Posts by pcdev

Claims Adjuster vs. Claims Examiner vs. Claims Administrator If you have filed a workers’ compensation claim in California, you are likely dealing with someone from the insurance company but their title might be claims adjuster, claims examiner, or claims administrator. These terms can be confusing, especially because they are often used interchangeably. Understanding who is…

If you are receiving workers’ compensation in California and remain employed, your employer should continue paying their portion of your health insurance premiums. However, you are still responsible for your share of the cost. Since you may not be receiving a regular paycheck, you may need to pay your portion directly to maintain coverage. If…

In a California workers’ compensation case, a claims administrator is the person or organization responsible for handling a workers’ compensation claim on behalf of the employer. This can be someone who works for an insurance company, a third-party administrator (TPA), or an employer who is self-insured. The claims administrator plays a central role in the…

In a California workers’ compensation case, a claims adjuster is the representative from the insurance company who is responsible for managing your claim. Their role includes reviewing your case, approving or denying benefits, coordinating medical care, and determining how much compensation you may receive. The claims adjuster is often your main point of contact once…

In California, the Claim Form (DWC-1) is the official document an injured worker uses to notify their employer of a work-related injury or illness and to start the workers’ compensation process. Filing this form is a required step to receive benefits, including medical treatment, temporary disability payments, and permanent disability compensation. When Should You File…

In California, a carve-out refers to a special agreement between unions and employers that allows them to handle workers’ compensation claims outside of the standard state process. These programs are allowed under Labor Code Section 3201.5 (construction industry) and 3201.7 (non-construction unionized employers). Carve-outs are only available in unionized workplaces, and both the employer and…

California Labor Code Section 132a makes it illegal for an employer to discriminate, retaliate, or fire an employee for filing a workers’ compensation claim or for being injured on the job. This section exists to protect injured workers from unfair treatment and ensure they are not punished for exercising their legal right to seek benefits.…

Cal/OSHA stands for the California Division of Occupational Safety and Health, the state agency responsible for enforcing workplace safety and health regulations. While Cal/OSHA does not handle workers’ compensation claims directly, its role in investigating workplace hazards, accidents, and safety violations can impact a workers’ compensation case. What Does Cal/OSHA Do? Cal/OSHA’s primary duties include:…

In a California workers’ compensation case, a benefit notice is a written communication sent by the insurance company to an injured worker. This notice explains the status of benefits, including what benefits are approved, denied, delayed, or modified. Benefit notices are required by law and are meant to ensure that injured workers understand what to…