Guide to Sacramento Workers Compensation

This guide contains descriptions of links that will give you all the information regarding workers' compensation, including recent changes, Q&A pages and information specific to California and Sacramento that you need to understand the workman's comp process.

These info sources are for everyone, whether you are an employee, a business, a medical provider or any other interested party. The most important starting point is to realize that these laws change often based on case law, so make sure your information is as up-to-date as possible. As you will see, things are about to change again very soon.

For California employers, January 1, 2017, will bring huge changes in the way they prepare for potential workers' compensation cases. That's the date when the state introduces a new formulation of the experience rating for workers' compensation claims. The Workers' Compensation Insurance Rating Bureau (WCIRB) of California explained the new estimation system:

"The 2017 Experience Rating Plan values includes expected loss rates, D-ratios, primary thresholds that vary by employer size and credibility values that have been filed with the California Insurance Commissioner. The user will see the estimated likely impact of the change from the $7,000 fixed split point plan to the 2017 variable split point plan on an individual employer's experience modification. As with the 2016 Estimator, the estimator will rely on payroll, classification and claims information supplied by the user."

The intent of these changes is to limit financial responsibilities for smaller businesses and assign higher limits for larger companies. Across the board, it is meant to give all businesses an incentive to seek out partners and contractors with higher safety rankings. To maintain higher ratings, these companies will have to invest in additional safety procedures, equipment and training. This could be encouraging news for employees in the state who have seen drastic reductions in benefits on these claims over the past several years.

Legal practitioners have to be more innovative than ever to maximize benefits for their clients while countering the restrictive legal moves of employers and their lawyers. The best place to start with any questions is the state's own guidebook on the most recent updates to workers' compensation law.

State Guidebooks and Information

California Division of Workers' Compensation

Information and Assistance Office, Sacramento

160 Promenade Circle, Suite 300, Sacramento, CA 95834-2962

Phone: 916-928-3158

http://www.dir.ca.gov/dwc/dwc_home_page.htm

Divisions Within the Sacramento DWC Office

Joel Harter, presiding judge

•          Audit Unit

•          Disability Evaluation Unit

•          Information & Assistance Unit

•          Subsequent Injuries Benefits Trust Fund

•          Uninsured Employers Benefits Trust Fund

Workers' Compensation in California: A Guidebook for Injured Workers

This was last updated in April 2016. It is now available in English and Spanish. This is a high-level overview of the California workers' compensation system. It was designed to help workers understand their rights and what steps to take after an injury on the job.

This book gives a very good overview of the process and system for Workers Compensation.

http://www.dir.ca.gov/InjuredWorkerGuidebook/InjuredWorkerGuidebook.html

The Division of Workers' Compensation (DWC)

This agency is responsible for the administration of workers' compensation claims. It offers administrative and judicial services to assist in resolving disputes that arise in connection with claims for workers' compensation benefits.

Here are links to detailed information and answers depending on who you are:

•          Injured Worker

•          Employer

•          Claims Administrator

•          Attorney

•          Self-Insured Employer

•          Medical Provider

•          Interpreter

•          DWC homepage

Additional Workers' Compensation Information for Employees

Basic Guides and Claim Forms Especially for Injured Workers

This is the DWC's site for injured workers, covering basic terms used in workers' compensation cases, temporary disability benefits and the state's uninsured trust funds. Guides here cover topics as basic as filing your first claim to complex issues like appealing a medical review.

www.dir.ca.gov/dwc/iwguides.html

Q&A for Employees by the California Workers' Compensation Institute

The CWCI offers data, analyses and practical expertise on issues and trends affecting California workers' compensation.

https://www.cwci.org/Employees_.html

The Supplemental Job Displacement Benefit

This is the site to helpful in determining if you could be eligible for supplemental job displacement benefit (SJDB) vouchers, depending on when the injury occurred. There are very different rules for those injured before or after January 1, 2013, so you'll need to read over the details carefully and consult your attorney.

www.dir.ca.gov/dwc/SJDB/SJDB_FAQ.html

Medical Provider Networks

A medical provider network (MPN) is an entity or group of health care providers set up by an insurer or self-insured employer and approved by DWC's administrative director to treat workers injured on the job. Under state regulations, each MPN must include a mix of doctors specializing in work-related injuries and doctors with expertise in general areas of medicine.

www.dir.ca.gov/dwc/mpn/DWC_MPN_Main.html

Additional Links

Federal Benefit Programs

Social Security Administration

www.ssa.gov

Medicare and Medicaid CMS Medicare Services Overview

www.cms.gov/WorkersCompAgencyServices/01_overview.asp

California Benefits Programs

California State Disability Insurance (SDI)

www.edd.ca.gov/Disability/

The Unemployment Insurance Program (UI)

www.edd.ca.gov/Unemployment/

Paid Family Leave Insurance Benefits (PFL)

www.edd.ca.gov/Disability/More_PFL_information.htm

California Government and California Law

California Government Home Page

www.ca.gov

Laws & Regulations

www.ca.gov/About/Government/State/LawsAndRegs.html

Fair Employment and Housing Administration (FEHA)

(Discrimination complaints regarding Age, Race, Sex, Nationality, Religion, Disability)

1-800-884-1684

www.dfeh.ca.gov/

Medical Records Privacy in a Workers' Compensation Case

http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/workerscomp.html

Updates on Recent Reform Legislation for 2016

http://www.dir.ca.gov/dwc/SB863/SB863.htm

Attorney Organizations

State Bar of California

www.calbar.ca.gov

California Applicant's Attorney Association (CAAA)

www.caaa.org/

California Employment Lawyers Association (CELA)

www.celaweb.org/