WCIRB CALIFORNIA ISSUES WORKERS’ COMPENSATION ‘LOSSES AND EXPENSES’ REPORT FOR 2020

On June 25, 2021, the Workers’ Compensation Insurance Rating Bureau of California (WCIRB) released its official report on workers’ compensation “losses and expenses” for the year 2020. In total, workers’ compensation insurers paid out more than $12 billion to process and resolve claims in California last year—a nearly 10% decrease when compared to 2019. In […]

EMPLOYERS MUST PROVIDE INJURED WORKERS A CLAIM FORM AND NOTICE OF RIGHTS TO RELY ON A STATUTE OF LIMITATIONS DEFENSE

Under California law, workers’ compensation claims are subject to a statute of limitations. As a general rule, most workers’ compensation claims must be filed by an injured employee within one year of the date of the accident or the “onset” of the injury/illness. If a worker fails to file a claim before the deadline, an […]

CALIFORNIA WORKERS’ COMPENSATION WATCH: STATE SENATE PASSES NEW BILL THAT REDUCES TIME FOR EMPLOYERS/INSURERS TO INVESTIGATE AND DENY CLAIMS

According to a report from Business Insurance, the California State Senate passed Senate Bill 335 (SB 335), a piece of workers’ compensation reform legislation that would, among other things, reduce the amount of time that employers/insurers have to deny a workers’ compensation claim. In this blog post, our Fresno workers’ compensation defense lawyers explain the […]

WORKERS’ COMPENSATION WATCH: APPEALS BOARD APPROVES BENEFITS FOR WORKER INJURED DURING ‘UNAUTHORIZED’ ACTIVITY

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. […]

CALIFORNIA LABOR CODE SECTION 132(A): WORK INJURIES, MEDICAL TREATMENT, AND SICK LEAVE BENEFITS

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 […]

THE EVER-CHANGING MEDICAL LEGAL-FEE SCHEDULE

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 […]

CALIFORNIA WORKERS’ COMPENSATION DEFENSE: LABOR CODE SECTION 3208.3 AND “SUDDEN AND EXTRAORDINARY” CLAIMS

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 […]

WORKERS’ COMPENSATION FRAUD

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 […]

CALIFORNIA WORKERS’ COMPENSATION COMMITTEE VOTES FOR A 2.7% INCREASE TO PREMIUMS

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 […]

DEMYSTIFYING CALIFORNIA WORKERS’ COMPENSATION BILLING: WHAT ARE EORS?

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” […]