Pasadena, CA – FAQs About Workers Comp Insurance from Employee Benefits Provider

As an employee benefits provider serving Pasadena employers, we frequently field questions about California’s workers compensation system. We understand it’s a complex topic loaded with legal terminology and intricate regulations. To help demystify workers comp, we’ve compiled answers to some of the most common FAQs we receive from Pasadena business owners and HR managers.

What Exactly is Workers Comp Insurance?

Workers compensation insurance provides medical, disability, and other benefits to employees who suffer job-related illnesses or injuries. This state-regulated system helps protect both employers and employees – employers avoid lawsuits, while employees receive care and compensation without having to prove fault.

Who Needs Workers Comp Insurance in California?

With few exceptions, all California employers must carry workers comp insurance for their employees. This includes private companies, nonprofits, churches, homeowner associations, and public entities. Specific exemptions apply for some execs/owners and independent contractors.

How Much Does Workers Comp Insurance Cost?

Premiums vary substantially based on risk classification, claims history, industry type, payroll size, etc. Costs typically range from $15 per $100 of payroll for low-risk clerical jobs up to $30 or more per $100 of payroll for hazardous occupations like roofing.

What Does Workers Comp Insurance Cover?

In addition to medical treatment, workers comp provides temporary and permanent disability benefits, death benefits for families, and vocational rehab services. Wage replacement rates vary from 60-80% depending on marital/family status.

What Types of Injuries are Covered by Workers Comp?

The injury must arise out of and occur in the course of employment to qualify. This includes traumas (falls, burns, cuts) as well as repetitive stress injuries. Illnesses may also be covered if caused by workplace hazards. Pre-existing conditions aggravated by work duties are often covered too.

How are Workers Comp Claims Filed?

Employees report injuries to their supervisor and complete a claim form. The employer then files it with their workers comp insurer within one working day in most cases. A claims examiner reaches out to coordinate medical treatment and disability benefits.

Can I Choose My Own Doctor for Treatment?

Within limits, yes. Employers get to designate an MPN network that provides initial care, but employees can switch once to a doctor of their choice after 30 days. Treatment must be reasonably required to cure or relieve effects of the work injury.

What if My Claim is Denied by the Workers Comp Insurer?

Don’t panic, denials are common. Request a re-review and submit additional medical documentation. If still denied, consider retaining an attorney experienced in the workers comp appeals process in your area. Legal help is critical for overturning unfavorable decisions.

How Long do Workers Comp Benefits Last?

Temporary disability benefits run for up to 104 compensable weeks within 5 years from date of injury. For serious injuries causing permanent impairment, additional money is paid at a rate based on the percentage disabilities. Lifetime medical care may also be provided in some cases.

Ready to Address Your Workers Comp Questions?

As you can see, workers compensation is multifaceted, but we’re here to guide Pasadena employers through this intricate process. Our extensive experience with work injury claims enables us to offer strategic advice tailored for your unique risk profile and HR budget. Contact our office today to discuss your workers comp needs in more detail. We look forward to helping protect your team.