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Workers' compensation is the nation's oldest social insurance program: It was adopted in most states, including California, during the second decade of the 20th century. The workers' compensation system is based on a trade-off between employers and employees. Employees are entitled to receive prompt, effective medical treatment for on-the-job injuries or illnesses no matter who is at fault and, in return, are prevented from suing employers over those injuries.
As a result, California employers are required by law to have workers' compensation insurance, even if they have only one employee. And, if your employees get hurt or sick because of work, you are required to pay for workers' compensation benefits. Workers' comp insurance provides six basic benefits: medical care, temporary disability benefits, permanent disability benefits, supplemental job displacement benefits or vocational rehabilitation and death benefits.
The vast majority of workers' compensation claims are resolved without any problems. However, sometimes a disagreement can arise between you and your employee over issues such as whether the injury was sustained on-the-job or how much in benefits they are entitled to receive.
When a dispute like that arises, the Division of Workers' Compensation can help resolve it through its Information and Assistance Unit or by going before a judge at one of the division's 24 local offices.
Please be advised that if you are a roofer and don't have any employees, you are still required to carry workers' compensation insurance. If you are a real estate broker you are required to carry workers' compensation insurance for your agents, even if they are independent contractors.
If you are an out-of-state employer you may need workers' compensation coverage if you have any employees regularly working in California, or if you enter into a contract of employment here.
Topics on this page include:
General information
Medical treatment information
Disability ratings
Return to work information
General information
Simplified flow chart for claims process 
More workers' compensation topics
Reporting suspected medical care provider fraud
Workers' compensation reference materials
Libros de referencia de compensacion de trabajadores
Doctors in California's workers' compensation system are required to provide evidence-based medical treatment. That means they must choose treatments proven to cure or relieve work-related injuries and illnesses. Those treatments are laid out in a set of guidelines that provide details on which treatments are effective for certain injuries, as well as how often the treatment should be given and for how long, among other things. The state of California has adopted a medical treatment utilization schedule (MTUS)—the formal name for the state’s medical treatment guidelines—that includes the American College of Occupational and Environmental Medicine's (ACOEM) Practice Guidelines, Second Edition, plus guidelines for acupuncture. The Division of Workers' Compensation also has a committee that continuously evaluates new medical evidence about treatments and incorporates that evidence into its guidelines. Upcoming rulemaking on the MTUS will include chronic pain, elbow guidelines, postsurgical treatment guidelines and a new functional improvement report form. Copies of the ACOEM guidelines are available for review at your local DWC office. The ACOEM guidelines are also available at many law, university and public libraries.
Additionally, you, or the claims administrator representing you, are required to have a program called utilization review (UR), which basically provides a way to double check that the doctor's treatment plan for your employee is sound. Check out our fact sheets and guides page and click on fact sheet A for more information on UR.
If your claims administrator has established a medical provider network (MPN) or a health care organization (HCO), your employees' work injuries and illnesses will be treated by a doctor in the network. These networks of doctors are similar to health maintenance organizations (HMOs). If your employees qualified to pre-designate a personal physician and did so prior to being injured they can go to their regular doctor for their workers' compensation care.
Submitted utilization review plans 
version version
This is a list of the groups that have sent actual utilization review plans to the Division of Workers' Compensation. The list does not contain the names of individual employers that might be covered by these plans. The plans have not been reviewed by DWC staff.
More utilization review topics
Current list of approved medical provider networks by name of applicant version version
Current list of approved medical provider networks by approval date version version
More medical provider network topics
Most workers fully recover from job injuries but some continue to have medical problems. Permanent disability is any lasting disability your employee experiences, which results in reduced earning capacity after maximum medical improvement is reached. If your employee's injury or illness results in permanent disability they are entitled to permanent disability (PD) benefits. Check out our fact sheets and guides page and click on fact sheet D for more information on PD.
Permanent disability rating schedule - 2005
This schedule is effective for dates of injury on or after Jan. 1, 2005. This schedule will also be used to rate permanent disability in injuries that occurred before Jan. 1, 2005 when there has been either no comprehensive medical-legal report, or no report by a treating physician indicating the existence of permanent disability, or when the employer is not required to provide a notice to the injured worker under Labor Code section 4061.
Permanent disability rating schedule - 1997
This schedule is effective for dates of injury on or after Apr. 1, 1997
Permanent disability rating schedule - 1988
This schedule is effective for dates of injury on or after Jul. 1988
More disability rating topics
Return to work information
Getting your employees back to work after an injury is one of the most important things you can do for their health and the health of your business. Workers who return to the job as soon as medically possible have the best outcomes: They recover from their injuries faster and suffer less wage loss. You, your employee and your employee's doctor should communicate openly and frequently for the best results.
The California Division of Workers' Compensation's has a return to work incentive program for small employers. Under the return to work regulations, employers with 50 or fewer workers who make modifications to a workplace to bring an employee injured on or after Jan. 1, 2004 back to the job can be reimbursed for up to $2,500 in expenses.
If you qualify you must use the DWC reimbursement form to apply. The form should be sent to:
Return to work reimbursements
Division of Workers' Compensation
1515 Clay Street, 17th floor
Oakland CA 94612
Another section of the return to work regulations provides an incentive for employers with 50 or more employees to bring injured workers back to the job. Employers with 50 or more workers who offer injured employees regular, modified or alternative work will pay 15 percent lower weekly permanent disability benefits once the offer is made. Conversely, employers with 50 or more workers who don't make a return to work offer will pay 15 percent more in weekly permanent disability benefits.
If you have questions about whether you qualify for reimbursement or how to utilize the program, call (510) 286-7100 and ask to speak to a representative of the return to work program.
More return to work topics
October 2008
