BAM SECTION 1400. » Every employer in CA » Including the STATE ˃Legally uninsured ˃Labor Code...

BAM SECTION 1400

» 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

» Workers’ compensation benefits cost the State

$??? Million» Fiscal year 2010/2011» Increase of $?? million from previous year

» 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

» Arrange 1st medical treatment

» Provide employee’s notice of potential eligibility (3301)

» Secure accident site» Prepare employer’s

claim of injury (3067)» Submit forms timely

» 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 1st!

» STD 618s

Sample contact letter can be modified to fit your needs…

See how much your department contributed to the $502 million total!

» Claim adjustment» Liability

determinations» Investigations» Benefit delivery» Legal representation

» 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).

» 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

Enhanced Industrial Disability Leave Labor 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

» 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

Line by line instructions to complete claim forms.

Detailed workers’ comp information for State agencies.

State Controller’s Office Dept of Personnel Administration

» Workers’ Comp: The Beginning Steps ˃ 2 days

» Workers’ Comp Documentation˃ 3 days

ppsdtraining@sco.ca.gov916-322-0683

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

I love to get questions, if I don’t know the answer, I know someone who does!