Scott
Scott Hauge
President
Small Business California
2311 Taraval Street
San Francisco, CA 94116
shauge@cal-insure.com
415-680-2188
California Workers’ Compensation Institute
BULLETIN
1111 Broadway #2350, Oakland, CA 94607 (510) 251-9470 http://www.cwci.org/
August 17, 2010
No. 10-20
As of October 8, California employers must begin distributing an updated version of the workers’ compensation new hire pamphlet to all employees hired on or after that date; post revised workers’ compensation employee posting notices; provide an updated version of the DWC-1/Notice of Potential Eligibility to injured workers and post new Medical Provider Network (MPN) notices if they use an MPN.
The MPN notice regulations developed by the Division of Workers’ Compensation and approved last week by the Office of Administrative Law affect several different California workers’ compensation notices. First, the revised MPN employee notification requirements found in CCR §9767.12 require that “Before MNP coverage is implemented, the complete written MPN employee notification shall also be posted in both English and Spanish in a conspicuous location frequented by employees during the hours of the workday and in close proximity to the workers’ compensation posting required under section9881.”
California Workers’ Compensation Institute
BULLETIN
1111 Broadway #2350, Oakland, CA 94607 (510) 251-9470 http://www.cwci.org/
August 17, 2010
No. 10-20
As of October 8, California employers must begin distributing an updated version of the workers’ compensation new hire pamphlet to all employees hired on or after that date; post revised workers’ compensation employee posting notices; provide an updated version of the DWC-1/Notice of Potential Eligibility to injured workers and post new Medical Provider Network (MPN) notices if they use an MPN.
The MPN notice regulations developed by the Division of Workers’ Compensation and approved last week by the Office of Administrative Law affect several different California workers’ compensation notices. First, the revised MPN employee notification requirements found in CCR §9767.12 require that “Before MNP coverage is implemented, the complete written MPN employee notification shall also be posted in both English and Spanish in a conspicuous location frequented by employees during the hours of the workday and in close proximity to the workers’ compensation posting required under section9881.”
Because the details on this “complete written MPN employee notification” are MPN-specific, claims administrators are scrambling to make sure these notices are ready for employers to post by the October 8 effective date. In addition, however, the recently adopted regulations require MPN information to be added to the workers’ compensation new hire pamphlets, the general workers’ compensation posting notices, and to the DWC-1/NOPE, so all of these materials are also being revised to reflect the new rules that take effect in less than two months.
Under the California Labor Code and state regulations, insured and self-insured employers are required to inform their employees of their workers’ compensation rights and obligations by posting state-approved notices (LC § 3550) and providing pamphlets to new hires (LC § 3551). The law specifies that insurers shall provide these notices to their policyholders with advice concerning the posting requirements and the penalties for failure to post and supply the information to employees [LC §§3550 (f) and 3551(c)]. Failure to provide the information can result in loss of employer medical control [LC §3550 (e)], civil penalties of up to $7,000 for each violation of the posting requirement [LC §6431], and toll the statute of limitations for filing a claim.
State regulations allow private enterprises to prepare and publish the posting notice or pamphlets if approved by the DWC, so for many years, insurers, employers and others have relied on CWCI to produce these materials and keep them current. Following the adoption of the regulations last week, CWCI submitted revised versions of its new hire pamphlet, “Facts About Workers’ Compensation,” and its posting notice, “If A Work Injury Occurs” for DWC review and approval. Once the approvals are given, CWCI will typeset, print and copyright the updated publications. To meet LC §3551(b) and CCR§9883(e), CWCI will also translate and print the revised pamphlets and posting notice in Spanish. In addition, the Institute will continue to produce the DWC-1/NOPE as a 5-part form, reformatted with the revised Notice of Potential Eligibility as a cover sheet.
Under the California Labor Code and state regulations, insured and self-insured employers are required to inform their employees of their workers’ compensation rights and obligations by posting state-approved notices (LC § 3550) and providing pamphlets to new hires (LC § 3551). The law specifies that insurers shall provide these notices to their policyholders with advice concerning the posting requirements and the penalties for failure to post and supply the information to employees [LC §§3550 (f) and 3551(c)]. Failure to provide the information can result in loss of employer medical control [LC §3550 (e)], civil penalties of up to $7,000 for each violation of the posting requirement [LC §6431], and toll the statute of limitations for filing a claim.
State regulations allow private enterprises to prepare and publish the posting notice or pamphlets if approved by the DWC, so for many years, insurers, employers and others have relied on CWCI to produce these materials and keep them current. Following the adoption of the regulations last week, CWCI submitted revised versions of its new hire pamphlet, “Facts About Workers’ Compensation,” and its posting notice, “If A Work Injury Occurs” for DWC review and approval. Once the approvals are given, CWCI will typeset, print and copyright the updated publications. To meet LC §3551(b) and CCR§9883(e), CWCI will also translate and print the revised pamphlets and posting notice in Spanish. In addition, the Institute will continue to produce the DWC-1/NOPE as a 5-part form, reformatted with the revised Notice of Potential Eligibility as a cover sheet.
Beyond these mandatory notices, the Institute is also updating its injured worker pamphlet, “Facts For Injured Workers” to reflect current TD rates and add MPN information. Although the 2002 reform bill (AB 749) eliminated the statutory requirement that claims administrators include a pamphlet explaining a worker’s benefits and obligations with the first notice of payment or notice of delay (LC §138.4), many companies continue to use “Facts For Injured Workers” as a way to provide claimants with basic information early in the life of the claim. The “Facts For Injured Workers” also can be used to meet the Insurance Code §1871.8 notice requirement on fraudulent receipt of temporary disability, and the LC §3553 notice requirement for victims of workplace crime. This pamphlet is available in English and Spanish as well.
Insurers, employers, TPAs, agents and brokers, and others who need to order the revised pamphlets and posting notices, as well as the revised DWC-1/Notice of Potential Eligibility may now do so by visiting the Institute’s online “Store” at http://www.cwci.org/ and placing a pre-order. Pending the DWC approvals, the Institute expects to have all of these materials ready for shipping by mid-September. In the meantime, the Institute will continue to stock the current notices and claim forms that should be used until October 7, and as a service to the community, has reduced the minimum order requirement so anyone needing a limited supply of the current materials to meet their interim needs can order them in smaller quantities. For further information regarding ordering, call Fran Perry at CWCI (510) 251-9470.
Information on these new notice requirements, as well as other recent regulatory changes, will be covered in an upcoming CWCI seminar, tentatively scheduled for mid-October. Specific dates and locations will be announced soon and posted in the seminar section of the Institute web site.
BY/
Copyright 2010, California Workers’ Compensation Institute
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