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Los Angeles Employer Workers' Compensation Law Blog

Does Your Small Business Need A Worker's Compensation Lawyer?

Running your own small business comes with its own obstacles and hassles, but dealing with workplace injuries is not the most obvious of those obstacles. Accidents do happen, and if you have employees, you've probably had the conversation about worker's compensation insurance. If one of your employees experiences injuries on the job and chooses to file a claim, you might be panicking and unsure of what your next move should be. If you're currently in one of these three situations, you want to consider hiring a worker's compensation lawyer to represent your small business.

Why you need to report employee first aid claims

Since January 1, 2017, all California employers carrying workers’ compensation coverage have been required to report any work accident or worker injury where medical care is provided and medical costs are incurred. This includes first aid treatment and “medical only” claims.

According to Brookhurst.com, first aid is a one-time treatment for minor injuries not usually requiring medical care, such as splinters, scratches, burns, cuts, etc., and any follow-up visit(s) for observation. Medical only is an injury or claim incurring medical treatment costs, whether or not the employer or insurer pays those costs, and whether or not a workers’ compensation claim form is filed. Both claim types must be reported individually. Employers are not, however, required to enter first aid claims on their 300 log for the Occupational Safety and Health Administration.

Excluded employees under California’s new workers’ comp law

Effective January 1, 2017, California’s law changed with respect to who can and cannot be considered an excluded employee for purposes of workers’ compensation coverage. The major change has to do with executive officers. Cavignac.com defines executive officers as follows:

  • President
  • Any vice president
  • Secretary
  • Assistant Secretary
  • Treasurer
  • Assistant Treasurer

In addition, executive officers include those so designated by the operating agreement of a limited liability company or by the charter or by-laws of a corporation and elected and empowered by the directors. Since there often are numerous vice presidents in a company, not all of whom are empowered by the charter, corporations should be aware that most insurance underwriters consider only those specifically referenced in corporate documents to be excludable from either workers’ compensation or the maximum payroll cap.

What is a repetitive stress injury?

For workers in California and all over the country, repetitive stress injuries are exceedingly common. Workers afflicted with these injuries are sometime unable to carry out job tasks, and their quality of life may even be affected. To this end, it’s important to understand the facts on repetitive motion injuries, from what areas are impacted to how they occur. 

According to WebMD, repetitive actions are at the heart of these types of injuries. They typically present as either bursitis or tendinitis, each of which has an array of painful symptoms and complications. In fact, both disorders may exist simultaneously, which can complicate proper diagnosis. More than 50 percent of injuries related to sporting activities involve some sort of repetitive motion, in addition to being quite common in workplace.

What should I know about workers’ compensation insurance?

In California, employers must be fully up-to-date on all applicable workers’ compensation regulations. Lack of knowledge can lead to a workplace being considered non-compliant, which in turn can lead to fines and even damaging lawsuits. To this end, having the right information is a top concern so that employers can steer clear of transgressions in the event of a work injury on the job.

Accordingly, California’s Department of Industrial Relations answers some of the more common questions afforded by employers in the state. For instance, many employers want to know if there are exemptions to the state’s worker compensation laws when it comes to coverage. According to state laws, all workplaces that employ at least one worker must have coverage in place. In some cases an employer may opt to implement a private policy, but this usually occurs when the business is a sole proprietorship.

How can you prevent fire injuries on construction sites?

As an employer in the Los Angeles construction industry, you likely know that your line of work consistently ranks among the most dangerous. Crews working outside during the summertime may be exposed to even more dangers than normal, particularly from fire. The exposure of equipment and materials to the heat combined with the dry conditions can make for an especially combustible mix. Fires present the potential for devastating injuries and even death, along with the risk of liability claims alleging inadequate safety and suppression measures. Fortunately, there are steps that you can take to help protect workers from fires on construction sites.

Standards set by the Occupational Safety and Health Administration place the responsibility on you to develop a fire protection program to cover all phases of a construction project. As part of this program, you must ensure the following:

  •          That all workers have access to reliable firefighting equipment at all times
  •          That all firefighting equipment be conspicuously located
  •          That all firefighting equipment be routinely inspected, and that any defective equipment be immediately replaced

Reviewing the potential benefits of self-insuring

It may be well-known amongst employers in Los Angeles that all companies in California that have more than one employee are required by law to carry workers’ compensation coverage. However, many business owners may find the cost to secure such coverage to be prohibitive. Those who carry workers’ compensation insurance soon discover have no control over the cost they pay in premiums. Yet many believe state-sponsored plans to be their only option if they want to be in compliance with the law. There are, however, other options that allow one to protect his or her company’s employees without being at the mercy of restrictive and unfavorable state-sponsored plan rules.

One such option is to self-insure. This can mean either controlling claims in-house or subcontracting this service to a third part administrator. As the Self-Insurance Institute of America points out, such a move allows a company to control costs by paying claims as they are incurred. As an added bonus, it offers one’s employees greater access to timely care. Yet it also points out that by self-insuring, companies take a greater financial risk by accepting having to pay workers’ compensation claims for employees.

Using Surveillance Cameras to Fight Workers' Comp Fraud

Fraudulent workers' compensation claims cost businesses a lot of money, and for those who insure themselves or for small businesses facing claims, these costs may put them out of business. Businesses must do everything they can to combat fraudulent behavior, which can range from claiming an injury that never happened to claiming an existing injury happened at work. One of the ways to combat this type of false claim is to install surveillance cameras in the workplace, and to notify workers that they are under surveillance. This can not only help you fight false claims, it can deter people from filing claims in the first place to avoid their own legal repercussions.

Can you detect workers’ compensation fraud before it is too late?

Workers’ compensation is an excellent resource for your employees to use if they are injured on the job. It is also valuable to you as the employer because you can protect your company and its reputation if an accident occurs. However, sometimes your employees may be tempted to take advantage of workers’ compensation benefits. Your vigilance can help you recognize fraudulent behavior before it is too late.

The HR Daily Advisor suggests some helpful precautions you can take to reduce workers compensation fraud from occurring in your establishment. Here are some of the things you can do:

  • Properly train management: Your entire human resources department and all other management who may deal with claims, should be thoroughly trained on recognizing fraud. They should all understand the protocols to follow before awarding compensation of any kind.
  • Designate a medical provider: Create a strong relationship with your pre-determined medical provider. Establish regulations that will guarantee that all injured employees have to see them for medical care.
  • Investigate all claims: Even if one of your employees seems to be telling a legitimate story with noticeable evidence to back it up, always conduct an investigation of your own. Determine that timelines match up, dates are correct and any witnesses have been interviewed.
  • Establish a clear policy: Make sure that each of your employees understand how the workers’ compensation policy functions. Encourage them to be forthright about any concerns and to immediately report any injuries. Implement programs aimed at helping your employees to recover and resume their responsibilities as soon as possible.

How does an investigator uncover fraudulent workers’ comp claims?

When an employee reports an on-the-job injury in California, you may assume that your workers’ compensation insurance will cover the costs of the medical bills and a portion of the lost wages. However, according to Property Casualty 360, false claims raise the cost of policies, so any red flags may warrant an investigation.

An examiner may recommend further investigation of a claim if there is record that the employee has pre-existing health problems, family or money issues, or is in a rush to settle the claim. Other indications that there may be fraud include injuries that occur in a situation that your employee should not have been in or injuries that are much higher than the accident conditions would signify. A lack of witnesses or refusal to provide evidence of the loss may also generate suspicion of the need for further examination.

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