1416 - Workers' Compensation Administrative Time Off

Category

Benefits and Insurance

Audience List

  • Personnel Officers
  • Personnel Transactions Supervisors
  • Return-to-Work Coordinators

Synopsis

This policy directs departments to grant Administrative Time Off (ATO) for specific instances that occur during the administration of a workers’ compensation claim.

Introduction

The workers' compensation system provides benefits to employees for work-related injuries or illnesses.  These benefits may include medical treatment, payments for lost wages, payments that compensate the injured employee for having a permanent impairment or limitation, vouchers to pay for retraining, and death benefits.

All state employees are covered by workers' compensation.  The cost of this protection is paid by the State of California, the employer.  Workers’ compensation benefits are tax free and are not subject to Social Security deductions.

The California Department of Human Resources’ (CalHR) Workers’ Compensation Program manages the State’s Master Agreement with State Compensation Insurance Fund (State Fund) to provide workers' compensation claims processing and legal representation for all the participating departments.  The Master Agreement is an Interagency Agreement.  Not all State of California agencies, departments, boards, and commissions are participants in the Master Agreement.  Some have opted to purchase an insurance policy from State Fund to cover the risks inherent to the workers’ compensation system.

Statement

When in the course of a workers’ compensation claim, an employee is asked to attend a medical-legal evaluation pursuant to Labor Code 4060, 4061 or 4062 with an medical evaluator, such as a Qualified Medical Evaluator (QME), an Agreed Medical Evaluator (AME), or an Independent Medical Evaluator (IME), the employee should be placed on Administrative Time Off (ATO) for any time lost from work.

Labor Code 4600(e)(1) states:

When at the request of the employer, the employer’s insurer, the administrative director, the appeals board, or a workers’ compensation administrative law judge, the employee submits to examination by a physician, he or she shall be entitled to receive, in addition to all other benefits herein provided, all reasonable expenses of transportation, meals, and lodging incident to reporting for the examination, together with one day of temporary disability indemnity for each day of wages lost in submitting to the examination.

State Compensation Insurance Fund (State Fund) will provide the reasonable transportation, meal and lodging expenses, but will not pay temporary disability indemnity.

If the above referenced medical-legal evaluation causes the employee to miss time from work, the hiring authority will grant ATO.

If the employee is already absent from work and receiving workers’ compensation temporary disability benefits such as Industrial Disability Leave (IDL), Enhanced IDL, 4800 time, 4800.5 time, or checks from State Fund, those payments continue, and there is no need to interrupt those benefits to grant ATO.

In addition to medical-legal appointments, ATO is also granted for anytime lost on the date of injury and for any time lost to attend a deposition.

Application

Are employees elegible for ATO for the following appointments or reasons for lost time?

  • Date of Injury: Yes
  • Regular Medical appointments: No
  • Physical Therapy, MRI, x-ray,etc.: No
  • Medical-Legal evaluations (QME/AME/IME): Yes
  • Deposition: Yes
  • Meet w/ attorney or attend WCAB event: No

Authorities

Resources

PML

  • PML 2012-015: PML 2012-015 - 6/13/2012 - Workers' Compensation - ATO for Medical/Legal Appointments

Related Policies

  • 1412: Industrial Disability Leave
  • 1414: Temporary Disability
  • 1415: Workers' Compensation
  • 1417: Workers' Compensation Liability Between Departments

Contact Person

Workers' Compensation Division
Program Managers, Workers' Compensation
Phone: 916-324-0522
Fax: 916-324-3213
Email: WorkComp@calhr.ca.gov

Authorized By

Ralph Cobb
Chief (Acting), Benefits Division

History

View History

Table of Contents

1000 - Equal Employment Opportunity

1100 - Selection

1200 - Appointments

1300 - Exempt Employees

1400 - Benefits and Insurance

1500 - Work Schedules

1600 - Third Party Pre-Tax Parking

1700 - Compensation

1800 - Savings Plus

1900 - Bona Fide Associations

2000 - Collective Bargaining

2100 - Leave

2200 - Travel/Relocation

2300 - State Owned Housing

2400 - Employee Recognition

2500 - Discipline

2600 - Layoffs

2700 - Retirement

2800 - Training

2900 - Workforce Planning

3000 - Examination and Hiring

3100 - Drug-Free Workplace