Workers’ compensation - California

Summary of differences between federal and state regulations

There is no federal workers’ compensation requirement for most private employers.

Insurance requirement: Competitive state fund or self-insurance by private carrier insurance, individual employers, or groups of employers.

Posting requirement: As of October 8, 2010, employers must post a “Notice to Employees – Injuries Caused by Work.” The notice must include the name of the workers’ compensation carrier, the types of illnesses and injuries covered by workers’ compensation, the employee’s right to receive medical care and the right to designate a physician, emergency phone numbers, the individuals to whom the injury should be reported, and more. Employers must also provide employees with a pamphlet entitled “Your Rights to Workers’ Compensation Benefits.” A company in a Medical Provider Network (MPN) must post an MPN notice next to the aforementioned notice as well as provide an MPN notice to injured employees informing them that medical treatment will be provided by the MPN unless the employee otherwise designated a physician or group prior to injury; give the effective date of coverage of the MPN; any changes to or terminations of an MPN must also be provided by written notice. Failure to post the required notices could result in fines of up to $7,000.

Exemptions from WC: None

Medical benefits provided: Full

Physician selection: Employer selects initial physician. After a specified period employee has free choice.

Benefits for temporary total disability (TTD): 66 2/3 percent of worker’s wage up to 104 weeks for most injuries.

Benefits for permanent total disability (PTD): 66 2/3 percent of worker’s wage for life.

Benefits for permanent partial disability (PPD): 66 2/3 percent of worker’s wage for up to 619.25 weeks (applicable to a worker with a 99.5 percent disability). 3 to 8 weeks of workers’ compensation payable for each 1 percent of permanent disability, depending on severity. Thereafter, if disability is at least 70 percent, but not more than 99.75 percent, a life pension of 1.5 percent of the employee’s weekly earnings will be paid for each 1 percent of disability over 60 percent subject to a maximum weekly rate of $116.27.

Scheduled awards: Scheduled awards are paid in addition to and upon termination of TTD benefits. Awards are not reduced because of TTD benefits.

Disfigurement benefits: Disfigurement of face due to scarring or deformity. No set figure, but the nature of the disfigurement shall be taken into account when determining the percentages of permanent disability.

Death benefits for surviving spouse and children: 66 2/3 percent of employee’s wage. Total amount payable is $145,000; or, with three or more dependents, $160,000.

Maximum burial allowance: $5,000

Waiting period: 3 days for temporary total disability only. Compensation is retroactive if disability continues for 14 days from date of injury (also retroactive if person is hospitalized).

Rehabilitation: Employer is responsible for vocational rehabilitation costs. They must also pay TTD and additional living expenses during physical and vocational rehabilitation. Mandatory payments generally capped at $16,000. Employees must request vocational rehabilitation within 5 years of the date of injury. Compensation will be withheld for refusal to cooperate. Employees receive TTD benefits plus maintenance at $246 (limited to 52 weeks) and living expenses necessitated by rehabilitation; terminated vocation rehabilitation services may be restored within 5 years after injury in certain cases.

Attorney fees: Determined by agency on an individual case basis.

Occupational hearing loss statutes: Employee has one year from date of discovery to file for compensation. Ratings for compensation purposes are determined as a percentage of permanent total disability.

What’s new – http://www.dir.ca.gov/dwc/dwc_home_page.htm

Forms - http://www.dir.ca.gov/DWC/forms.html

NOTE: Electronic versions of these forms are currently being prepared for download. They will be posted as they become available

State

Contacts

California Division of Workers’ Compensation

Website: http://edd.ca.gov/
Website: http://www.edd.ca.gov/Payroll_Taxes/File_and_Pay.htm

Regulations

Title 8, California Code of Regulations - The Administrative Director's regulations are Sections 9710 through 10204 and the WCAB rules are Sections 10300 through 10999.

Federal

Contacts

None.

Regulations

None.