Worker’s Compensation – The Necessary Evil

Worker's Compensation, Workers Comp Insurance, Business Insurance


The insurance that most businesses can’t stand but know they must have is Worker’s Compensation insurance. The State of California requires this insurance for ANY business that has employees other than the owners. In fact, there are steep penalties for any business that does not carry proper worker’s compensation insurance.

Why do you need it?

The State wants to ensure that any individual who is injured on the job has access to medical coverage, lost pay and rehabilitation. This insurance is based on an amount per $100 of payroll and varies by industry. If you work in the construction industry you will pay more for worker’s compensation insurance versus someone in an office job.

How does a claim start?

An employee must be given a worker’s compensation claim form and access to medical services within 24 hours of an injury occurring or liabilities may arise.

What does Worker’s Compensation Cover?

Medical: Worker’s Compensation’s first and foremost priority is providing medical coverage to an employee. Whether they have health insurance or not, it irrelevant. An employee is entitled to medical coverage under worker’s compensation insurance. However, keep in mind that medical coverage is guided by secondary physicians and adjusters who must authorize any treatment beyond initial consultations. In fact, the WC system has often been considered one of the toughest HMOs in the State. Saying that, the system is designed to provide you lifelong treatment for anything arising from the same injury.

Lost Wages: Should your physician find that you are unable to perform your job for a period of time, WC provides provisions to get paid temporary disability payments. These are limited in amounts and are only a partial amount of your normal salary but it gives you some relief while you recover.

Permanent Benefits: Should the issue last for an extended period, there is also the possibility that you could be entitled to permanent disability payments. These would be for you having a long term injury that will forever limit your abilities in some fashion.

Retraining: WC also provides mechanism to be retrained should your injury prevent you from returning to your normal occupation. The scope of this, as with other aspects of WC, is limited but it gives you a good start in getting the needed retraining to return to the workforce.

Lifetime Benefits: In the unfortunate situation that you have a severe injury, WC does provide the ability to get limited, lifelong benefits as a result of your injury.

What injuries are covered?

Any accident or injury in the workplace is covered. This seems simple but it is more complicated than this statement. First, the system does cover any specific accidents that occur on an exact date. Second, the WC program also includes any injuries that occur over time. For instance, if you are a warehouse employee and develop chronic back pain over time, this is a covered injury. Third, WC covers anything occurring during “work” even if it is not directly work related. Thus, if you walk to the company water fountain and you slip/fall, this is covered. Should you drive to pick up items at a store for work, you are covered.

This may all seem very complicated but a quality insurance agent can help you navigate through the many facets of worker’s compensation insurance. Whether you are in San Ramon, Danville, Walnut Creek, San Francisco, or anywhere in California, you are welcome to contact Joyce Feldman Agency to answer your insurance questions.