New California State Claim Reporting Requirements Beginning January 1, 2017

Posted on

January 16th, 2017


shutterstock_250505056 - CopyThe State of California recently amended the California Workers’ Compensation Uniform Statistical Reporting Plan. As of January 1, 2017 it now requires insured employers to report first aid claims to their claims administrators. This does not apply to self-insured organizations that handle claims in-house.
Common types of workers’ compensation claims include:

  • First Aid Claims, described by the California Labor Code as those involving a single treatment and subsequent observation of a minor injury. This might include antiseptics, bandaging and non-prescription medication.
  • Incident Only Claims are actually not claims at all, but rather documentation of an incident that does not result in any treatment or disability.
  • Indemnity Claims involve exposure to indemnity benefits (temporary or permanent disability).
  • Medical Only Claims involve treatment which exceeds the definition of first aid but does not involve any indemnity exposure. A medical only claim can cover a maximum of 3 days of lost time.

Common practice has been for employers to handle first aid in-house, without documentation. This can save time and have a positive effect on experience mods (and therefore insurance premiums). This change in policy suggests that the State of California now considers these hazards relevant to the overall safety conditions of a workplace. To learn more about how these changes could affect your organization, contact us.