Date:      December 15, 2000

To:        Christine Baker, Executive Officer
             Commission on Health and Safety and Workers' Compensation

From:     Juliann Sum, Project Coordinator
              Labor Occupational Health Program, UC Berkeley

Re:       FINAL REPORT

• Project To Improve Laws and Regulations Governing Information for Workers

• Project To Augment, Evaluate, and Encourage Distribution of the Prototype Educational Materials for Workers

______________________________________________________________________________

These two projects were, respectively, a one-year augmentation of the 1998-99 Benefit Notices Project and a two-year augmentation of the 1996-98 Educational Materials Project. In these projects, we have completed a seventh factsheet, prepared a proposed memorandum for employers on how to fulfill their legal obligations to educate their employees, identified and analyzed changes in statutes that could improve information for workers, conducted group discussions with injured workers on how to revise available materials, and collected information and ideas on how to update the Commission's factsheets and encourage their use.

We wish to thank the Commissioners and Commission staff for the opportunity to conduct these projects, and for your continual support and assistance throughout all of our projects.

______________________________________________________________________________

A. Goals of the Projects 3

B. Previous Activities 3

1. Factsheet on "Working After a Job Injury" 3

2. Memorandum for Employers on Their Legal Obligations 4

3. Recommended Changes in Statutes that Govern Information 4

C. Final Activities 5

1. Discussions with Injured Workers Regarding Informational Materials 5

a. Discussion-Group Participants 5

b. Questions Asked of the Participants 6

c. Insights and Ideas Obtained from the Participants 6

• Content and Design of the "Notice of Potential Eligibility for Benefits"

• Design of a "Comprehensive Guide" for Injured Workers

• Important Topics for All Workers

• Different Languages

2. Revisions To Improve and Update the Factsheets 12

a. Usefulness of the Factsheets in the Community 12

• Distribution and Use of the Factsheets

• Suggestions on Design, Format, and Content

b. Updating the Content of the Factsheets 14

• Terms and Phrases

• Availability of Books and Other Resources

• Addresses, Telephone Numbers, Websites, and Book Editions

3. Recommendations 18

• Enforcement of Employers' Informational Requirements

• Notice of Potential Eligibility for Benefits

• Comprehensive Guide for Injured Workers

• Important Topics for All Workers

• Different Languages

The goals of these projects were as follows:

Goal 1: To study and identify methods for informing injured workers about aspects of returning to work.

Goal 2: To inform employers about how they can use the prototype materials to fulfill their legal obligations to educate injured workers on workers' compensation benefits and procedures.

Goal 3: To further identify statutory and regulatory requirements that cause the greatest problems with benefit notices, from the injured worker's perspective, and to identify and propose practical changes in statutes and regulations to improve (a) benefit-notice information for injured workers and (b) basic information for all workers.

Goal 4: To identify and develop proposed methods for (a) improving the content, design, and distribution of the factsheets, from perspectives of both workers and distributors, and (b) updating substantive information in the factsheets.

 

1. Factsheet on "Working After a Job Injury"

To achieve Goal 1, we designed and pilot tested a 10-page educational factsheet called "Working After a Job Injury (Factsheet #3C)." This factsheet was designed to meet the objectives that had been specified in the Educational Materials Project in 1996. Those objectives were to design and test educational materials that would enable injured workers to (a) request workers' compensation benefits, (b) recognize when there may be a problem with their claim, (c) handle common problems, and (d) know where to go for further information or help.

In spring 1999, the first draft of Factsheet #3C was prepared based on advisory comments that the project team obtained in 1998 regarding a set of proposed "teaching points." In summer 1999, a second draft was prepared based on advisory comments regarding the first draft. This second draft was then pilot tested with a group of injured workers. In winter 1999-2000, a third draft was prepared based on results of the pilot test and sent to project advisors for their review and comment.

The final version of this factsheet, dated March 2000, includes revisions based on comments made by project advisors on the third draft. The factsheet was approved by the Commission in April 2000. We have translated the factsheet into Spanish. Color versions of the factsheet will be delivered shortly.

2. Memorandum for Employers on Their Legal Obligations

To achieve Goal 2, in early 1999 we prepared a draft memorandum addressed to employers. This draft memorandum was based on (a) results of the 1994-96 focus-group sessions and interviews in the Commission's project, "Navigating the California Workers' Compensation System: The Injured Worker's Experience," (b) analysis of employers' and claims administrators' statutory and regulatory obligations to inform employees about workers' compensation, and (c) information obtained from representatives of the Division of Workers' Compensation and other advisors in our different projects.

In March 1999, the draft was sent to members of the project advisory committee for their review and comment. No suggestions for any changes were received. On May 26, 1999, the memorandum was adapted by Commission staff in its final form. We have assisted the staff in their activities to distribute the memorandum to employers throughout California.

3. Recommended Changes in Statutes that Govern Information

To achieve Goal 3, in late 1999 and early 2000 we first focused on recommended changes in statutes, at the request of the Commission. More specifically, we identified statutory requirements that cause the greatest problems with benefit notices, from the injured worker's perspective, and practical changes in statutes that could improve both benefit-notice information and basic information for workers. This initial work was based on the following:

• Results of the 1998-99 Benefit Notices Project. This project, described in our report to the Commission dated September 9, 1999, had included the following:

a) Discussion sessions with five groups of injured workers regarding experiences with benefit notices;

b) One session with a sixth group of injured workers to pilot test a set of model notices;

c) Interviews with claims administrators from three insurance companies, two third-party administrators, and one self-insured, self-administered employer regarding problems with benefit notices;

d) Continual input from project advisors.

• Input from project advisors, from October 1999 through April 2000. This work included the following:

a) Consulting with State Compensation Insurance Fund regarding their proposals to simplify the workers' compensation system;

b) Reviewing, analyzing, and incorporating comments solicited from project advisors on draft recommendations distributed in December 1999;

c) Reviewing, analyzing, and incorporating comments received on revised draft recommendations, at a meeting of the advisory committee on March 28, 2000.

In May 2000, the Commission incorporated the results of this initial work in its report entitled "Recommendations: Information for Injured Workers." Later, the legislative portions of the Commission's recommendations were included in Senate Bill 996. The bill passed in both Houses, but was vetoed by Governor Davis. The Commission's recommendations, however, may be included in future legislation.

1. Discussions with Injured Workers Regarding Informational Materials

Because of deadlines imposed by the legislative session, we were required to complete the work described above prior to obtaining input from injured workers through a series of group discussions. In May and July 2000, we conducted the discussion-group sessions that were part of the original proposal for the project to improve laws and regulations governing information for workers. Because we had already completed our analysis for the Commission regarding problematic statutes and possible legislation, the discussion-group sessions focused on regulatory requirements and desirable improvements in governmental materials and other materials that are given to injured workers. Below, we describe the opinions, preferences, insights, and ideas discussed in the discussion-group sessions.

a. Discussion-Group Participants

Two English-speaking sessions with injured workers were conducted in Berkeley in May 2000. The two groups consisted of six and nine participants, respectively. One Spanish-

speaking session, consisting of injured workers who were not fluent in English, was conducted in San Jos� in July 2000 through a subcontract with Santa Clara University. This group consisted of five participants.

The three groups were recruited through flyers that were made available at state Division of Workers' Compensation offices, union halls, and support group meetings. Each participant read and signed a consent form, as required by federal regulations governing human-subjects research. They were each paid a stipend of $50.00 for their participation.

b. Questions Asked of the Participants

The discussion guide that was prepared and used in the sessions included introductory information describing the project, basic ground rules regarding the confidential and voluntary nature of the project, and key questions to guide the discussions. The key questions delved into the following:

• Content and design of the notice that accompanies the claim form;

• Design and format of a comprehensive guide for injured workers (if developed in the future);

• Content of posters in the workplace and of written information for new employees;

• How best to inform workers who read different languages.

c. Insights and Ideas Obtained from the Participants

The sessions were tape recorded. The Spanish-speaking session was also transcribed and translated into English. We reviewed and analyzed the tapes and the translated transcript.

• Content and Design of the "Notice of Potential Eligibility for Benefits"

In each session, the facilitator described some topics that might be included in the notice of potential eligibility for benefits that accompanies the claim form ("DWC-1"). The topics were derived from the Commission's "Recommendations: Information for Injured Workers," May 2000. They were as follows:

(a) How to request workers' compensation benefits;

(b) Description of different types of workers' compensation benefits;

(c) From whom you can obtain medical care for your injury;

(d) What happens with the claim form after you file it;

(e) Role of the treating physician in workers' compensation;

(f) Rights to select and change the treating physician;

(g) How to get medical care while waiting to find out if you will receive workers' compensation;

(h) Protections against job discrimination;

(i) Right to disagree with decisions, how to contact state Information & Assistance officers, and how to get names of attorneys.

The facilitators asked the participants to name the topics that they felt were the most important ones that should be emphasized on the claim form. The participants were also asked to discuss where they felt the information should be placed, how the form should be designed to encourage workers to read important information on the reverse side of the form (currently on the reverse side of the employee's temporary, green-colored copy), and how the form should be designed to encourage workers to keep their own copies of the form.

Many of the participants felt that information about medical care was critical, including information about where you can obtain care, the role of the treating physician, rights to select and change the treating physician, and how to obtain medical care while a claim is pending. However, each of the other topics was discussed and named as important

by at least one participant. In other words, no topic was considered unimportant by all the participants.

When they were shown that some of the important information was already given on the reverse side of the employee's temporary copy of the claim form, most of the participants expressed surprise and said that they never realized that fact. They named several factors that they felt contributed to this lack of awareness:

• The signature line is on the front side, which allows the employee to complete the form and sign it without having to look at the reverse side.

• The printing on the reverse side is gray and faint, thus giving the impression that it is unimportant.

• Workers filling out the claim form are injured, and therefore less likely to be diligent in reading what appears to be fine print on a form.

In discussing how to increase the chances that important information will be read and that injured workers will keep their copies of the claim form, different participants offered the following ideas:

* Place the important information on the front side of the claim form.

* Give the important information about workers' compensation at the beginning, before the claim-form questions are asked.

* Place the signature line at the end, after the important information has been presented.

* Attach or include the important information on the injured worker's permanent (pink) copy of the claim form, not just on the temporary (green) copy.

* Add a separate sheet that describes workers' compensation rights and procedures, and attach it to the front of the claim form.

* Use legal-size paper (8-1/2 by 14 inches), to allow the notice and the claim form to be presented on one side.

* Add: "Information Very Important" in red ink.

* Add: "Employee: You must [or should] read . . . . " This would be parallel to the statement on the claim form addressed to the employer that says, "Employer: You are required to date this form and provide copies to . . . ."

* Add: "See Over" or "See the Back."

* Add: "This is a legal document. Keep it for your records."

* Print the important information in dark, or bold, type.

* Print the important information in larger type.

 

• Design of a "Comprehensive Guide" for Injured Workers

The facilitators explained that in the future, a comprehensive guide might be developed and given to every worker who receives workers' compensation payments—that is, to workers who receive payments for lost time or permanent disability, but not to workers who only receive medical care. This idea was introduced by State Compensation Insurance Fund in August 1999 in their proposals to simplify the workers' compensation system, and it was incorporated by the Commission in "Recommendations: Information for Injured Workers," May 2000.

The participants were asked to discuss what a comprehensive guide for injured workers should look like, including how big the guide should be and how it should be designed so that injured workers will understand that they should keep it for reference later.

With regard to size, assemblage, and space to record and store personal notes and claim-related documents, no clear consensus emerged among the participants. Many said they would prefer that the guide be designed as a workbook or reference book, consisting of text on letter-size pages (8-1/2 by 11 inches), with blank spaces for personal notes, and assembled into binders to allow insertion of updates and other documents. About an equal number of participants said they would prefer a smaller-size, stapled or bound booklet or pamphlet, because it would be easier to carry around, and that claim-related documents could be stored separately in a folder. Other participants expressed preference for a combination of the above: a larger book or booklet (8-1/2 by 11 inches), with the pages stapled or otherwise permanently bound together, to avoid the guide being dissembled or getting lost.

With regard to visual attractiveness, participants in all three groups offered suggestions. Some emphasized that the guide should be designed to catch people's attention and be "visually grabbing"—"as if the state were trying to sell it." To this end, some suggested glossy paper for the guide's cover, because it would be "motivating" and "uplifting." Some participants said that photographs could be helpful (e.g., photographs of important forms), but that resources should not be wasted on photographs that relay little content (e.g., photograph of a workers' compensation judge).

Participants in one of the discussion groups voiced a compelling request that in developing educational materials, state agencies give injured workers as much respect as they give employers. One of the participants had brought to the session a copy of the Division of Workers' Compensation's new, 52-page booklet entitled "An Employer's Guide to Workers' Compensation in California," dated February 2000. As compared to DWC's 6-page pamphlet entitled "The Injured Worker," DWC's 14 "How To . . . " guides for injured workers on specific legal procedures, and the Commission's seven educational factsheets for workers, the participants felt that the employers' guide is much more attractive (i.e., in color, with a glossy cover and photographs) and gives much more information. They asked us to relay to the state: "Don't denigrate us by giving us something of lower quality than the state gives employers"; "If they can take the time for employers, they should spend the same amount of money for employees."

• Important Topics for All Workers

The facilitators described some topics that might be included in the poster required in workplaces and in the written information required to be given to new employees. The topics, also derived from the Commission's "Recommendations: Information for Injured Workers," May 2000, were as follows:

(a) How to get emergency treatment, if needed;

(b) The events, injuries, and illnesses that are covered by workers' compensation;

(c) Injured employees' right to receive medical care;

(d) Right to select and change the treating physician;

(e) Right to receive different types of benefits;

(f) Who to report to about an injury;

(g) The existence of time limits for reporting an injury;

(h) Protections against job discrimination;

(i) The nearest state Information & Assistance officer.

The participants were asked to name the topics that they felt were the most important ones that should be emphasized on the poster and in written materials for new employees. Again, issues involving medical care seemed to be identified and discussed more frequently than the other issues. However, as with the notice accompanying the claim form, each of the other topics was named and discussed by at least one participant. In fact, participants in two of the sessions said that all of the above topics are important.

• Different Languages

The facilitators explained that in this project, different views had been expressed as to whether the claim form, workplace poster, and other information should be given (1) in both English and Spanish in the same document, (2) in both English and Spanish in different documents, (3) in English only, or (4) in other languages also. The advantage of more languages would be that the information can reach more people; the advantage of presenting multiple languages in one document would be that it avoids the possibility that a worker will be given a document in the wrong language; and the advantage of fewer languages would be that larger type size and design would be allowed, making documents easier to see and understand.

The participants were asked to discuss their opinions as to how the claim form, notice of eligibility for benefits, workplace poster, and other materials should be prepared.

The participants expressed different views with no clear consensus. In the two English-speaking groups, some participants felt that for workers who read English, the claim form should be English-only because there is not enough space for two languages. Some felt that multiple versions of materials should be developed in Spanish and in other non-English languages. It was pointed out that the state Department of Motor Vehicles provides a driver's test in six different languages, for example.

In the Spanish-speaking session, participants felt that workers' compensation materials should be available in more than just English, because it is essential that everyone receive the same information and the same rights. In addition, some of the participants explained out that for Spanish-speaking workers who can read some English, it is helpful when document is written in both Spanish and English, because it allows the reader to compare translations, thus aiding comprehension.

2. Revisions To Improve and Update the Factsheets

To achieve Goal 4, we have evaluated the usefulness of the factsheets through a review of oral and written comments received from members of the workers' compensation community. In addition, we have collected information on changes in addresses, telephone numbers, websites, and other resources described in the factsheets. The results are described below.

a. Usefulness of the Factsheets in the Community

Throughout this project, in conjunction with Commission staff we sought and received comments from representatives of different organizations about their experiences in using the factsheets, opinions regarding the factsheets' usefulness, and suggestions for improving the factsheets. We have compiled comments from the state Division of Workers' Compensation, ten employer organizations, nine insurer or third-party-administrator organizations, five labor unions, five attorney or community-based legal services organizations, four injured worker support groups, four school-related or university-based organizations, and two health care or vocational rehabilitation services organizations.

• Distribution and Use of the Factsheets

Experiences have varied widely. The Information & Assistance offices of the state Division of Workers' Compensation make available and distribute the factsheets throughout California. In addition, they have used the content of the factsheets to develop and produce a six-page DWC pamphlet, "The Injured Worker." They distribute approximately 30,000 copies of the English version of this pamphlet per year throughout California. DWC representatives have expressed on ongoing commitment to working with the Commission in developing and providing useful information to injured workers.

Similarly, representatives from labor unions, community-based legal services organizations, injured worker support groups, and school-related and university-based organizations have reported that they use and distribute the factsheets to their members and clients. Earlier this year, for example, the state Department of Education sent the 2-page "Factsheet for Young Workers" to 820 public high schools and occupational training programs throughout California. Since 1999, LOHP has integrated the same factsheet in workshops given to more than 400 youth employment trainers.

Comments from the above organizations have been positive: "kudos on the terrific factsheets"; "did a great job with the factsheets"; "rave reviews"; "excellent resources"; "the most helpful materials available for injured workers"; "the factsheets answer most of the members' questions about workers' compensation"; "they are great in the way they are written"; "have seen the factsheets help many individuals."

Representatives from employer, insurer, and third-party-administrator organizations, on the other hand, gave responses showing that most of those organizations are not systematically using or distributing the factsheets. The most common reason given was that sending the factsheets would impose additional administrative tasks and postage costs in the handling of claims. Another reason given was that the particular respondent organization had already developed workers' compensation materials that also explained other, employer-specific benefits and that were more tailored to their employees' literacy level.

Despite apparent low utilization by employers and claims administrators, however, most of the opinions relayed by the representatives of these organizations were positive. Representatives said that they or their organizations thought the factsheets were "good" or were a "vast improvement" over previously available materials. In contrast, a few representatives gave negative comments about the factsheets' "tone," expressing fear that distribution of the factsheets would create an issue in the DWC auditing process and concern that the factsheets "would encourage litigation."

Standard Register, a company that sells printed copies of the factsheets, gave us some partial data on their productions and sales (as of November 1, 2000). Factsheet #1 ("What Every Worker Should Know") has been the most popular. This year Standard Register has been selling over 200 copies per month, on average, of the English version of this factsheet and over 1,500 copies per month, on average, of the Spanish version of this factsheet. Each of the other factsheets are being sold at rates of 50 to 250 copies per month, on average.

• Suggestions on Design, Format, and Content

Suggestions were offered on how to improve the design, format, and content of the factsheets. The most common suggestion was to consolidate the factsheets into one document: a handbook, booklet, or binder. The purposes of consolidation would be to avoid piecemeal receipt of important information, reduce the volume and clutter of paperwork that workers must track and maintain, and avoid workers not receiving the right factsheet. This suggestion was made by representatives from the DWC and from employer, claims administrator, injured worker, and community-based legal services organizations.

One employer representative recommended that the online versions of the factsheets (available at the Commission's website) be provided in a format that can be revised electronically after being downloaded, to encourage customization by distributors.

Representatives from a labor union and an injured worker support group recommended that the factsheets be made available in other languages spoken by California workers besides English and Spanish. Representatives from a community-based legal services organization and a health care organization said that if the materials were written in Chinese, they would be very useful for their Chinese-speaking clients.

Some representatives offered suggestions to clarify or make more accurate the content of the factsheets, including the following:

• Clarify that when the employer is self-insured, the term "claims administrator" can refer to a person who is not from an insurance company. (Possible language: "Some claims administrators work for employers, and some work for insurance companies or other organizations that handle workers' compensation claims for employers.")

 • Further explain the relationship between workers' compensation and other legal systems and benefits that are available to injured workers, such as State Disability Insurance.

• When referring the reader to the "Keep Your Claim on Track" page, replace "For more information, . . . ." with "For sources of information, . . . . ," because this page lists sources of information rather than the information itself (Factsheets #2, #3A, #3B, and #3C).

Finally, some representatives offered suggestions in areas where information seems incomplete, as follows:

• Add a qualifying statement that with late payments, the claims administrator is not required to pay an additional 10% of the payment if the worker had not previously filed a claim form (Factsheets #3A, #3B, and #3C).

• Add a qualifying statement that payments for temporary total disability cannot be paid if the worker is receiving wages from another employer (Factsheet #3A).

• Add that if you settled your case through stipulations with request for award and your condition gets better, the claims administrator has a right to request reduction in benefits (Factsheet #3B). Currently the factsheet only states that if your condition gets worse, you have a right to request additional benefits. These statements do not apply to cases settled through a compromise and release.

b. Updating the Content of the Factsheets

In summer and fall 2000, we compiled information on changes in names, titles, addresses, and telephone numbers, and changes in the availability of written materials and other resources. We also obtained the addresses of websites that have useful information. The information listed on the following pages was in effect as of November 1, 2000.

• Terms and Phrases

"Workers' Compensation Administrative Law Judge." The factsheets describe the role of a "Workers' Compensation Referee." This term has been replaced with the term "Workers' Compensation Administrative Law Judge." Division of Workers' Compensation representatives have requested that where this term appears for the first time in a factsheet, the full five-word title be used. Thereafter, the three-word term, "workers' compensation judge," can be used. (This would be consistent with both terms being used in Labor Code sections 27, 123.5, and 123.6.)

"Website." The factsheets refer to the "Web site" of different organizations. Since the time that the factsheets were originally produced, conventional ways to spell and capitalize the term "website" have evolved. Over time, the term has been combined into one word, and it is no longer capitalized.

• Availability of Books and Other Resources

"Workers' Compensation" Book. Factsheet #4 ("For More Information") lists Workers' Compensation, which is a reference book for legal assistants. This book is no longer in print, nor is it widely available in libraries.

"Basic Stuff" Book. Factsheet #4 lists Basic Stuff, which is a "survival guide" for injured workers. This book is available only on a limited basis, and the telephone number that is listed for readers to purchase the book is no longer in effect.

Information & Assistance Workshops. On the "Keep Your Claim on Track" pages, the factsheets say that Information & Assistance officers "hold workshops around the state." This is no longer true. The workshops are now offered at district offices at the discretion of the Presiding Judge. Therefore, in describing I&A officers it would be more accurate to state that "some I&A officers hold workshops for injured workers."

Injured Worker Support Groups. Factsheet #4 lists two organizations that give information and support to injured workers (Association for Repetitive Motion Syndromes and Compensation Alert). Those organizations' telephone numbers are no longer in effect. Instead, CTD Resource Network, Inc., maintains a website that lists injured worker support groups. They have agreed to be listed in the factsheets as follows:

"These groups share practical information and provide support for people with job injuries. For information about support groups and other resources for injured workers, view the following website of the CTD Resource Network, Inc.: www.tifaq.org. Through this website, link to: General Information/Support Groups."

• Addresses, Telephone Numbers, Websites, and Book Editions

References to Phone Book Listings. Throughout the factsheets, the reader is instructed to contact a particular governmental agency by looking in "your" phone book. Division of Workers' Compensation representatives have pointed out that in some remote areas, telephone directories do not contain listings to all of these governmental agencies. Therefore, it would be more accurate to instruct the reader to look in "a" phone book.

State Bar of California. The State Bar of California is listed on the "Keep Your Claim on Track" pages of the factsheets and on page 5 of Factsheet #4 ("For More Information"). The telephone number of the State Bar department that certifies workers' compensation attorneys has changed to 1-415-538-2100. In addition to this telephone number, the State Bar lists certified workers' compensation attorneys at their website, www.calbar.org (link to: Legal Specialization).

California Applicants' Attorneys Association. The California Applicants' Attorneys Association is listed on the "Keep Your Claim on Track" pages of the factsheets and on page 5 of Factsheet #4. CAAA's telephone number for injured workers is still in effect. In addition, CAAA lists applicants' attorneys at their website, www.caaa.org (link to: Members).

Medical Evaluation Guides for Workers. Factsheet #3B ("Permanent Disability") instructs the reader to call the state Industrial Medical Council and ask for their written guides, "Your Medical Evaluation" and "Getting Your Medical Evaluation," and also to see the Department of Industrial Relations website. The guides are still available in both English and Spanish. However, they have not yet been listed at the IMC's website (as of the date of this report). Therefore, it may be more accurate to qualify the reference to the website by stating, "For more information about the IMC, see the Department of Industrial Relations website: www.dir.ca.gov."

Schedules for Rating Permanent Disability. Factsheets #3B and #4 describe two schedules that are used to rate permanent disabilities. To buy a copy, the reader is instructed to call the California Department of General Services. The telephone number of that department has been changed to 1-916-928-4630.

Division of Workers' Compensation. Factsheet #4 lists all of the district offices of the Division of Workers' Compensation. Since the time that the factsheets were originally produced, some of these offices have changed locations or closed, and some have new telephone numbers. The current information is available through the Department of Industrial Relations website, www.dir.ca.gov (link to: Workers' Compensation/Division of Workers' Compensation).

Industrial Medical Council. Factsheet #4 instructs the reader to call the IMC's main toll-free number if there is a problem with a QME or a QME report. The IMC now has a separate toll-free number for investigating complaints about QMEs, 1-800-999-1041.

Occupational Health Clinics. Factsheet #4 lists the Association of Occupational and Environmental Clinics and gives its telephone number. AOEC also has a website that lists occupational health clinics in California, www.aoec.org (link to: Clinic Member Roster).

California Division of Occupational Safety and Health. Factsheet #4 instructs the reader on how to look up the state Division of Occupational Safety and Health in the telephone book. DOSH also has a website that lists district offices, www.dir.ca.gov (link to: Occupational Safety & Health).

Labor Occupational Health Program, UC Berkeley. Factsheet #4 lists LOHP's telephone number. In addition, LOHP now has a website that has information for workers, unions, and other organizations, www.lohp.org.

Labor Occupational Safety and Health Program, UCLA. Factsheet #4 lists LOSH's telephone number. That number has been changed to 1-310-794-5964.

California Employment Development Department. Factsheet #4 gives instructions on how to look up local EDD offices in the telephone directory. In addition, EDD now has a toll-free number, 1-800-480-3287, and a website that lists their local offices, www.edd.ca.gov.

U.S. Social Security Administration. Factsheet #4 lists SSA's toll-free number and gives instructions on how to find local offices in the telephone directory. SSA also has a website that lists their local offices: www.ssa.gov.

Employment Attorneys. Factsheet #4 instructs a reader facing discrimination on how to get names of attorneys who specialize in employment law. In addition to the organizations that are listed in the factsheet, the reader can be instructed to check the yellow pages of a phone book and look under: Attorney Referral Service.

U.S. Equal Employment Opportunity Commission. Factsheet #4 lists EEOC's toll-free number and gives instructions on how to find local offices in the telephone directory (i.e., by looking under United States Government Offices). It would be helpful if the reader were also instructed to look under the heading, "Discrimination" (e.g., Look under: United States Government Offices/Discrimination). In addition, EEOC has a website that lists their local offices, www.ssa.gov.

California Department of Fair Employment and Housing. Factsheet #4 lists DFEH's toll-free number and gives instructions on how to find local offices in the telephone directory. DFEH also have a website that lists their local offices, www.dfeh.ca.gov.

Nolo Press Book. Factsheet #4 lists the first edition of the Nolo Press book for injured workers on workers' compensation. The current version is now entitled, Take Charge of Your Workers' Compensation Claim, 2nd edition, by Christopher A. Ball, 2000. The factsheet lists Nolo Press' toll-free number, which is still in effect. In addition, Nolo Press has a website that describes its publications, www.nolo.com.

"California Workers' Compensation Practice" Reference. Factsheet #4 lists the 1996 edition of California Workers' Compensation Practice. This comprehensive reference for attorneys is now in its fourth edition, dated 2000. Because different authors wrote different chapters of the fourth edition, credit is now simply given to the Continuing Education of the Bar, California.

"Navigating the California Workers' Compensation System" Report. Factsheet #4 lists the Commission's report, "Navigating the California Workers' Compensation System: The Injured Worker's Experience," 1996. The reader is instructed to call the Commission for a free copy. The Commission's telephone number has changed to 1-415-703-4220. In addition, the report can be viewed through the Department of Industrial Relations' website, www.dir.ca.gov (link to: Workers' Compensation/Commission on Health and Safety and Workers' Compensation).

The input obtained from discussion-group participants on how to improve some of the materials given to injured workers and the suggestions offered by members of the workers' compensation community on how to improve and update the factsheets are described in this report. These activities complete our Benefit Notices and Educational Materials Projects. The input and suggestions described above can be used by the Commission, the Division of Workers' Compensation, and the workers' compensation community in ongoing efforts to improve workers' compensation information for workers, as discussed below.

• Enforcement of Employers' Informational Requirements

The discussion-group participants further confirmed that basic information about workers' compensation is needed both before injury and soon after injury, and that informational requirements applicable to employers need to be enforced. It is widely perceived that many employers do not comply with existing legal requirements to post information about workers' compensation, give workers' compensation information in writing to new employees, and provide a claim form and "notice of potential eligibility for benefits" to an injured worker within one working day of knowledge of the injury, and that lack of early information contributes to problems later in a claim. It appears that no governmental agency directly enforces these requirements.

We recommend that these requirements be enforced. Possible options are discussed on pages 11-12 of the Commission's "Recommendations: Information for Injured Workers," May 2000.

• Notice of Potential Eligibility for Benefits

The discussion-group participants further confirmed that soon after injury, workers need practical, instructional information on rights and procedures in workers' compensation. (This need was described in our report of September 9, 1999, and in the Commission's "Recommendations: Information for Injured Workers," May 2000.) The participants also pointed out that this information, some of which appears in gray print on the reverse side of the employee's temporary copy of the claim form, needs to be made more noticeable.

We recommend that steps be taken to address the deficiencies in the completeness and visibility of this notice. This would be through careful review, selection, and implementation of some of the ideas offered by the discussion-group participants, which are listed on pages 8-9 of this report.

Revisions to the current notice and the circumstances under which the notice must be given to an injured worker could be effected by changes to sections 138.4 and 5401 of the California Labor Code and changes to section 10118 of title 8 of the California Code of Regulations (which was adopted to implement provisions of Labor Code section 5401). (NOTE: Because many of the discussion-group participants felt that the notice should not be on the reverse side of the claim form, the legislation that was proposed in the Commission's "Recommendations: Information for Injured Workers," May 2000, may need to be revised to give DWC flexibility in determining how, physically, this notice will be incorporated as part of the claim form.) Alternatively, the notice could be revised by changing only the regulation.

• Comprehensive Guide for Injured Workers

Many members of the workers' compensation community have promoted and supported the idea of consolidating the contents of the educational factsheets into one document, or "comprehensive guide," for injured workers (see page 13, above). It is believed that consolidation would make it easier for organizations such as the Information & Assistance offices of the Division of Workers' Compensation, claims offices, and community-based groups to distribute the information to workers, and that it would also make it easier for workers to read, keep, and refer to the information when needed. In addition, consolidation might ameliorate concerns of some employers and claims administrators over increased administrative costs and increased risk of DWC audit penalties.

The contents of a comprehensive guide for injured workers should include the topics listed on pages 7-8 of the Commission's "Recommendations: Information for Injured Workers," May 2000. In addition, suggestions for revising the content of the factsheets, described on pages 13-14, above, and information on changes to update the factsheets, listed on pages 14-18, above, can be used in developing this guide.

We recommend that serious consideration be given to the discussion-group participants' request that a guide for workers be developed that is as comprehensive, attractive, and readily available as the Division of Workers' Compensation's new guide for employers (see page 10, above). DWC representatives have estimated that approximately 100,000 copies of the employer guide were produced and distributed in the 8-month period February through September 2000.

A comprehensive guide for workers, to be published or approved by DWC and distributed by claims administrators, could be specified through changes to sections 138.4 and 139.6(a) of the California Labor Code. Alternatively, these sections of the Labor Code currently give sufficient authority for DWC to publish or approve a comprehensive guide (if prepared as a pamphlet). In addition, sections 9810(d) and 9882 of title 8 of the California Code of Regulations, which require claims administrators and employers to distribute a "general benefits information pamphlet," could be revised to be consistent with sections 138.4, 139.6(a), and 5401 of the Labor Code (as revised).

• Important Topics for All Workers

The discussion-group participants further confirmed that all workers need more information about workers' compensation than is currently provided. (This need was described in our report of September 9, 1999, and in the Commission's "Recommendations: Information for Injured Workers," May 2000.)

We therefore recommend that requirements concerning the workplace poster and written information for new employees be revised to include all of the topics listed in the Commission's recommendations.

Revisions to the workplace poster and to written information for new employees could be effected by changes to sections 3550 and 3551 of the California Labor Code and changes to sections 9880 and 9881 of title 8 of the California Code of Regulations (which were adopted to implement provisions of Labor Code sections 3551 and 3550, respectively). Alternatively, the poster and written information for new employees could be revised by changing only the regulations.

• Different Languages

The language issues discussed by some members of the workers' compensation community and some of the discussion-group participants merit further study. One participant pointed out that six different languages are used by the state Department of Motor Vehicles for their driver's test. Similarly, election materials for voters in California are available in Chinese, Japanese, Spanish, Tagalog, and Vietnamese, as well as English.

We recommend that further study be undertaken to determine the best way to ensure that non-English-speaking workers have access to understandable workers' compensation materials.