Workers’ Compensation Program BAM SECTION 1400

Objectives: Learn about Workers’ Compensation Understand the responsibilities of all the interested parties Discuss the basic benefits Get resources and information about other training courses

What is workers’ comp? Why do you care?

History… Boynton Act of 1913 Great compromise No fault Employer paid benefit program All employees covered

1401 General Information All employers in California, including the state, must provide workers’ compensation benefits to employees who sustain a work related injury or illness. Labor Code 3700

1401 General Info Need written policies for an injury and illness prevention program (IIPP) Labor Code And a reporting system for job related injuries, illnesses or death

Cost to the State For Fiscal Year 2014/2015 $626 Million Decrease of $26 million from previous year About 46,800 open disability claims

What is an “injury?” In the workers’ comp world…

An “Injury” is any… Injury or illness that arises out of and in the course of employment o (AOE/COE) o Labor Code 3600 Specific or Cumulative 1% causation

Some Exceptions: Intoxicated Self inflicted/Suicide Commission of a felony Recreational activity After notice of layoff Coming and going rule

Psychiatric Injuries Employment is predominant cause – 51% Unless victim of or exposure to a violent act – 35% Labor Code

Psyche Exceptions Must have been hired over 6 months prior After notice of termination or layoff Lawful, nondiscriminatory, good faith personnel action Inmates

1402 Employee’s Responsibility Read and understand all materials provided Guide to Workers’ Compensation for New State of California Employees Provided at hire and when claim filed Pre-designate personal physician in writing before injury occurs

Provide at Hire New State of California Employee’s Guide to Workers’ Compensation Form number e13546 Opportunity to pre-designate their treating physician Fill in the blanks…

Employee’s Responsibility Report all incidents to supervisor Get medical treatment if needed Go to pre-designated provider or MPN provider Report all absences and provide medical substantiation

Post the Notice Notice to Employees Form number DWC 7 See State Fund web page for recommended text to fill in the blanks before printing

1403 Employer’s Responsibility Post or provide forms Provide the workers’ comp claim form and notice of potential eligibility to employee within 1 day of knowledge Arrange for first medical treatment o The posted MPN provider o Pre-designated physician

Provide to Employee Workers’ Compensation Claim Form and Notice of Potential Liability AKA “Claim Form” Form number e3301 / DWC 1

1403 ER Responsibility Complete the Employer’s 1 st Report of Injury Send 1 st report to SCIF in 5 days Provide all necessary forms and information o Guides (Workers’ Comp & MPN) o “I’ve just been injured on the job, what happens now?”

Provide when Injured Guide to the State Fund Medical Provider Network for State of California Employees Form number e13174 Employees Guide to the State Fund MPN by Harbor Health Form number e3851

1404 Personnel Office Responsibility Give employee the Industrial Disability Leave with Supplementation Information and Benefits Selection form (STD 618s) 15 days to decide to supplement Pay IDL timely after State Fund notifies you of the time Maintain good records

Payroll Training Workers’ Compensation: The Beginning Steps (2 days) Workers’ Compensation Documentation (3 days) (TTY)

1405 State Fund’s Responsibility Case management Investigation Liability decisions Benefit delivery MPN network Legal representation

1406 BENEFITS $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$

Medical Treatment Employer must provide treatment to cure or relieve the effects of the injury Medical Provider Network Utilization Review Chiropractic and therapy limits

Temporary Disability Payments for lost wages 3 day waiting period unless disabled more than 14 days, hospitalized or victim of assault ATO on DOI

Temporary Disability (TD) Paid by State Fund every 14 days Limited to 104 compensable weeks to be used within 5 years from DOI 2/3 of average weekly wage 2016 limits $ to $ PML

Industrial Disability Leave (IDL) Paid in lieu of TD for up to 52 weeks in a two year period from first date paid Based on current wages No maximum or minimum First 22 working days = full net salary Then 2/3 gross salary PML and PML

Enhanced IDL (EIDL) Check bargaining unit contract for specific classes and conditions Subject to the department’s appointing power or designee Continuation of IDL Full net salary for up to 3 years

4800 and Time DOJ and CalWild peace officers CHP officers Full GROSS salary for up to one year

More to Learn… Permanent Disability Supplemental Job Displacement Benefit Death  The Life of a Workers’ Compensation Claim 6 hours long!! o June 13 th

1407 Forms and Brochures Link from BAM on our web site Step by step instructions also included Go directly to State Fund State Fund Forms Ask your Return to Work Coordinator Ask ME!!

Did you: Learn about Workers’ Compensation? Understand the responsibilities of all the interested parties? Discuss the basic benefits? Get resources and information about other training courses?

Thank you! Be safety kids!!