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Published byJessica Quinn Modified over 9 years ago
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BAM SECTION 1400
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» Every employer in CA » Including the STATE ˃Legally uninsured ˃Labor Code §3700 ˃Purchase a yearly policy ˃Participate in Master Agreement » Everyone covered ˃No open enrollment ˃No lapse in benefits » Employer paid no fault system » Covers injury and illness that arise out and in the course of employment ˃AOE/COE Labor Code §3600 ˃1% causation for physical ˃51% causation for psyche +unless traumatic event
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» Workers’ compensation benefits cost the State $??? Million » Fiscal year 2010/2011 » Increase of $?? million from previous year
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» Read and understand all provided material » “New Hire” packette ˃Guide to Workers’ Compensation for New State of California Employees ˃Predesignation form » Posted Notices ˃Notice To Employees ˃Guide to the State Fund MPN for State of California Employees » Report all injuries, illnesses, and incidents » Get treatment ˃Posted provider OR ˃Predesignated provider » Substantiate any missing time ˃Std 634 or equivalent form
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» Arrange 1 st medical treatment » Provide employee’s notice of potential eligibility (3301) » Secure accident site » Prepare employer’s claim of injury (3067) » Submit forms timely
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» Notify employee of all benefit options » Options Letter ˃Sample on DPA web site » DPA publications for employees ˃I’ve just been injured on the job, what happens now? ˃Supplementing IDL ˃Supplementing TD » Pay Industrial Disability Leave (IDL) and/or supplementation timely » Must receive verification from State Fund 1 st ! » STD 618s
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Sample contact letter can be modified to fit your needs…
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See how much your department contributed to the $502 million total!
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» Claim adjustment » Liability determinations » Investigations » Benefit delivery » Legal representation
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» Medical treatment ˃Subject to Utilization Review ˃Plus mileage +if claimed » Temporary disability ˃IDL or TD ˃Plus supplementation +if requested ˃EIDL +If applicable & approved ˃4800 or 4800.5 time +DOJ & CHP officers only » Permanent disability ˃Due 14 days after TD ends ˃+/- 15% » Supplemental Job Displacement Benefit ˃Paid after claim settlement if no RTW after TD ends » Death ˃Paid to dependent(s).
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» 3 day waiting period ˃Waived if disabled 14 days, hospitalized, or assaulted » Paid by employer to eligible employees AFTER State Fund verifies time » PERS or STRS members » Limited to 365 days of benefit within 2 years of the first date of disability » First 22 days of disability = full net salary » Then 2/3 of gross salary (can supplement) » Can be used for verified medical appointments
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Enhanced Industrial Disability LeaveLabor Code 4800 or 4800.5 Time » Subject to bargaining unit provision and director approval for specifically caused physical injuries » Continues IDL full net salary benefit up to 3 years ˃No supplementation needed » Sworn officers ONLY » No waiting period » Full gross salary up to 1 year or 2080 work hours » After 1 year of this benefit, still eligible for 2 years of TD
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» 3 day waiting period ˃Only served ONCE per claim » Paid by State Fund every 14 days to employees not eligible or have exhausted their IDL benefit » Limited to 104 weeks within 5 years of DOI ˃1 year of IDL + 1 year of TD = 2 years of TD benefits » Full days only (no medical appointments) » 2/3 of average weekly wage (can supplement) ˃Maximum benefit in 2011 = $986.69, in 2012 = $1010.50 ˃Minimum benefit in 2011 = $148.00, in 2012 = $151.57
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Line by line instructions to complete claim forms. Detailed workers’ comp information for State agencies.
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State Controller’s OfficeDept of Personnel Administration » Workers’ Comp: The Beginning Steps ˃2 days » Workers’ Comp Documentation ˃3 days ppsdtraining@sco.ca.gov ppsdtraining@sco.ca.gov 916-322-0683 800-735-2929 (TTY) » Return to Work Training Class ˃3 days once/year » Annual Overview » Life of a W/C Claim ˃1 day several times/year » Quarterly Forums ˃Simultaneously web cast http://www.dpa.ca.gov/benefits/workers-comp/main.htm
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I love to get questions, if I don’t know the answer, I know someone who does!
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