| How Workers' Compensation Works
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| | Classifications are developed and
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| All California employers must provide
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| | assigned by the workers' compensation
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| workers' compensation benefits to their
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| | Insurance Rating Bureau (WCIRB) in most
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| employees under California Labor Code
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| | cases.
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| Section 3700. There are five basic types
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| | Rating
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| of workers' compensation benefits -
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| | Workers' compensation insurers assign a
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| medical care, temporary disability
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| | specific rate to each occupational
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| benefits, permanent disability benefits,
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| | classification code. Currently,
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| vocational rehabilitation services, and
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| | California workers' compensation insurers
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| death benefits.
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| | operate under an "open" rating system.
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| How Is Coverage Structured in a Workers'
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| | This means that individual companies set
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| Compensation Policy?
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| | rates based on their ability to
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| Workers' compensation coverage is offered
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| | adequately cover losses and expenses in
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| under Part One of a workers' compensation
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| | each classification (occupational
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| insurance policy. In Part One, the
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| | business class). Open rating requires
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| insurance company agrees to promptly pay
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| | that all workers' compensation insurers
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| all benefits and compensation due to an
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| | file their rates and all applicable
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| injured worker. Employers Liability
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| | supplementary rate information with the
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| insurance can provide important coverage
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| | California Dept. of Insurance. Rates must
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| in addition to workers' compensation
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| | be adequate to maintain the solvency of
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| insurance. Employers Liability is offered
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| | an insurance company. The Insurance
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| under Part Two of a workers' compensation
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| | Commissioner will not approve rates if
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| and Employers Liability Insurance policy.
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| | they are inadequate to cover an insurer's
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| Employers Liability Part Two protects the
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| | losses and expenses, unfairly
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| employer against instances where an
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| | discriminatory, or create a monopoly in
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| employee's injury or disease is not
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| | the marketplace. The rate itself is
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| considered work related.
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| | expressed in dollars and cents and is
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| How Is Workers' Compensation Insurance
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| | multiplied by each $100 of payroll per
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| Purchased?
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| | classification.
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| Employers must purchase workers'
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| | Insurance Claims
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| compensation insurance from either a
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| | The California Dept. of Industrial
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| licensed insurance company or through the
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| | Relations, Division of Workers'
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| State Compensation Insurance Fund (SCIF).
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| | Compensation assists employers and
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| SCIF is a state-operated entity that
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| | employees with workers' compensation
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| exists in order to transact workers'
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| | claims. When disputes arise regarding a
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| compensation on a non-profit basis. SCIF
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| | workers' compensation claim, the
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| competes with private workers'
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| | Information and Assistance Unit attempts
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| compensation insurance companies for
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| | to resolve the dispute. If they are
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| business and also operates as the insurer
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| | unable to resolve the dispute, then a
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| of last resort if private companies are
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| | formal application for adjudication can
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| not willing to offer workers'
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| | be filed with the Workers' Compensation
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| compensation insurance.
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| | Appeals Board. The Workers' Compensation
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| What Happens to an Employer Who Does Not
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| | Appeals Board has exclusive jurisdiction
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| Purchase Workers' Compensation Insurance?
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| | over dispute resolution.
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| Employers who fail to purchase workers'
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| | Issues That Complicate the Workers'
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| compensation insurance are in violation
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| | Compensation System in California
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| of the California Labor Code. The
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| | Despite what appears to be a
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| Director of the Department of Industrial
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| | straightforward and well orchestrated
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| Relations has the authority to issue a
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| | system, there are many issues that
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| stop order against any company who is
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| | complicate the efficient and
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| discovered to be unlawfully uninsured for
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| | cost-effective implementation of workers'
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| workers' compensation. A stop order
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| | compensation in California, among those
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| closes down business operations until
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| | issues are:
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| workers' compensation insurance is
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| | • the cost to employers of insurance
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| secured.
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| | premiums;
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| How Are Workers' Compensation Premiums
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| | • type and scope of coverage;
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| Calculated?
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| | determination of injury or illness;
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| Classification
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| | • benefit amounts;
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| Workers' compensation premium calculation
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| | • cost of vocational rehabilitation;
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| is based upon how employees are
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| | fraud on the part of doctors, workers and
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| classified according to their specific
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| | employers;
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| work duties and the rate assigned to each
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| | . timeliness of benefit payments;
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| corresponding employee classification.
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| | uncovered workers; attorneys' fees.
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