Is Workers Compensation the Same as State Disability?
No. Workers' compensation is only for injury or illnesses that occur due to employment. State disability is for injuries or illnesses that are not work-related. The Employment Development Department (EDD) handles these. State Disability Insurance (SDI) is automatically deducted from the employee's paycheck.

Is Every Injury a Reportable Work Comp Claim?
No. Certain injuries are treated as “first aid” claims and handled outside of the workers compensation process. Contact us for additional information on “first aid” injuries.

What is an Early Return to Work Program?
It is the process of bringing an injured employee who has not fully recovered back to work as early as possible. The focus is on functional recovery, not on just the relief of symptoms. It is critical in decreasing lost workdays, and avoiding unnecessary disability syndromes.

What is an Experience Modification Factor?
Experience rating assesses whether your company's claims experience is greater or less than average by comparing your company's payroll and claims history with other businesses in the same industry. In California, this statistical comparison is made by the Workers' Compensation Insurance Rating Bureau, which uses your recent policy history to compute your business's experience modification. The "ex-mod" is a percentage factor that modifies your current workers' comp premium. If your claims are less than the average, your premium will be adjusted downward. Conversely, if your business has had higher losses than the rest of your industry, your premium will be higher. Some states have a similar process, while others belong to NCCI for computing these “ex-mods”. There is a minimum premium level necessary to qualify, and the plan is mandatory for all qualified businesses. For California in 2006, that premium level is $28,400 over a three-year (or shorter) period. The premium level is based on the pure premium rates.

How Do I Handle Independent Contractors (ICs) Without Workers Compensation Insurance?
Compensation laws provide that the hiring employer may be responsible for compensation of the employees of uninsured ICs. In determining compensation premiums, you will be charged premium for coverage in connection with these ICs unless you can provide satisfactory evidence of such insurance. For your protection, you should obtain certificates of insurance from all ICs working on your behalf.

Can I Exclude My Executive Officers/Partners/Members from Coverage?
If you are a closed corporation (all the company’s stock is owned by the Executive Officers) or partnership, you can exclude coverage for these individuals. In those instances, where you cannot exclude the officers/partners/members, each state allows you to cap the compensation for these individuals in the premium computation. In California for 2006, the maximum cap is $81,700 of remuneration and the minimum amount is $32,500.

What is Included in Remuneration?
Remuneration includes an employee’s wages, salary, cash payments to subcontractors, bonuses, commissions, vacation, holiday and sick pay, straight time for overtime hours, market value of lodging provided, market value of gifts and all other substitutes for money.

Medical Care – A Claims Administrator (Insurance Company or Third Party Administrator) will pay all reasonable and necessary medical care for your work injury or illness. Medical benefits may include doctor visits, hospital services, physical therapy, lab tests, X-ray and medicines. The Claims Administrator will pay the costs directly so your workers should never see a bill.

Temporary Total Disability (TTD) - If an employee cannot work while recovering from a job related injury or illness, he/she will receive temporary disability payments. Typically these represent 2/3 of the employee weekly compensation subject to a minimum and maximum as stated by law. These payments may change or stop once the doctor says the employee is able to return to work. These benefits are tax-free. Payments are not made for the first three days an employee is off the job unless employee is hospitalized overnight or cannot work for more than 14 days.

Permanent Disability (PD) - If a doctor says that an employee’s injury or illness results in permanent disability, the employee may receive additional payments. The amount will depend on the type of injury, age of the employee, occupation and date of injury.

Vocational Rehabilitation (VR) - If a doctor says an employee injury or illness prevents him/her from returning to the same type of job and you as an employer fail to/cannot offer modified or alternative work, the employee may qualify for Vocational Rehabilitation. If the employee does qualify, the Claims Administrator will pay the costs up to the maximum set by state law. In California, VR is for injuries that occurred prior to 1/1/04.

Supplemental Job Displacement Benefits (SDJB) - If an employee does not return to work within 60 days after the temporary disability ends, and you do not offer modified or alternative work, the employee may qualify for nontransferable voucher payable to a school for training and/or skill enhancement. If the employee does qualify these costs will be paid by the Claims Administrator up to maximum prescribed by state law based on the employee’s percentage of permanent disability. In California, SJDB is a benefit for injuries that took place after 1/1/04.

Death Benefit - If the injury or illness causes death, payments may be made to relatives or household members who were financially dependent on the deceased worker. The amount varies by state and is determined by a variety of factors.