Workers’ compensation insurance is a “no fault” system to compensate workers’ for injuries and disabilities sustained in the course of their employment, or their dependents in the event of their death.

California law requires all businesses to have workers’ compensation insurance if they have 1 or more employees. If an employee sustains a work related injury or occupational disease, workers’ compensation insurance provides “coverage” for the injury or illness without consideration of who is at fault for the injury.

Insured employers reporting employee injuries can rely on their insurance company to pay for medical treatment, indemnification for loss time and any other benefits the worked is entitled to because of the injury.

An uninsured employer is subject to prosecuted for a misdemeanor, large fines and even a jail sentence. The cost of penalties for being uninsured will far exceed the amount the employer would otherwise have paid for insurance premiums.

If an employee is injured or becomes ill because of work and your business is not insured, then you are responsible for paying all bills related to the injury or illness. Also, the employee can a file a civil action against the business in addition to filing a workers' compensation claim.

If an injured worker files a workers' compensation claim that goes before the Workers' Compensation Appeals Board and a judge finds the employer had not secured insurance as required by law, when the dispute is resolved the uninsured employer may be assessed these penalties:

• $10,000 per employee on the payroll at the time of injury if the worker's case was found to be compensable, or
• $2,000 per employee on the payroll at the time of injury if the worker's case was non-compensable, up to a maximum of $100,000.

An insurance agent represents you and your business during the insurance purchasing transaction. He or she may provide information about your company to several insurance companies. If an insurance company is interested in providing insurance coverage to your business, they will give your agent a price quote for the coverages specified. Your agent then presents one or more of these quotes, and recommends an insurance company that meets your business needs from a service and price perspective.

Insurance companies, like Preferred Employers Insurance, issue a policy that establishes a contractual relationship between the policyholder and company for specific coverages. Each party is responsible for fulfilling certain obligations under the contract, and in turn, the insurance company agrees to pay for losses experienced by the business specific to the insurance policy coverage. For workers’ compensation, the insurance company agrees to pay medical, indemnity and other expenses associated with employee injuries.

Contact your agent when there are changes in your business. For example, changes in your company ownership or corporate officers, adding or closing locations, or starting new operations or processes. These events can result in changes in your premiums and your agent should be notified.

The fundamental aspects of pricing workers’ compensation insurance relies on classification code(s) assigned to your business and rates assigned to each classification code. Premium for each classification code is determined by multiplying the rate and by every $100 dollars of payroll associated with the classification code.

For example: Premium for an employer who operates a restaurant with an annual payroll of $100,000 is determined as follows:

Classification Code - Rate – 9079 Restaurants and Taverns = $3.00 (rate shown is for sample calculation purpose only and is not actual rate for restaurants.)

Payroll/100 x Rate = Manual Premium - (100,000/100) x $3.00 = $3,000

If your business becomes experience rated, then an additional pricing factor will be used to calculate the workers’ compensation premium.

Classification Codes - the Workers’ Compensation Insurance Rating Bureau (WCIRB) develops and assigns classification code(s) for an industry. A classification code generally includes all occupations and operations of a business; however, some business may have more than one classification code. There are approximately 500 classifications in California.

Rating - California workers’ compensation insurance companies operate in an “open” rating system. In this system, insurance rates are not regulated by the state. The California Department of Insurance requires every workers’ compensation insurance company licensed to write workers’ compensation in California to file rates for each classification code. Insurance companies determine rates for each code using historical exposure (payroll and losses) for a specific classification. Rates will vary from company to company.

Rates will also vary commensurate with the severity of the hazards related to each classification. For example, the classification code for a clerical worker has a significantly lower rate than the code for a roofer because the average workplace hazards and injuries for these two jobs are quite different.

The actual premium calculation uses these two factors:

• The rate for the workers’ compensation classification code(s) assigned to your business.
• Annual payroll for employees assigned to those classification codes.

Every business in California receives one or more classification codes based on the business operations, not the work performed by specific employees.

Who can be excluded from the workers’ compensation policy depends on the business entity type (i.e. Corporation, Limited Liability Company, Partnership, or Sole Proprietorship.) Note: Link each entity type to the corresponding description that follows.

When an owner, director or officer elects to be included for coverage on the workers compensation policy, payrolls used to calculate premium are subject to minimum and maximum amounts. The minimum/maximum is set by the Workers Compensation Insurance Rating Bureau and is usually adjusted each calendar year.

Corporations – for an individual to be excluded from policy coverage, these conditions must exist:

• The individual must be an Executive Officer or a Director.
• The individual must own shares of the company.
• Executive Officers or Directors must hold 100% of the stock. This is referred to as a “Closed Corporation.”

If investors hold any corporate stock and are not Officers or Directors, then all active Officers and Directors must be included in the coverage. This is “Open Corporation.”

Exclusion from coverage on the workers compensation policy is elected. This does not occur automatically when the policy is issued.

Limited Liability Company (LLC) – for a person or person(s) to be excluded from policy coverage, these conditions must exist:

• When the LLC is organized as “Member Managed,” then all members are eligible for exclusion.
• If the LLC is organized to have both “Managing Members” and “Members,” only the managing members are eligible for exclusion.

The Articles of Organization for the Limited Liability Company will identify how the business is organized.

Exclusion from coverage on the workers compensation policy is elected. This does not occur automatically when the policy is issued.

Partnership – two types of partnerships are considered: General and Limited Partnerships.

• General Partners are eligible for exclusion.
• Limited Partners are not eligible for exclusion.

Exclusion from coverage on the workers’ compensation policy is elected. This does not occur automatically when the policy is issued.

Sole Proprietorship – when a business is 100% owned by one person, then the owner and all residing relatives are automatically excluded from coverage.<

Yes, but to avoid problems with workers’ compensation insurance, unemployment insurance, and federal and state tax laws a thorough understanding of the employer and independent contractor relationship is needed.

State agencies most involved with determining independent contractor status are the Employment Development Department (EDD) and Division of Labor Standards Enforcement (DLSE). Since different laws may be involved in a particular situation, the same individual may be considered an employee for purposes of one law and an independent contractor under another law.

The DLSE presumes a worker is an employee, however, the final determination depends on multiple factors. The most significant one being whether or not an employer or principal has control or the right to control the manner and means by which the worker performs his or her services.

Some additional factors that may be considered are:

• Whether the person performing services is engaged in an occupation or business distinct from that of the principal.
• Whether the employer or the worker supplies the tools, equipment, materials and place required to do the work.
• Whether the services rendered require a specific skill.
• The kind of occupation, with reference to whether in the locality, the work is usually done under the direction of the principal or by a specialist without supervision.
• If the worker performed similar services for others or advertises their services.
• The method of payment, whether by time or by the job.
• Whether the service rendered is an integral part of the alleged employer’s business.
• If the worker has a business license and/or workers’ compensation insurance.

For additional information regarding independent contractors as it relates to workers’ compensation insurance contact our Premium Audit Department at 1-888-472-9001.

This is the lowest premium amount for a policy. The minimum premium for a policy is shown on the bottom of the Insurance Policy Information page.

The experience rating modification system is a merit rating system intended to provide employers a financial incentive to prevent injuries. Experience rating uses the employer's own history of payroll and employee injuries for a rolling three-year period (collectively referred to as "experience") to adjust the premium that the employer will pay for workers' compensation insurance coverage. Employers with experience better than the average for their industry will have an experience rating modification less than 100%, resulting in reduced premium. Employers whose experience is worse than the average will have an experience modification greater than 100%, resulting in increased premium.

No, a business qualifies for an experience rating modification (X-mod) when the insurance premium calculated for the business exceeds the experience rating eligibility threshold. The experience rating eligibility threshold premium is adjusted each year to reflect wage inflation and advisory pure premium rate changes. To determine eligibility go to: https://wcirbonline.org/wcirb/Employer_Guide/eligibility.html

Policy holders can make payments on-line or through our automated telephone service using a secure network for electronic fund transfers from bank accounts or credit cards (Visa or MasterCard). You can mail a check with the bill statement remittance or payroll report also to make payments. On-line payments can be made at www.peiwc.com.

• Via telephone at: (855) 931-3814.
• There are no fees for using any of these services.
• Services are available 24 hours a day / 7 days a week

Filing a workers’ compensation claim does not automatically increase the premium the same way as auto or other liability insurance. However, if your business has more worker injuries or illnesses than expected, based on payrolls, or if there is a particularly expensive claim (ex. Back injury requiring surgery) then you may see an increase in premium.

If your business has an experience rating modification factor, then other factors come into play when determining how worker injuries effect premiums. Use this link to learn more about California’s experience rating system: http://www.wcirb.com/guide-to-workers-compensation/experience-rating.

This is review of payroll at the end of the policy year to ensure that you are not paying too much or too little premium. There are two types of final audits:

• Voluntary audit – the business receives a form to enter payrolls for each classification assigned to the business. The completed payroll report is returned to Preferred Employers for processing.
• Physical audit – a premium auditor visits your business to gather information from payroll records and tour the facility. A physical audit is required when policy premium exceeds a level set by the Workers’ Compensation Insurance Rating Bureau.

For policyholders on an installment payment plan, the premiums that you pay are based on the payroll estimates that you provide for your business at the beginning of the policy year. The Checking Audit helps ensure that the payroll estimates continue to be accurate, as payrolls for small businesses can fluctuate. If accurate payroll estimates are maintained throughout your policy period, large premium adjustments at final audit can be avoided.

Contact your insurance agent to report the change in payrolls. He or she will send Preferred Employers the required documents to make these changes to the policy.

We can send billing statements or audit payroll reports to the payroll company. Just provide our customer service department with the company name and mailing address for the service you use.

Payroll reported for workers’ compensation purposes uses Gross Payroll and includes the following:

• Wages
• Vacation Pay
• Sick Pay
• Bonuses
• Holiday Pay
• Employee contributions to a 401k or other deferred compensation plan
• Auto Allowances
• Market value of provided lodging (example: Free or reduced rent for apartment)
• Value of free meals provided by the employer
• Travel or “show-up pay”
• State prevailing wage fringe benefits paid directly to an employee
• Commissions
• Payments for hand tools provided by the employee, either directly or through a third party

Yes, but only the portion of overtime wage that is equal to the regular hourly wage. Overtime wages paid an employee results in what is called overtime excess. The additional wage that is paid from the overtime work is not included in the payroll reported for premium calculation purposes.

For example:

Sam’s regular hourly wage is $10.00/hour. He receives time and a half or $15.00/hour for hours worked in excess of 8 hours/day or 40 hours/week. Last week Sam worked 41 hours, he earned 1 hour of overtime pay.

Please call our toll free number, 888-472-9001, then press 2. Please have your policy number handy and a representative will be happy to assist you with your questions.

• Step 1: Please email [email protected] with your policy number to request a copy of the audit worksheet for review. Review audit worksheets to determine if a valid dispute exists. If you have questions on how the audit was completed, please feel free to contact us during business hours at 888-472-9001, option 2.
• Step 2: After review of the worksheets and if you would like to proceed with the dispute, you will need to send a signed letter or email describing the specific details of what is being disputed to our Audit Department. You may forward the dispute to: Preferred Employers Insurance Attn: Audit Department P.O. Box 85478 San Diego CA 92186-5478, Fax: 888-472-9876 or Email: [email protected].
• Step 3: The assigned reviewer will be in contact with you within 2 business days of receipt to advise the next steps or ask for additional supporting documentation.

Every audit is different and may require different documentation but the most common records requested to perform the audit are:

• Quarterly De 9c
• Payroll Summary report
• Federal 941’s
• W-9’s
• 1099’s
• Quickbooks Reports or other payroll company report

A payroll verification form is used to obtain 3 months of payroll which is compared to your policy estimates. This form only applies to your business if you are on an installment plan and your annual premium is above $2,500.

The purpose of the verification form is to ensure you payroll is properly estimated. Should you payroll be significantly higher than the payroll estimate on the policy will be amended to reflect this.

Any injury or illness that is caused by the job is covered by workers’ compensation. The phrase often used is “arising out of or in the course of employment.”

These injuries can fall into two categories:

• Those that occur from an event at work that causes the injury like a back strain from lifting, being burned by a hot surface, or getting a particle in the eye.
• Repeated or cumulative injuries that occur over time. Examples are carpal tunnel syndrome from performing the same motion repeatedly, hearing loss from working in a loud environment and respiratory disorders from breathing a hazardous substance.

We encourage employers to report all claims, including first aid injuries (Learn more about first aid injuries). If on a later date, we need to become involved, the time restrictions that govern how we may manage the claim are based on the employer's date of knowledge, not Preferred Employers’ date of knowledge. Injuries with no treatment or activity are reviewed regularly and closed.

California’s Labor Code defines first aid as, any physician directed one-time treatment and follow-up visit for the purpose of observation of minor scratches, cuts, burns, and splinters or other minor industrial injuries, which do not ordinarily require medical care.

We ask our customers to report first aid claims, because occasionally these injuries evolve into something more serious. If this happens, we are in a better position to manage claims costs. When the injury remains a first aid injury, employers can pay for the medical treatment.

A Medical Provider Network (referred to as an MPN) is a group of doctors and other health care providers that are established by an insurance company or large self-insured employer to treat workers injured on the job. Each Medical Provider Network must be approved by the California Division of Workers’ Compensation and must include a mix of doctors specializing in work-related injuries and doctors with expertise in general areas of medicine.

To find doctors within the Preferred Select MPN, you may either call our telephone hotline at (888) 472-9001 (press 1 for claims, then 2 for MPN questions) or click on the “Find A Doctor” icon on the home page of this website.

After the initial appointment, a newly injured employee may choose from any doctor within the Preferred Select MPN network.

An employee may go to a physician outside of the MPN if he/she has pre-designated a personal physician before a work injury occurs.

There are specific criteria that allow an employee to pre-designate a physician.

• Your business must offer employees group health coverage.
• The doctor the employee designates is their regular physician. He or she shall be either a physician who has limited their medical practice to general practice or is a board-certified or board eligible internist, pediatrician, obstetrician, gynecologist, or family practitioner, and has previously directed their medical treatment and retains the employee’s medical records.
• The “personal physician” may be in a medical group if it is a single corporation or partnership composed of licensed doctors of medicine or osteopathy, which operates an integrated multi-specialty medical group providing comprehensive medical services predominantly for non-occupational illnesses and injuries.
• Prior to the injury, the employee’s doctor must agree to treat the employee for work injuries or illnesses.
• Prior to the injury, the employee must provide the employer the following in writing:
  • Notice that the employee wants their personal doctor to treat a work-related injury or illness, and
  • The personal doctor’s name and business address.

A form is provided in the Workers’ Compensation Forms and Notices folder you received when from Preferred Employers.

After the initial appointment, a newly injured employee may choose from any doctor within the Preferred Select MPN network.

An employee may go to a physician outside of the MPN if he/she has pre-designated a personal physician before a work injury occurs.

There are specific criteria that allow an employee to pre-designate a physician.

• Your business must offer employees group health coverage.
• The doctor the employee designates is their regular physician. He or she shall be either a physician who has limited their medical practice to general practice or is a board-certified or board eligible internist, pediatrician, obstetrician, gynecologist, or family practitioner, and has previously directed their medical treatment and retains the employee’s medical records.
• The “personal physician” may be in a medical group if it is a single corporation or partnership composed of licensed doctors of medicine or osteopathy, which operates an integrated multi-specialty medical group providing comprehensive medical services predominantly for non-occupational illnesses and injuries.
• Prior to the injury, the employee’s doctor must agree to treat the employee for work injuries or illnesses.
• Prior to the injury, the employee must provide the employer the following in writing:
  • Notice that the employee wants their personal doctor to treat a work-related injury or illness, and
  • The personal doctor’s name and business address.

A form is provided in the Workers’ Compensation Forms and Notices folder you received when from Preferred Employers.

Medical Care: On behalf of the employer, Preferred Employers will pay all medical treatment necessary to cure or relieve the effects of a work-related injury or illness.

This includes physician services, hospitalization, physical restoration, dental care, prescriptions, X-rays, laboratory services, mileage reimbursement and all other necessary and reasonable care ordered by the treating doctor.

Temporary Disability (TD): When a physician states the injured employee is unable to return to work because of a work- related injury or illness and the employer does not offer the employee modified work that pays or replaces a portion of the employee’s usual wage, then the employee is eligible for TD benefits.

Temporary disability benefits begin after the employee misses 3 days of work. If the employee misses more than 14 days of work, then the employee is entitled to wage replacement for the first 3-day period.

Temporary disability benefits are two-thirds of the gross (pre-tax) weekly wages the employee received before the injury. The amount cannot be less than the minimum weekly amount or more than a maximum weekly amount as set by law.

Permanent Disability (PD): An employee becomes eligible for PD benefits if an injury or illness results in permanent impairment. Having a permanent disability does not necessarily mean you cannot return to your job. It simply means that the employee’s ability to compete in the open labor market may be reduced, or they have loss the ability to complete daily living activities.

A disability is considered permanent after an employee has reached “maximum medical improvement” or his or her condition has been stationary for a reasonable period. The term you will hear is “permanent and stationary." PD benefit amounts are set by law and paid every two weeks until the benefit is completely paid or when the employee settles the case and receives a lump sum.

Supplemental Job Displacement Voucher: Employees injured on or after Jan. 1, 2004, who are permanently unable to do their usual job, and whose employer does not offer other work, may qualify for this benefit. It is in the form of a voucher that promises to help pay for educational retraining or skill enhancement, or both, at state-approved or state-accredited schools. Making an offer of modified or alternative work can determine worker eligibility.

Employees who do not return to work for their employer within 60 days of the last temporary disability payment may receive a voucher. The amount of the voucher is based on the percentage of the injured worker’s permanent disability.

Employee will not be eligible for the supplemental job displacement benefit if within 30 days of the end of temporary disability payments, the employer makes an offer of modified or alternative work and the employee rejects or fails to accept the offer.

Death Benefits: Benefits are payable to a surviving spouse and dependent(s). Benefits continue for the dependent(s) until they reach 18 years of age. Burial expenses are also included, not to exceed $5,000.

No, you don’t have to, but by providing modified work, claims costs can be contained. There are several other benefits to offering modified work:

• Having the employee come to work even for a shortened workday keeps the employee in a “work routine”.
• Productivity levels don’t drop off from being short a person or having to train a person to perform the injured employee’s job.
• A return to work program reflects well on the company and work environment.

If you have questions or valuable information regarding a claim, we encourage you to call the claims examiner managing the claim using our toll free number, 888-472-9001, then press 1. The examiner can provide information about claims costs, medical treatment status, eligibility of the injured worker to return to work, any suspicions we have regarding claim legitimacy, and other information.

Under California and Federal law, injured worker medical records are considered protected documents and access to these records is restricted. Preferred is able to share the following information with employers we insure:

• The diagnosis of injury or illness for which workers' compensation is claimed.
• The treatment provided for the claimed injury or illness.
• Medical information that is necessary to allow the employer to modify the employee's work duties.

Investigation reports and statements usually contain sensitive and confidential information that directly impacts the outcome of the claim. Because discretion is required with the timely release of the information contained in an investigation report, we do not share these reports. However, upon request, a copy of the statement transcript may be provided to the specific individual interviewed.

Yes, if an injured worker wants to make sure they qualify for all the benefits they may be eligible to receive from a work related injury or illness. In the case of a fatal injury or illness, the form must be completed by a dependent of the injured employee, or by an agent of the deceased or dependent. If you do not file the claim form within a year of your injury, you may not be able get benefits.

The employer must provide the injured worker a DWC-1 claim form within one day of receiving notice of the injury or illness.

When the injured worker completes the claim form and returns it to the employer or insurance company, it opens your workers’ comp case. State law also lays out benefits that the injured worker may qualify once the claim form is returned to the employer or insurance company. Those benefits include, but are not limited to:

A presumption that the injury or illness was caused by work, if the claim is not accepted or denied within 90 days of giving the completed claim form to the employer or insurance company.

Up to $10,000 for medical treatment, under medical treatment guidelines, while the claims administrator evaluates the claim.

An increase in disability payments if payments late.

A way to resolve any disagreements that might come up between the injured worker and the claims administrator over whether the injury or illness happened on the job, the medical treatment receive and whether payments for permanent disability benefits will be made.

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The employer must provide, personally or by first class mail, a claim form (DWC-1) and a notice of potential eligibility for benefits (NOPE) to the injured employee, or in the case of death, to his or her dependents within one working day of receiving notice or knowledge of injury or illness which results in medical treatment beyond first aid or results in lost time beyond the date of injury or illness.

To inquire about being added to our Medical Provider Network call 888-472-9001, press 1, and then ask for the Medical Provider Network Administrator or you mail email your request directly to [email protected]. If you are a medical provider interested in joining the Preferred Select Medical Provider Network (MPN) please email your request and include your practice locations and specialty.

Generally, the employer should be prepared to comply with a subpoena for employee records. When the subpoena is related to a claim for workers' compensation benefits, we recommend that the employer discuss the request with Preferred at the time the subpoena is received. We can guide you through the response process.

Cumulative trauma injuries and repetitive strain injuries (RSI) are broad terms used to refer to several distinct conditions that can be associated with repetitive tasks, forceful exertions, vibrations, mechanical compression, or sustained/awkward positions. Examples of conditions that may sometimes be attributed to such causes include edema, tendinitis, carpal tunnel syndrome, cubital tunnel syndrome, De Quervain syndrome, thoracic outlet syndrome, intersection syndrome, golfer's elbow (medial epicondylitis), tennis elbow (lateral epicondylitis), trigger finger, radial tunnel syndrome, and focal dystonia.

As a rule, an injured worker is paid two-thirds of their gross (pre-tax) wages at the time of injury, with minimum and maximum rates set by law. An injured worker’s wages are calculated using all forms of income received from work: wages, food, lodging, tips, commissions, overtime and bonuses. Wages can also include earnings from work you did at other jobs at the time you were injured. Proof of earnings must be provided to the claims examiner. The claims examiner will consider all forms of income when calculating TD benefits.

TD payments begin when your doctor says you can’t do your usual work for more than three days or you are hospitalized overnight. Payments must be made by the insurance company every two weeks. Generally, TD stops when you return to work, or when the doctor releases you for work, or says your injury has improved as much as it can.

There is a specified period from the date of injury that TD payments can be received.

1. If an injury happened between April 19, 2004 and Jan. 1, 2008, the TD payments won’t last more than 104 weeks from the date of the first payment for most injuries.
2. Those injured on or after Jan. 1, 2008 are eligible to receive 104 weeks of disability payments within a five-year period. The five-year period is counted from the date of injury.
3. Payments for a few long-term injuries, such as severe burns or chronic lung disease, can go longer than 104 weeks. TD payments for these injuries can continue for up to 240 weeks of payment within a five- year period.

TD payments begin when the primary treating physician says you can’t do your usual work for more than three days or you get hospitalized overnight. Payments must be made by the insurance company every two weeks. Generally, TD stops when you return to work, or when the doctor releases you for work, or says your injury has improved as much as it can.

There is a specified period from the date of injury that TD payments can be received.

1. If an injury happened between April 19, 2004 and Jan. 1, 2008, the TD payments won’t last more than 104 weeks from the date of the first payment for most injuries.
2. Those injured on or after Jan. 1, 2008 are eligible to receive 104 weeks of disability payments within a five-year period. The five-year period is counted from the date of injury.
3. Payments for a few long-term injuries, such as severe burns or chronic lung disease, can go longer than 104 weeks. TD payments for these injuries can continue for up to 240 weeks of payment within a five- year period.

Medical Only Claims Worker injuries or illnesses that require only medical treatment or result in temporary disability can be resolved rather easily. Once the medical provider releases the injured worker to return to full work and medical bills are received and paid, the claim can be closed.

Permanent Disability Claims If the injured worker loses time from work due to an injury or illness that resulted in permanent disability, the case can be resolved when there is an agreement between the injured worker and the claims administrator or a judge issues an order about the injured worker’s workers' compensation payments and future medical care that will be provided to the injured worker.

In order to protect the injured worker’s rights, whether or not the worker is represented by an attorney, settlements must be reviewed by a workers’ compensation administrative law judge, to determine whether they are adequate.

What types of settlements are there? There are two different ways to settle a permanent disability case:

• Stipulations with Request for Award (Stips)
• Payments – the injured worker and the claims administrator agree on the amount of temporary disability (if not already paid) or permanent disability payments you will receive. This is usually paid in bi-weekly payments
• Medical care - The claims administrator usually agrees to pay for medical care, if needed.
• Compromise and Release (C&R)
• One payment - The claims administrator agrees on an amount to resolve your claim. This is usually paid in a lump sum
• Medical care - If the lump sum includes the estimated cost of future medical care, the claims administrator will no longer pay your doctor. This becomes your responsibility.

There a several ways to obtain claim forms and notices. You can do any of the following:

1. Call our customer service hotline at 888-472-9001, then press 2 at the prompt. A customer service representative will ensure the materials you want are emailed or mailed to you.
2. Send an email to the customer service dept. with your materials request. Email address: [email protected].
3. You can access claims and Cal/OSHA Injury and Illness forms from our secured Customer Connect website.

You can also find medical providers near your business, make policy payments and provide payroll for monthly or final audit reports. You’ll need to register to access Customer Connect. To do this you’ll need the following information:

1. Policy number
2. Policy effective date
3. Last 4-digits of the business tax ID code/FEIN number

We consider any claim information about injured workers to be confidential, so we take measures to ensure that this information is being given only to an authorized company representative, this includes your broker.

To request a claim report, fax the request on company letterhead to 866- 472-9602. Ensure the request is signed by an owner/officer of the company. We may call to validate the request if the signature is someone not listed as an owner/officer on the policy.

Fraud in workers’ compensation can occur several ways. Here are the most common types of workers’ compensation fraud:

• 1. Worker fraud – workers are guilty of fraud when they:
  • Fake an injury.
  • Lie about the extent of their injury.
  • Falsely deny making any previous workers’ compensation claims.
  • Fail to disclose a prior injury to the same body part.
  • Claim a non-work injury as work related.
  • Work illegally while obtaining benefits.
• Doctor and Lawyer fraud – this occurs when workers are sent to medical clinics or attorney offices which scheme and validate fake claims.
• Premium fraud – occurs when an employer tries to lower their insurance premium by intentionally misstating annualized payroll or the nature of their work.
• Provider fraud – some medical or other health providers fraudulently maximize the number of medical reports and referrals in each case to increase the number of billings.

Remember: You cannot discourage an employee from pursuing a legitimate claim by misrepresenting workers’ compensation benefits.

Regardless of what type of workers’ compensation fraud you may suspect, call Preferred Employers with specific details as to why fraud is suspected.

Contact Preferred Employers Claims Department using the toll free hotline: 888-472-9001. Try to have this information ready:

• Claim number.
• Policy number.
• Employee’s name.
• What circumstances make you suspect fraud?
• Your phone number for a person in our office to call you back, if necessary.

Preferred Employers sometimes will use independent, licensed field investigators to collect information about a claimed work-related injury. The gathered information is used to determine if the claim is legitimate or whether a third party may be responsible for the injury.

An Injury and Illness Prevention Program is a safety program. In 1991, legislation was passed and incorporated into California’s Labor Code requiring all businesses to have an effective Injury and Illness Prevention Program (IIPP). Cal/OSHA enforces this regulation through the inspection of businesses. Fines can be levied against businesses that do not have an effective IIPP.

Having an “effective” Injury and Illness Prevention Program is key to complying with this Cal/OSHA regulation. To be an effective program, it must be written, include procedures and most important, put into practice. These elements must be included in the program:

• Management commitment(usually expressed /assignment of responsibilities;
• Safety communications system with employees;
• System for assuring employee compliance with safe work practices;
• Scheduled inspections/evaluation system;
• Accident investigation;
• Procedures for correcting unsafe/ unhealthy conditions;
• Safety and health training and instruction; and
• Record keeping and documentation.

Preferred Employers provides a model IIPP for employers to use as a guide to develop a program. You will need to tailor the 8 elements (see prior question and answer) to reflect your business organization and culture. Call our toll free hotline (888-472-9001) to speak to a Safety and Health Consultant or visit our website at peiwc.com to print the model program.

Yes, experience is not a substitute for safety; it is a complement to it. New employees bring experiences and work habits to a new job, and these may not always meet your expectations. It only takes a short time to review a job with a new employee and describe how you expect the job to be safely performed.

There are several factors that influence how often these activities are performed: past injury experience, business operations, changes to existing processes, machines or equipment, and number of employees.

Most small businesses that have no injuries or a minor injury during a calendar year generally hold meetings and conduct formal workplace inspections each quarter.

Preferred Employers wants to be a multi-purpose resource for California’s small business community. Informative and free Safety and Health materials are designed to “make it simple” for small business to manage workers’ compensation programs.

• Model regulatory programs that can be customized to your business’s operations and processes.
• Informational bulletins, the Preferred Press, that give concise information about topics that effect small business.
• Safety meeting topics to help build and maintain safety awareness in your business.
• Quarterly newsletters to keep you informed of current safety, insurance and personnel trends.
• Human resource references to get answers to employee relation issues.
• A library of safety videotapes for meetings, training sessions, safety orientations and other informational gatherings.

All materials are available on our website at www.peiwc.com. Please have your policy number and policy effective date available to log into the “Policy Holders” page.

Workplace safety programs, safety topics and other valuable accident prevention tools can be obtained using several methods. You can do any of the following:

1. Call our customer service hotline at 888-472-9001, and then press 3 at the prompt. A safety and health consultant will discuss your needs with you and ensure materials are promptly emailed or mailed to you.
2. Send an email to the Safety and Health Department with your workplace safety materials request. Email address: [email protected].
3. You can access model Injury and Illness Prevention Programs, safety meeting topics, streaming videos and more from our secured Customer Connect website.

You can also find medical providers near your business, make policy payments and provide payroll for monthly or final audit reports. You’ll need to register to access Customer Connect. To do this you’ll need the following information:

1. Policy number
2. Policy effective date
3. Last 4-digits of the business tax ID code/FEIN number

The federal government and the California Department of Industrial Relations requires employers to post information related to wages, hours, working conditions and worker rights in an area frequented by employees where it may be easily read during the workday. Industry specific posting requirements apply to some workplaces. For a list of available workplace postings visit: http://www.dir.ca.gov/wpnodb.html. From this website you can download or print the posters that apply to your business.

California requires all businesses to post the Industrial Wage Commission (IWC) poster. This poster is industry specific. To find the poster you need you can go to http://www.dir.ca.gov/IWC/WageOrderIndustries.htm.

Combined state and federal posters can be purchased from the California Chamber of Commerce and All In One Posters, www.allinoneposter.com. The combination poster will not have the IWC poster as this is industry specific.

Preferred Employers will provide the Notice to Employees – Injuries Caused By Work (DWC-7) poster and Initial Written Employee Notification (Medical Provider Network Notice) in the Workers’ Compensation Claim Forms and Notice folder sent to your business when your initial policy was issued.