Workers’ Compensation in California
As a business owner, your employees are your most valuable asset. We understand how important it is to keep these employees healthy and safe, which is why we’ve designed a system to help care for their needs. When it comes to helping with workers’ compensation, UrgentMED is here to ensure your team is well taken care of.
Offering a specialized network of facilities, we provide medical examinations designed to help facilitate your workers’ compensation claim. With 15 Southern California locations, we hold contracts with workers’ compensation insurances. If you want to offer UrgentMED’s Network to your employees, find out how we can cover you by contacting us today.
What is Workers’ Compensation?
California’s Workers’ Compensation Act entitles injured employees to have their medical costs covered by the employer, meaning the initial doctor’s visit, as well as any medical treatment required thereafter. This law also entitles an injured employee to a partial wage replacement in the event that the employee is unable to work during the recovery process.
However, this compensation is not automatic and requires particular actions to be taken in a specific order. Being examined by a doctor that specializes in workers’ compensation is only the first step towards receiving your deserved benefits. At UrgentMED, we can help with this first step and guide you through the rest of the process, ensuring your employees are well taken care of.
Should You Be Providing Workers’ Compensation Benefits?
The majority of California residents are covered for workers’ comp since the state of California requires all employers to pay for this type of insurance. No matter the size of the business, employees are required to provide insurance either through a private insurance company or through the State Compensation Insurance Fund (SCIF). As an employer, one of the best ways to stand out from the crowd in today’s competitive economy is to ensure you provide the best coverage available.
One-time accidents, injuries incurred from repetitive motions (known as cumulative injury), or illness due to the working environment are all eligible for workers’ compensation. The most common workplace injuries that occur are due to accidents such as falling, injury when lifting/moving heavy objects, or being struck by a vehicle. While these might seem unlikely in your business, having the legally required coverage is necessary for your business.
Making A Workers’ Compensation Claim
Insurance companies typically deny workplace-induced illnesses that cannot be directly attributed to being caused by the place of employment (i.e. stress-related sickness or psychiatric injury). Additionally, employees can expect to be denied compensation for any injuries that are their own fault, including:
- Self-inflicted injury
- Injury during fighting or horseplay
- Injuries sustained during a crime
- Injuries occurring under the influence of alcohol/drugs
- Workers’ Compensation in California
Beyond these injuries, those that were a result of job hazards or conditions beyond your employee’s control can fall on you as the business owner. Before securing insurance for your employees, explore the UrgentMED Network for your workers’ compensation examination needs. We accept many workers’ compensation insurance providers and offer tailored services to meet the needs of your employees.
How to File a Workers’ Compensation Claim in California
Eligibility to receive workers’ compensation benefits in California is a relatively straight-forward process. It begins by reporting the injury and is followed by time-sensitive paperwork that must be completed by the injured employee and the employer. Missing the deadline for the paperwork or failing to make a claim within 30 days of your injury could cause you to lose your workers’ compensation benefits, so be very mindful of the specific timeline of this process.
Step One: Reporting the Injury
As an employer, it’s important you stress to your employees the importance of reporting any on-the-job injuries with a written notice as soon as an injury occurs. Failing to report the injury or illness within the first 30 days of its occurrence could render them ineligible to receive workers’ comp benefits. While this is possible for accident-based injuries which provide a clear date of injury, there are other instances that are not so black and white and can make reporting a work-related injury more difficult, which makes reporting all the more important.
Step Two: Get a Medical Evaluation
Not all doctors treat work-related injuries, so be sure that the physician is aware of the specific nature of your appointment. In the State of California, injured employees must be seen by a doctor selected by your employer, which virtually eliminates the possibility that such a conflict could occur. Doctors that handle workers’ compensation cases will be required to fill out specific documentation detailing the specifics on your condition, such as necessitating time off work, job duty modifications, or determining whether you have a permanent injury.
With UrgentMED as your preferred provider, we take good care of your employees and ensure proper filing of any claims they make.
Step Three: File Form DWC-1
After receiving a workers’ compensation injury report, you, the employer, should provide a workers’ compensation claim form, formally known as the DWC-1. After the form is filled by both you and your employee, you will have to submit a form directly to the insurance company. It is recommended you advise your employee to keep a copy for his or her records as well.
Step Four (Optional): File an Application for Adjudication of Claim
If you or your employee have a disagreement with the insurance company regarding a fair claim amount, the Application for Adjudication of Claim (Form WCAB-1) is required to make your case eligible for appeal. It must be filed within one year of the date of injury, the last day of employer-provided medical benefits, or the last day of temporary disability benefits.
How Long Does it Take to Receive Workers’ Compensation Benefits?
After submitting the DWC-1 form, the employer’s insurance company will investigate to determine whether the workers’ compensation claim is valid. Until a decision has been reached, the insurer is liable for up to $10,000 in medical costs. If the claim hasn’t been denied within 90 days of submitting the DWC-1 form, the claim can be considered to be approved.
If your workplace injury results in missing work, temporary disability benefits should be provided within 14 days of the reported injury. If it takes any longer than 14 days, it will result in the insurer being subject to a 10% penalty for untimely distribution of benefits. Temporary disability covers two-thirds of average weekly salary – the maximum payout in 2018 being $1215.27.
Finding a Doctor for Your Workers’ Compensation Claim
The doctors of the UrgentMED Network are here and ready to assist with all your California workers’ comp needs. If your employees have incurred a work-related injury such as back strains, lacerations, stress-related ailments, or require x-rays or foreign body removal, the licensed physicians within the UrgentMED Network are available seven days a week to evaluate your injury or illness.
Injured employees can be seen with no appointment necessary and physical therapy is available on-site. Visit the clinics within the UrgentMED Network, conveniently located throughout Los Angeles and Anaheim, to receive a fast medical examination for your workers’ compensation claim and begin your filing process as quickly as possible.