On May 20th, 2021, the Workers’ Compensation Appeals Board for the State of California (Sacramento District Office) issued a decision in the workers’ compensation claim of Alex v. All Nation Security Services, Inc.. In ruling in favor of an employee, the WCAB relied on previous case law on injuries that occur during so-called ‘unauthorized’ activities. […]
When someone is hurt on the job in California, they have a right to file a workers’ compensation claim to seek medical coverage and wage replacement benefits. An employer is strictly forbidden from taking any adverse action against an employee who is exercising their right to file a claim. An employee cannot be fired, discriminated […]
From time to time the DWC feels the need to intervene in not only how the workers’ compensation system is running but also, how people get paid in the workers’ compensation system. What that usually means as defendants, employers and third-party administrators is more work, and sometimes there is no cost savings. The DWC has […]
Under California law, an employee may bring a workers’ compensation claim for a mental or emotional injury. Under California Labor Code Section 3208.3, a “psychiatric injury shall be compensable if it is a mental disorder which causes disability or need for medical treatment” and certain other criteria are satisfied. Under the statute, employees are generally […]
In California, businesses, non-profit organizations, and legal entities are required to provide no-fault workers’ compensation insurance coverage to their employees. When someone is hurt on the job, they can pursue a workers’ compensation claim. Unfortunately, not all employees play by the rules. Workers’ compensation fraud remains a significant problem in our state. The California legislature […]
According to a report from the Insurance Journal, the committee governing the Workers’ Compensation Insurance Rating Bureau of California (WCIRB) has voted to move forward with a 2.7% increase to the “pure premium” of workers’ compensation rates. The governing committee of the WCIRB cited both the COVID-19 pandemic and other structural changes as significant factors […]
Workers’ compensation claims are complicated, especially when it comes to the issue of resolving bills from medical providers. You may have come across an unfamiliar industry-specific term — EOR. As defined in the state’s Workers’ Compensation Medical Billing and Payment Guide, Explanations of Review (EORs) are the “explanation of payment or the denial of payment” […]
California mandates that employers must provide workers’ compensation insurance coverage for their employees. Uninsured employers face serious liability risks. Among other things, an uninsured California employer may face civil liability through a personal injury lawsuit, financial sanctions from the state, and even criminal penalties. As a general rule, an uninsured employers’ workers’ compensation claim starts […]
On February 3, 2021, the California Department of Insurance announced workers’ compensation fraud charges against a Kern County man accused of bilking an insurance company. According to the allegations raised by the agency, this man unlawfully failed to disclose a previous work-related injury in an effort to collect workers’ compensation benefits that he did not […]
As described by the California Department of Industrial Relations (DIR), Qualified Medical Evaluators (QMEs) are trained physicians who have been certified by our state’s Division of Workers’ Compensation to examine and evaluate injured workers. In general, QMEs are brought in to resolve outstanding questions about the nature/severity of an employee’s injury. All parties to a […]