California Admin/Reporting

First Report of Injury Form Information

State's First Report of Injury form
Number of the form (if applicable)
Revision date of the First Report of Injury form
Which State Agency administers workers' comp claims?

First Report Submission Requirements and Preferences

State's Preferred Method for receiving the First Report
State accept claims via EDI?
State accept claims via Email?
State accept claims via Online?
State accept claims via FAX?
State accept claims via US Mail?

Reporting Requirements

Types of Injuries/Accidents is the Employer required to report
Injuries/Illnesses not covered?
Date the State requires the First Report to be submitted
Time Requirement for the Injured Worker to File a Claim
Employer Required to Keep Records of Claims?

Penalties

Monetary Penalties for Failure to Report?
Imprisonment Penalties for Failure to Report?

Vocational Rehabilitation and Return to Work Policies

Rehab Services are Provided by the State
Employer/Carrier Responsibilities for Voc Rehab
Employee's responsibilities regarding Voc Rehab
Penalties to the Employee for non-compliance
Employee's benefits during Voc Rehab
Services are provided by the State WC Rehab Unit
State's Codes/Regulations for Voc Rehab
Funding source for the rehabilitation of disabled workers
Maintenance Allowance Benefits provided during rehabilitation of Disabled Workers?

Fraud Provisions

Does the State have a Fraud Bureau?
Claim Fraud defined as a specific crime?
Underwriting Fraud a specific crime
Insurer Fraud a specific crime?
Fraud Plan required?
SIU required?
Annual Fraud Reports required?
Fraud Warning required?
Fraud provisions for Insurer-to-Insurer fraud?
Notify the Licensing Board?

Immunity Provisions

Specific Immunity for Insurer to Insurer?
Specific Immunity for reporting to Law Enforcement?
Specific Immunity for reporting to the Fraud Bureau?
Specific Immunity for reporting to the NAIC?
Specific Immunity for reporting to the NICB?

Subrogation Statutes and Provisions

Carrier sue the Third Party directly?
Intervention?
UM/UIM Recovery?
State's Subrogation Statutes

Medical Malpractice Statutes and Provisions

Medical Malpractice as a Third Party?
Legal Malpractice as a Third Party?
Recovery Limits
Employer Negligence?
Future Credit?
Personal Injury Statute of Limitations

Reporting Requirements and Information for Occupational Diseases

Occupational Diseases are covered
Time limit for filing a claim for Occupational Disease
Medical Care Provisions for Occupational Disease claims
Compensation Provisions for Occupational Diseases
Claims settled or resolved

Administration and Appeals Provisions

Time limit for modifications of award?
Attorney Fees determined?
Method for paying Attorney's Fees
Administrative agency that has purview over appeals provisions
Time requirement to file an appeal
Court(s) for Appeals
Process and procedure for filing an appeal
Appeal process by way of a Jury Trial?