Workers' Compensation FAQs
Q. How must employees in California fund workers comp insurance for their employees?
A. An employer can fund WC (Workers Compensation) benefits by either purchasing a worker’s compensation insurance policy, by buying coverage thru The State Compensation Insurance Fund or by being self-insured, either in whole or in part. An employer is allowed to self insure for monetary benefits and has the policy to cover medical benefits. An employer may want to cover volunteers and exempt employees to save himself from being sued in ordinary negligence should they be injured on the job. If the volunteer or exempt employee is covered by a WC insurance policy, that becomes the exclusive remedy.
Q. Can a California Individual Proprietor purchase WC insurance?
A. Yes, Workers Compensation Insurance is available for sole proprietors. Even otherwise excluded category employees or volunteers may be covered if an employer elects to purchase such coverage for them.
Q. Are individuals who do personal undertakings around an employer’s home, such as babysitters or occasional maids covered by WC insurance?
A. Not exactly. After 1976, all comprehensive Homeowners Insurance or Renters Insurance Policies sold in California must cover home-based or personal service individuals who are performing work in an employer’s home that is not in the regular course and scope of an employer’ business. So a babysitter or occasional maid will be covered if they are injured so long as there is Homeowners or Rental Insurance.
Q. Where do I buy workers' compensation insurance?
A. You can buy workers' comp insurance coverage through an agent or a broker from any privately licensed insurer who does business or write policies in California. The California Department of Insurance website has a last on their website. If you are refused coverage, the State Compensation Insurance Fund (State Fund) is required to provide you with coverage. Members of a trade association might want to check with it first - some trade groups negotiate special rates for members. Also, consider the chamber of commerce for advice.
Q. How much are Burial Expenses for an employee killed on the job in California?
A. The family of An employee who dies as a result of an on the job injury can receive up to $10,000 in burial expenses for any injury after 1-1-2006.
Q. How much are death benefits in the California Workers Comp system for dependents of individuals who die as a result of being injured on the job?
A. That depends if the dependent is a total or a partial dependent. A total dependant is wholly dependent on the deceased employee. A partial dependent received some assistance in meeting living expenses from the deceased employee but was not totally dependent on him or her.
- If one total dependent, $250.000.
- If there are two total dependents, they can receive $290,000. If three or more total dependents, $320,000.
- If there are one total and one partial dependent, the total death benefit is $250,000 plus 4X the amount of support given to the partial dependent but not to exceed $290,000 total.
These are the general amounts recoverable, but the total sum depends on the total of partial plus Total Dependants.
Q. What is the time deadline for filing for California Workers Compensation Death Benefits?
A. Dependents must file with the Workers Compensation Appeals Board within 1 year of the date of the death of the employee and also within 240 days of the injury that caused the death.
Q. Who are “Qualified dependents” for a Workers Compensation Death Claim?
A. Qualified Dependents are usually certain categories designated by the Board. They include:
- Members in good faith of the employees household
- Husbands or Wives
- Children or children conceived but not yet born before the employee's death
- Fathers and Mothers
- Brothers and Sisters
- Uncles or Aunts
- A brother in law or sister in law
- A nephew or niece
Q. My father was a police officer, and he was killed violently while on the job. I am his son, 17. Are there any benefits I may qualify for?
A. Yes, children of police officers or Sheriff’s officers or CHP Offices as well as Fireman and Correction Officers may be entitled to a scholarship if a parent was killed or totally disabled violently in the line of duty. The scholarship is “need-based” and can be up to $6.000 paid over a period of not to exceed 6 years. In calculating “Need.” Any death benefits received from the Workers Compensation System cannot be considered.
Q. Same question as to Medical benefits that may be available to children?
A. Minor dependents to age 21 can receive medical benefits to the same extent of coverage as their parent had at the time of the injury resulting in death. Benefits are payable until the child is 21.
Q. If an injured worker was intoxicated while or the job or under the influence of a controlled substance and sustained an injury, can he or she recover in the California Workers Comp system?
A. Possibly. The fact alone that an employee went to work while under the influence of drugs or alcohol and was injured does not deny them, by means of those facts alone of Workers Compensation benefits. To deny employee benefits, the employer must prove all three things:
A. The employee had consumer alcohol or a controlled substance;
B. The employee was legally intoxicated as defined by state law at the time of the injury;
C. The fact that the employee was intoxicated actually caused the injury.
For example, an employee could be drinking from a wine bottle with a subsequent blood alcohol test reading of .08 or greater and be struck by a negligent motorist. The mere fact that the employee was drinking, and even intoxicated does not prevent him from obtaining workers comp benefits if he was just a victim of the negligent motorist and had no contribution to the accident itself.
Q. Are there any penalties assessed against employers if they illegally hire a minor under 16, and such minor is injured on the job?
A. Yes. An employer may only hire a minor under 16 if such a minor is attending school and Has a work permit from the principal. If an employer has any other minor under 16 working and such minor is injured on the job, the normal worker's comp benefits paid are increased by a penalty of 50 percent.
Q. What happens if my employer discriminates against me or discharges me because I make a workers comp claim?
A. Any employer who does the above or even threatens to do so can be convicted of a misdemeanor. Additionally, any workers compensation benefits paid or that should have been paid, are increased by a penalty of 50 percent up to $10,000. Any employee actually discharged because of this behavior can be reinstated and receive back pay.
There is a one-year time limit to bring an action for employment discrimination.
I'm Ed Smith, a Sacramento California Workers' Compensation Lawyer. If you or a family member has been injured at work and need advice, call me for free, friendly advice at (916) 921-6400 or (800) 404-5400.
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