Posted December 3rd, 2018 by Amy Danise
California requires all businesses to have workers comp for employees, with only a few exceptions. Workers compensation insurance typically pays medical bills and a portion of lost income for an employee who's injured while doing a work-related task. Work injuries that can be covered by workers comp range from broken bones to carpal tunnel to breathing problems.
California workers compensation laws define many details of who must be covered, who can be exempt from coverage, and the limits of workers comp payments. Below are many of the specifics contained in the workers comp law in California. The California department of insurance also has a page with helpful information for employers.
Who has to be covered by California workers compensation?
Can any employees opt out of California workers compensation with a waiver?
Yes - corporate officers can.
Is self-insurance for workers comp allowed in California?
Yes, for individual employers, groups of employers and political subdivisions. Political subdivisions in California are the state or a city, county, special district, school district or public agency.
By self-insuring, a business assumes responsibility for paying their own workers comp claims. A self-insured company typically hires a claims service company to handle claims administration and other services.
Are there exclusions for:
Small employers? No.
Agricultural employers? No.
Domestic employers? Yes, if the workers earns less or works less than a certain amount, or if the employer pays less than a certain amount in wages.
Independent contractors? Yes.
Casual employees? No.
Volunteers? Yes, but limited to ski patrol volunteers and other volunteers.
Professional athletes? No.
California workers comp medical benefits
Is there a California workers comp fee schedule?
Fee schedules define payments for surgery, radiology, hospital services, chiropractic care, ambulance service, prescription drugs and other medical services for an injured worker.
Are there limits on medical treatment?
Yes, for chiropractic care, physical therapy and occupational therapy.
Who makes the initial choice of treating physician?
The employee, from a list provided by the employer or from within the employer's managed care plan.
Disability payments for workers compensation insurance in California
Workers comp generally pays an employee part of their salary when they can't work due to a job-related injury. State laws define limits on the disability payment amounts and length, based on both temporary and permanent disability.
How are temporary total disability (TTD) payments calculated?
66 2/3% of the employee's pre-injury weekly wage, subject to a minimum and maximum.
Weekly minimum: $169.26
Weekly maximum: $1,128.43
Maximum length of TDD benefits: 104 weeks (with limited exceptions for benefits for 240 weeks)
How are permanent total disability (PTD) payments calculated?
66 ⅔% of the employee's average weekly wage, subject to a minimum and maximum.
Weekly minimum: $224
Weekly maximum: $1,128.43
Are there cost of living increases for PTD payments? Yes, based on the increase in the state average weekly wage.
Maximum length of PTD benefits: Lifetime
How are permanent partial disability (PPD) payments calculated?
⅔ of the employee's average weekly wage, subject to a minimum and maximum.
Weekly minimum: $160
Weekly maximum: $290
Fatality benefits under California workers compensation law
Maximum burial benefit: $10,000
Dependency benefits, weekly minimum / maximum: $224 / $1,128.43
When do children's dependency benefits end? At age 18; benefits can continue if child is disabled.
Other injuries covered by California workers compensation
Mental stress with no physical injury? Yes.
Cumulative trauma (such as injuries caused by repeated exposure or repetitive motion)? Yes.
Occupational hearing loss? Yes.
Source: Workers Compensation Research Institute, May 2016 report
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