Chapter 1: California Workers' Compensation History

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Questions and Answers

What is a defining characteristic of workers’ compensation benefits compared to group health coverage?

They include arbitrary limits on treatment covered.

They are always greater than health insurance benefits.

They have no arbitrary limits on frequency, duration, or extent of services. (correct)

They cover only temporary injuries.

Which of the following injuries is covered by workers’ compensation under the no fault rule?

An injury resulting from employer misconduct.

An injury caused by a workplace accident. (correct)

A self-inflicted injury.

An intentional act of harm by an employee.

What occurs to benefits for injuries resulting from the serious and willful misconduct of the injured employee?

Benefits are reduced by half. (correct)

Benefits are increased by half.

Benefits are completely revoked.

Benefits remain unchanged.

In which situation is the employee's compensation increased by half?

When the employer has committed serious and willful misconduct. (A) Signup and view all the answers

What is necessary for penalties related to serious and willful misconduct to be imposed?

The Workers’ Compensation Appeals Board must find serious and willful misconduct. (A) Signup and view all the answers

Which aspect of the workers’ compensation system has seen evolution due to rising costs?

Legal measures regarding claims handling and medical evaluations. (D) Signup and view all the answers

What were some of the issues addressed by measures enacted in 1989 and 1993 regarding workers’ compensation?

Medical legal examination fees and fraud deterrence. (B) Signup and view all the answers

Which of the following is NOT a factor considered under the Labor Code for penalties relating to serious and willful misconduct?

The employee's history of prior injuries. (A) Signup and view all the answers

What was a significant barrier for injured workers pursuing civil tort actions before the establishment of workers' compensation systems?

The high costs of pursuing claims meant few could afford legal representation. (D) Signup and view all the answers

Which act required most employers in California to secure workers' compensation coverage?

The Boynton Act (A) Signup and view all the answers

What major event prompted California to pass its first workers' compensation act in 1911?

A devastating fire at the Triangle Shirtwaist Company factory. (B) Signup and view all the answers

What did the Workers’ Compensation Insurance and Safety Act of 1917 emphasize regarding permanent disability assessment?

The ability of an injured employee to compete in the labor market should be a factor. (C) Signup and view all the answers

What change was made in 1951 regarding the assessment of permanent disability in California's workers' compensation system?

Obvious physical impairments and subjective factors like pain were considered. (D) Signup and view all the answers

What significant coverage expansion has occurred over the years in California's workers' compensation system?

Inclusion of all employees, including farm workers and domestic workers. (A) Signup and view all the answers

Before the development of workers' compensation systems, why was proving employer negligence challenging for workers?

Workers often assumed risks unknowingly and could be blamed. (C) Signup and view all the answers

Which of the following statements correctly describes a feature of the ‘No Fault’ rule in workers' compensation systems?

Workers are automatically granted compensation regardless of fault. (B) Signup and view all the answers

What is one key aspect of the workers’ compensation system for employees?

It provides temporary payment for lost wages and medical treatment for work-related injuries. (B) Signup and view all the answers

What is meant by the 'No Fault' aspect of the workers' compensation system?

Employers must pay benefits regardless of who caused the injury. (D) Signup and view all the answers

What does the Exclusive Remedy component of the workers' compensation system entail?

Injured workers cannot sue their employer unless they are uninsured. (A) Signup and view all the answers

Which of the following benefits is assured through the workers’ compensation system?

Defined benefits that the employer must pay. (B) Signup and view all the answers

What trade-off does the historic compromise in workers' compensation represent?

Employees give up the right to sue for any injuries in exchange for guaranteed benefits. (A) Signup and view all the answers

Which group of employees is excluded from California's workers’ compensation system?

Federal employees. (C) Signup and view all the answers

Why might a civil action take longer to resolve compared to a workers' compensation claim?

Civil actions require a jury trial for resolution. (C) Signup and view all the answers

What is a potential additional recovery available to employees under certain circumstances?

Claims against third parties responsible for the injury. (C) Signup and view all the answers

Study Notes

California Workers' Compensation System

Workers' compensation systems were established in the early 20th century.
Prior to this, injured workers had to sue employers, often failing to prove negligence or facing employer defenses.
The Triangle Shirtwaist Factory fire in 1911 led to California passing its first workers' compensation act.
The Boynton Act (1913) initially allowed employers to opt for workers' compensation.
The 1917 Workers' Compensation Insurance and Safety Act revised the previous act, noting consideration of the injured employee's reduced ability to compete in the job market.
Laws subsequently broadened required coverage to include more employees, like farm workers, domestic workers, and prison inmates.

Historic Compromise

The workers' compensation system trades the right to sue for compensation in court for guaranteed prompt compensation.
Employees trade potential high court awards for definite, faster benefits.
The compromise has three components: no-fault system, exclusive remedy, and assured and fixed benefit.

No-Fault System

Employers are responsible for paying benefits regardless of fault in work-related injuries.
This protects employers from potentially large lawsuits.
Exceptions exist for self-inflicted injuries, serious/willful employee misconduct, employer misconduct, and injuries to minors.

Exclusive Remedy

Injured workers are unable to sue their employers for further damages beyond workers' compensation, unless the employer is uninsured.
This excludes responsibility for any other parties (third parties) involved in the work-related injury.

Assured and Fixed Benefit

Workers' compensation systems have defined, payable benefits.
Workers' compensation awards tend to be lower than those achievable through a court process.

Evolution of California's Workers' Compensation System

Attempts to control costs have driven evolution.
Measures have addressed medical evaluations, physician-related fees, medical provider networks, and utilization reviews.
Recent measures involve medical treatment utilization schedules, permanent disability ratings, resolving medical disputes, and updates to medical fee schedules.

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Description

Explore the evolution of the workers' compensation system in California, from its early beginnings to key legislative acts. Understand how the historic compromise between workers and employers shaped the benefits and coverage available today.