What is Workers' Compensation?
Worker compensation, also known as workers’ compensation or workers’ comp, is an insurance program designed to protect and provide benefits to employees who have been injured or become ill due to work-related activities.
In California, worker compensation benefits cover a wide range of situations, including workplace accidents and occupational diseases.
This means that if an employee suffers from a work-related injury or illness, they are entitled to compensation benefits, irrespective of whether the employer or a third party is responsible.
By law, all businesses must carry workers’ comp insurance or qualify for self-insurance to ensure that employees are protected in case of job-related injuries or illnesses.
California law requires that employers, including those in the construction industry, carry workers’ compensation insurance, even if they have only one employee. [1]
Who Is Covered By Worker Compensation in California?
Coverage extends to a wide range of employees, including full-time and part-time workers. It doesn’t matter if you’re a seasoned employee or a new hire, all employees are entitled to worker compensation benefits if they meet the eligibility criteria. This coverage extends even to minors and employees who are not U.S. citizens.
Another important aspect of workers comp coverage is that it does not discriminate based on an employee‘s experience or tenure. Whether you are a seasoned employee who has been with the company for years or a new hire, you are still entitled to the benefits provided by WC if you meet the eligibility requirements.
Executive officers of corporations may also have the choice to be excluded from worker compensation coverage if they meet specific requirements.
Employers Covered by WC
Most employers in California are required by law to have workers’ compensation insurance. This includes private companies, state and local government agencies, nonprofit organizations, and even out-of-state employers with employees working in California. [2]
Complying with the WC coverage requirement is not only necessary to comply with the law, but it also ensures that your employees are protected in the event of a work-related injury or illness. Failing to provide adequate coverage can not only result in legal consequences but can also lead to significant financial burdens for both the employer and employee.
Self-Employed Workers Covered by Workers Comp
In general, self-employed workers in California are not required to carry workers’ compensation insurance for themselves. This includes sole proprietors, freelancers, consultants, and independent contractors. Unlike traditional employees, self-employed individuals have the freedom to choose whether or not to obtain workers’ compensation coverage.
Having workers’ compensation coverage as a self-employed individual can provide a safety net in case of medical expenses, lost wages, and disability benefits.
It can provide the necessary support during the recovery process, allowing self-employed workers to focus on their health and well-being without worrying about their financial stability.
Exceptions to Workers Compensation Coverage
The first exception to workers’ compensation coverage applies to certain types of workers who are classified as “independent contractors.” Independent contractors are individuals who work for themselves and have control over how, when, and where they perform their work.
Another exception to workers’ compensation coverage applies to domestic workers who work in private households. While household employers are not required to carry workers’ compensation coverage for these workers, they still have the option to purchase it voluntarily.
Certain categories of workers employed by religious, charitable, or nonprofit organizations are also exempted from workers’ compensation coverage.
Volunteers and interns, may not be eligible for workers’ compensation coverage.
However, there are specific regulations in place to protect volunteers in certain situations, including volunteer firefighters and ambulance workers.
What Is Covered By Workers' Compensation in California?
Death Benefits
In California, the workers’ comp system recognizes the devastating impact a work-related death can have on a family. That’s why death benefit payments are provided to help ease the financial burden during this difficult time. These benefits offer financial support to the dependents of the deceased employee, ensuring that they are not left without proper assistance.
The death benefits available under workers compensation coverage typically includes reasonable burial expenses. Losing a loved one is emotionally challenging, and the last thing any family should have to worry about is the financial strain of arranging a funeral. Workers’ compensation death benefits help alleviate this burden by covering the cost of laying the deceased worker to rest with dignity.
Work-Related Injuries or Illnesses
Workers who suffer work-related injuries or illnesses should promptly report their injuries to their employers and seek medical attention. By doing so, they can initiate the workers’ compensation process and ensure that their rights are protected.
In turn, employers should have processes in place to handle such incidents and prioritize employee well-being and safety.
Workers comp settlements in the US range between $2,000 and $40,000, with recent data estimating the average amount to be at $20,000. [3]
One-time accidents are the most frequently occurring work injuries in California, with slips-and-falls being the predominant type of workplace injury, followed by being hit by an object. Repetitive stress injuries are also a very common type of injury in California workplaces. These include injuries to backs, hands, and arms. [4]
Permanent Disability Benefits
Permanent disability benefits are a workers’ comp benefit designed to assist employees who are unable to return to their previous job or experience a significant reduction in their earning capacity due to their work-related injuries or illnesses. These benefits recognize the lifelong impact of the disability and aim to provide ongoing financial stability for the injured worker.
The amount of permanent disability benefits awarded to an injured employee depends on several factors, including the extent of the disability and its impact on the employee’s ability to work.
The severity of the disability is assessed by evaluating medical reports, expert opinions, and any limitations or restrictions documented by healthcare providers.
Temporary Disability Benefits
Temporary disability payments are designed to provide income replacement for employees who are unable to work for a time due to a work-related injury or illness.
These benefits are intended to compensate for the wages lost during the period of time that the employee is temporarily disabled and unable to perform their regular job duties.
The amount of temporary disability benefits awarded to an injured worker is based on a percentage of their pre-injury wages. In California, employees are typically entitled to receive two-thirds of their average weekly wage, up to a maximum weekly benefit amount set by state law.
The duration of temporary disability benefits can vary depending on the nature and severity of the injury, with a maximum limit of 104 weeks within a five-year period.
To be eligible for temporary disability benefits, injured workers must obtain appropriate medical treatment from a healthcare provider authorized by their employer’s workers’ compensation insurance company.
Medical Expenses Related to Injury or Illness
One of the key aspects of the workers’ compensation system is the requirement for injured employees to seek medical treatment from a healthcare provider approved by their employer’s workers’ compensation insurance company.
These approved medical providers, known as the Medical Provider Network (MPN), are carefully selected to ensure that injured workers receive appropriate medical care.
To ensure that all medical expenses related to the work-related injury or illness are covered, injured workers must keep detailed records of all their medical treatments, visits, and expenses.
This documentation will play a big role in supporting the workers’ compensation claim and ensuring that all the necessary medical expenses are reimbursed.
In some cases, injured workers may require ongoing medical treatment or specialized care for their injuries or illnesses.
The workers’ compensation system acknowledges this and provides coverage for these additional medical expenses as long as they are directly related to the work-related injury or illness.
What Are the Benefits of Hiring a California Workers’ Comp Attorney?
Hiring a California workers’ comp attorney can be extremely beneficial for injured employees. Not only will an attorney have expertise in the relevant laws and regulations, they can also provide invaluable guidance throughout the process of filing a claim and ensure that all of the necessary paperwork is completed accurately and promptly.
If you have experienced a workplace injury or have a work-related illness, consider reaching out to Goldberg & Loren, California worker’s compensation lawyers, for assistance.
Sources
[1] California, S. O. (n.d.). Workers’ Compensation Requirements. Workers’ Compensation Requirements. https://www.cslb.ca.gov/contractors/maintain_license/workers_compensation.aspx
[2] Workers’ Compensation Laws – State by State Comparison | NFIB. (2017, June 7). NFIB. https://www.nfib.com/content/legal-compliance/legal/workers-compensation-laws-state-by-state-comparison-57181/
[3] What is the highest workers comp settlement in the US? (n.d.). What Is the Highest Workers Comp Settlement in the US? | Insurance Business America. https://www.insurancebusinessmag.com/us/guides/what-is-the-highest-workers-comp-settlement-in-the-us-448424.aspx
[4] Sunshine, R. (2019, July 18). Top 12 Facts About Workers’ Comp in California | Pie Insurance. Pie Insurance. https://pieinsurance.com/blog/workers-comp/top-12-facts-about-workers-comp-in-california-you-need-to-know/
