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Worker's Compensation

Worker's Compensation

What is Workers’ Compensation?
Workers’ Compensation is a state-mandated program that compensates employees when they suffer a job-related injury or illness. Compensation includes payments for wage loss, medical expenses and physical therapy.

Who should I contact if I’ve suffered a job-related injury or illness?
The employee should contact their supervisor first. Your supervisor will obtain the required forms, make sure they’re completed and returned to Human Resources. If your supervisor is not available you can also contact Human Resources.

Where can I find the workers’ compensation forms to file a claim?
Instructions and claim forms can be found on the Human Resources website.

Will my claim be automatically approved?
Intercare Holdings Insurance Services, Inc., the County’s Third Party Adjuster, reviews all claims that are submitted. If a claim is placed on Delay, Intercare has up to 90 days to investigate the claim before they approve the claim or issue a denial. During this time frame, medical bills typically will be covered up to $10,000 with some limited exceptions; wage loss will not be paid until the claim is approved. Please note that all claims submitted for stress are placed on Delay and are investigated.

Does Workers’ Compensation just cover my medical bills?
Workers’ Compensation will cover medical bills and wage loss for approved claims. Workers’ Compensation Wage loss is paid on your regular County paycheck but like SDI, it is not employment compensation.

Does Workers’ Compensation cover my time when I have my physician appointments?
No. Employees are to use their accruals (sick leave, vacation) when they have a physician appointment during working hours. Occupational Medicine Clinics are also open evenings and weekends.

Can I see my physician for my injury?
If you have a completed Physician Pre-Designation Form in your medical file and he/she accepts workers’ compensation, you can see your physician. Otherwise, you must see a physician that is in the Medical Provider Network. Monterey County Medical Provider Network can be accessed at www.intermedccs.com\commpn

The physician has given me work restrictions. What does that mean?
 If the physician reports that you can return to work under specific work restrictions, any work assigned to you must meet these restrictions. Your supervisor will work with Human Resources to identify appropriate work within your restrictions. You might change certain tasks or utilize helpful equipment, for example. If work is not available that meets your restrictions, you will not be able to return to work until work that fits within your restrictions is available and/or your restrictions are modified or lifted.

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