California workers' compensation insurance: Your ultimate resource

Who is covered?

Policies include protection for full and part-time employees.

Some exemptions from workers’ comp in California may include, for example:

• Sole proprietors and business owners (excluding roofers)
• Workers who receive food and shelter as compensation
• Volunteer workers, including nonprofit volunteers
• Deputy sheriffs and deputy clerks
• Amateur sports officials 

Covered injuries and illnesses

Workers' compensation covers a range of work-related injuries and illnesses, including physical injuries resulting from an accident and occupational diseases that may develop over time due to job conditions. 

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Benefits provided

California workers’ comp insurance provides three types of benefits for work injuries:

• Medical benefits
• Lost wages 
• Death benefits

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These benefits include:

• Medical treatment for work-related accidents, injuries and/or illnesses 
• Mileage reimbursement for travel to get treatment
• Temporary disability benefits 
• Permanent disability benefits
• Benefits for funeral expenses and surviving dependents

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California workers’ compensation rates

The weekly compensation rate in California is 66 ⅔% of the employee’s average weekly wage, not to exceed or fall below a maximum and minimum amount set by the law. 

Find more information on California’s disability rates.

Filing a workers' compensation claim

In the event of a work-related injury or illness: 

Step 1: Employee reports injury to employer 

Employees in California should report their injury to their employer immediately but no later than 30 days from the accident.

Step 2: Seek medical care

The employee should immediately seek medical attention. 

Step 3: Employer reports injury

Once notified of the injury, employers should file a report of the accident with their workers' compensation insurance partner within one working day.

Step 4: Receive benefits

If the workers’ compensation claim is accepted, an injured employee may begin to receive workers’ compensation benefits, such as lost wages and medical benefits.

Step 5: Return to work

Following their recovery, a worker is expected to resume work safely. If a work injury has left an injured employee unable to do any type of work, the employee might be entitled to permanent disability benefits.

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Choosing a healthcare provider 

In California, workers can predesignate a physician as their treating doctor if they notify their employer of their doctor’s name and address in writing before the workplace injury.

Some employers may use a medical provider network or healthcare organization. In this instance, the injured worker must receive treatment from a physician within the network or organization. If the employer does not use a medical provider network or healthcare organization, in most cases, the claims administrator can choose the initial treating physician.  

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Compensation for missed work

If an employee is off work:

• Less than three days: They are not eligible for temporary disability payments. 
• More than three but less than 14 days: They are eligible for lost time benefits beginning on the fourth day. 
• More than 14 days: They are eligible for benefits retroactive to the first day they stopped work.   

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Resolving disputes

If an employee or employer wishes to dispute a claim, they can contact the Information and Assistance Unit for information concerning rights, benefits and obligations under California’s workers’ compensation law.