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California Workers Comp Quick Facts
The following represent the state of the law as of January 1, 2006. Please note that worker's compensation law can be complex and these laws and policies are subject to amendment at any time. If you need help with a worker's compensation issue, please consult a licensed attorney.
Is Worker's Compensation Compulsory? Yes
Are Waivers Permitted? No
Numerical Exceptions: None.
Choice of Physician: Employer makes the initial selection of physician. After a period of time specified by state law, the employee has free choice. Unless the employer or the employer's insurer has established a "medical provider network", employer has initial selection of physician and employee can change to physician of own choosing after 30 days. An employee who has notified his or her employer in writing prior to injury that they have a personal physician, and whose providers provide nonoccupational health care coverage, has the right to be treated by his or her personal physician after job-related injury. By statute, a maximum of seven percent of all employees statewide may so predesignate. The right to be treated by one's personal physician at the outset of injury also applies if the employer has failed to post notice of workers' compensation rights as required. If an employer or insurer has established a medical provider network, then under most conditions the employer controls the initial selection of physician and all care must be provided within the network for the life of the claim.
Waiting Period For Comp Benefits After Injury: 3 days (temporary total disability only.)
Compensation is retroactive if disability continues for what period of time from the date of injury? 14 days (also retro- active if person is hospitalized)
Attorney Fees Permitted: Individual case basis; however an attorney cannot collect a fee for representation.
Division of Workers' Compensation - Information for employers, physicians and insurers concerning first aid treatment for workers' compensation injuries
First aid treatment is included as medical care that all employers must provide for their injured employees. In conjunction with the California Department of Insurance (CDI), the Department of Industrial Relations (DIR), Division of Workers' Compensation, wants to remind all employers, physicians, insurance carriers and self- insurers of the need to comply with section 6409(a) of the California Labor Code.
Section 6409(a) requires a physician who treats an injured employee to file a "Doctor's First Report of Injury" (DFR) with the claims administrator for every work illness or injury, even first aid cases where there is no lost time from work. Although the Labor Code contains "first aid" exceptions for the "Employers' Report" (form 5020) and the "Employee Claim Form" (DWC-1), there is no such exception for the DFR. The insurance carrier (or the employer if the employer is self-insured) must forward these DFRs to the Department of Industrial Relations, Division of Labor Statistics and Research (the address is listed at the top of the form). There is no "first aid" exception to this statute.
CDI and DIR believe there are improper arrangements in place between some medical providers and employers that allow the employer to dictate how injuries are to be classified by the physicians. In some cases, and at the request of the employers, the physicians send the DFR only to the employers and not to the insurance carriers. This arrangement occurs even though the injuries clearly are beyond first aid. This agreement is often marketed to employers as a way to keep premiums from rising or to lower them. Such marketing practices are both improper and may also contribute to possible criminal violations related to premium fraud and the fraudulent denial of workers' compensation benefits to injured workers.
September 2008
http://www.dir.ca.gov/dwc/firstaid.htm
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