Worker's Compensation in San Diego, CA

Workers' Compensation protects your employees should an injury occur during the course of employment. Payments are made to the injured party and can consist of medical payments, loss of wages or therapy.
All states require all employers to carry Worker's Compensation insurance and each state has individual standards that must be met.
At the very minimum, Workers' Compensation insurance policies will cover an employee's medical expenses and reimburse him or her for some percentage of lost wages.
Almost all states are "open market", which means the coverage is underwritten by private insurers; and some states are "closed" or "monopolistic" - the coverage is underwritten by a state-sponsored fund (ND, OH, WA, WV, WY). In states that are open, rates can vary between insurance carriers depending on the type of business the carrier is attempting to attract. In an open market, the rates for workers' compensation are competitive.
Employers with one or more employees are subject to the provisions of their states Disability Benefits Law. This law provides benefits to employees who may become disabled because of injuries/sickness off the job or that may arise from other conditions such as pregnancy. Payments for these types of benefits are only allocated for the payment of wages... unlike that of workers' compensation which provides payment for medical costs.
Rates for these policies are dependent on the degree of hazard that each occupation carries. Each occupation is coded and defined by state laws. Premiums are determined by the amount of payroll in each occupation code and is subject to annual audit for verification.
Recommendations - Please hire a professional payroll service and keep handy your "941 Forms" each quarter of the year your payroll services will send you a copy. These documents will come in handy when you get an audit from your Workers' Compensation.
Below are links to information on filing claims, customer service and the audit process for insured with FirstComp policies. You may also visit and then select "Services" and then "Claims".
Save up to 45% combining workers' compensation with your payroll services.
For more information call us at 866-610-0616
Understanding California's Experience Modification Formula
“Common misconceptions of Experience Rating”
• Once a claim is greater than $7,000 you no longer need to be concerned about the value of
• that claim.
• The ex-mode formula has a “claim counter” in the calculation, so a claim that is valued at
• $0 will adversely impact your Business Ex-mode Factor.
• You have no control over your Business Ex-mode factor.
The basic Objectives of experience rating are to:
• Distribute the costs of worker's compensation equitably among employers assigned to an industry classification.
• “Benchmark” your Business against other Companies of similar size, with similar operations
• Provide incentives to reduce work related accidents.
Experience Rating Form Header:
BUREAU NUMBER: the # assigned by the WCIRB ( Worker's Comp Insurance Rating Bureau)
EFFECTIVE DATE: The effective date on this experience modification
INSURER: normally your current Worker's Comp Insurance Carrier
CLASS CODE: Indicates the job/industry Insured operates in and is used to more accurately compare data by job/industry
PAYROLL: Indicates the payroll by class code for the stated period.
EXPECTED LOSS RATE: rate per $100 of payroll, used to determine the expected losses by class code
EXPECTED LOSSES: expected loss dollars by class code.
“D” RATIO: Discount Ration is the percent of expected losses less than or equal to $7,000
EXPECTED PRIMARY LOSSES: Expected loss dollars, by class code, less than or equal to $7,000
EXPECTED EXCESS LOSSES: Insured's expected Severity portion of their total loss dollars
CLAIM NUMBER: Claim # assigned by Carrier
INJURY TYPE/#CLAIMS: 2 digit injury type code for losses over $2,000 or number of claims under $2,001
OPEN/CLOSED: Status of Claim(s)
ACTUAL LOSSES: The actual dollar value of the claim, it includes paid & outstanding amounts
ACTUAL PRIMARY LOSSES: Portion of actual loss that is considered “frequency” The actual loss value is used if the amount is $7,000
ACTUAL EXCESS LOSSES: Considered to be the actual “severity” portion of the claim.
Steps to improve your Business Ex-Modes
• Establish “top-down” commitment to safety.
• Safety should be emphasized by management on daily basis & included in performance reviews.
• Clearly define & assign responsibilities & accountabilities
• Supervisors & managers should be accountable for safety orientation, training & inspections
• Establish program objectives &measure performance
• Executives have established loss reduction goals, managers have departmental goals that are in line with safety action goals.
• Understand role of the safety staff or consultant
• Guide, assist train & consult with line managers in achieving safety goals.
• Create supervisory involvement, include accident investigation, inspections
• Employee safety training & safety meetings
• Thoroughly evaluate all employees, stress your safety culture, include employee input/feedback & provide incentives & recognition
• Provide adequate training, safety training should be frequent, effective, job specific, well documented & easily understood.
• Promote consistent enforcement of safety rules to managers, executives & visitors.
• Implement return to work programs and best practices to minimize abuse & fraud.