Pocket Guide to Workers’ Compensation in California (2nd ed., 2014)
$27.00
By Juliann Sum
Updated by John Holstedt and Eric Ledger
2nd edition, 2014
147 in stock
Description
The Pocket Guide to Workers’ Compensation in California gives an overview of workers’ compensation law and procedure. It provides a brief history of the law and a summary of citations to applicable statutes, regulations, and precedent cases. The guide includes pertinent resources, a glossary, and an index of terms.
The guide covers:
-
- Stages of a compensation claim
- Benefits
- Rights and obligations
- Labor-management carve-outs
- Rights of employees whose employers are illegally uninsured
- How workers’ compensation law relates to disability rights laws, job-protected leave laws, and public benefits.
The guide is a valuable reference and training tool, and helpful to anyone who needs to understand the workers’ comp process in both the public and private sectors in California.
Table of Contents
Table of Contents
I. Scope and Operation of the Workers’ Compensation System | 1 |
---|---|
A. Introduction | 1 |
B. California workers’ compensation laws apply to most injuries and illnesses caused by employment |
2 |
C. Injured workers may not sue the employer in court, and benefits are limited |
3 |
D. Employers are required to have insurance | 4 |
E. Coverage of post-termination claims is limited | 4 |
F. Coverage of psychiatric injuries is limited | 5 |
G. Sleep dysfunction and sexual dysfunction claims also limited | 6 |
H. Five categories of benefits are paid | 6 |
I. Administrative law judges adjudicate disputes | 7 |
II. Preliminary Rights and Responsibilities | 8 |
A. Employers and workers can prevent injuries and illnesses | 8 |
B. Some workers may predesignate their personal physician | 8 |
C. Employers and unions may create labor-management carve-outs | 10 |
III. Requesting Benefits After Injury | 11 |
A. The injured worker should inform the employer and get emergency treatment if needed |
11 |
B. Filing a claim form preserves the injured worker’s rights | 12 |
C. Employees of illegally uninsured employers may sue the employer and apply for Uninsured Employers Benefits Trust Fund benefits |
14 |
D. Presumptions of compensability apply to public safety officers | 15 |
IV. Medical Care | 15 |
A. Employers and providers may not collect payment from an injured worker for medical care |
17 |
B. Scientifically based medical treatment guidelines govern care | 17 |
C. Claims administrators must promptly authorize treatment | 18 |
D. The primary treating physician has a role in determining benefits | 19 |
E. How the initial primary treating physician is selected depends on whether the worker predesignated and whether there is a medical provider network (MPN) or health care organization (HCO) |
19 |
F. The injured worker’s rights to switch primary treating physiciansdepend on whether the worker is being treated in an MPN or HCO and whether the worker predesignated |
21 |
G. Disputes over out-of network medical treatment | 22 |
V. Resolving Problems with Medical Care and Medical Reports | 24 |
A. An injured worker may discuss concerns with a treating physician or switch physicians |
24 |
B. Steps to dispute a treating physician’s opinion about necessary care depend on whether the injured worker is being treated in an MPN or HCO |
24 |
C. Decisions to authorize care are made in a utilization review (UR) process, followed by an Independent Medical Review (IMR) appeal process |
25 |
D. The injured worker has the right to challenge a decision denying treatment |
26 |
E. The injured worker and the claims administrator may dispute a treating physician’s opinion on matters other than treatment |
27 |
F. A medical evaluation is required to dispute an opinion by a treating physician or a decision to deny care |
28 |
VI. Temporary Disability Benefits | 30 |
A. Temporary disability (TD) benefits are paid to injured workers who are disabled while recovering |
30 |
B. Payment amounts depend on lost wages | 31 |
C. TD benefits are paid on a schedule | 31 |
D. Penalties are payable for delays | 32 |
E. When TD payments end is based on the worker’s medical condition, return to work, or duration of payments |
32 |
VII. Working After Injury | 34 |
A. Workers’ compensation law prohibits discrimination against workers with job injuries |
34 |
B. The treating physician determines work capacities and restrictions | 35 |
C. The employer may reduce its liability for certain benefits by offering work |
35 |
D. Actions taken in a workers’ compensation claim do not eliminate rights and obligations under disability rights laws |
37 |
VIII. Permanent Disability Benefits | 40 |
A. Permanent disability (PD) benefits are paid to workers who will always be limited in their ability to work |
40 |
B. Benefits depend in part on a medical report | 41 |
C. The worker’s disability is given a permanent disability rating | 41 |
D. Payment amounts depend on ratings of the disability, date of injury, pre-injury wages, and whether the employer offers work |
43 |
E. PD benefits are paid on a schedule | 43 |
F. Penalties are payable for delays | 44 |
G. PD benefits are commonly settled | 44 |
XI. Supplemental Job Displacement Benefits | 46 |
A. A supplemental job displacement benefit (SJDB) is a voucher that promises to pay for educational retraining or skill enhancement |
46 |
B. Benefit amounts depend on the worker’s permanent disability rating |
47 |
C. Voucher expiration date | 47 |
X. Sources of Further Information and Help | 48 |
A. California agencies | 48 |
B. Reference materials | 49 |
XI. Glossary | 50 |
XII. Index | 61 |
Additional information
Weight | 0.625 lbs |
---|---|
Dimensions | 10 × 6 × 0.5 in |
Institute for Research on Labor and Employment, UC Berkeley
California's number one resource for employer/employee relations