to an employee within one day of finding out about the injury. When the employee returns the form, the employer has one day to complete it and submit it to the insurer. The employer’s report must be sent to the insurer within five days. The required pamphlet must be given to the employee within five days of finding out about the injury.
5.
CalOSHA has special training requirements for hospitals and medical facilities.
6. The most frequent type of workplace injury is sprains and strains.
7.
Employers must post a notice of compensation carrier in a conspicuous place at the work site. This poster provides employees information on the company's workers' compensation coverage and where to get medical care for work injuries. Specific requirements are contained in sections 3550-3553 of the California Labor Code. Failure to post this notice is a misdemeanor that can result in a civil penalty of up to $7,000 per violation. Contact your insurer to get the posting notice and the required information that must be included on it.
8.
An employer cannot ask employees to help pay for the insurance premium. Workers' compensation insurance is part of the cost of doing business.
9.
The definition of employee includes anyone who performs a service for you including undocumented workers and minors.
10.
Each employee must be given the opportunity at the time of hire to pre-designate a personal physician by whom s/he wants to be treated in the event of a workplace injury. The choice must be made in writing before the injury occurs, it must be the employee’s regular, primary care physician under the employer’s health insurance plan and the physician must agree to be pre-designated. Prior to January 1, 2005 the employee may see his/her own pre-designated physician for the first 30 days if the employer does not have a Medical Provider Network in place. After January 1, 2005, the employee can be treated by the Medical Provider Network indefinitely, except under limited circumstances.

 

 


Please note: Information on this website is published as a service to the public. Nothing contained herein shall constitute the giving of legal advice. You are strongly advised to seek advice from competent professionals, including attorneys qualified in the appropriate field of law. Although we make every effort to provide accurate information, the rules, regulations and best practices in the field are constantly changing. No reliance should be placed on any information contained herein, all of which should be independently verified and evaluated.

 

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