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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
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!