If you have a work-related injury or illness, your employer is required by law to pay for workers' compensation benefits. You could get hurt by:
One event at work, such as hurting your back in a fall, getting burned by a chemical that splashes on your skin or getting hurt in a car accident while making deliveries.
Repeated exposures at work, such as hurting your wrist from doing the same motion over and over or losing your hearing because of constant loud noise.
Report the injury to your employer by telling your supervisor and Company Nurse right away. If your injury or illness developed over time, report it as soon as you learn or believe it was caused by your job.
Reporting promptly helps prevent problems and delays in receiving benefits, including medical care you may need.
Get emergency treatment if you need it. Company Nurse will refer you to a facility for medical treatment (Clinic Map). Tell the health care provider who treats you that your injury or illness is job-related.
If you are injured or become ill, either physically or mentally, because of your job, including injuries resulting from a workplace crime, you may be entitled to workers’ compensation benefits. Use the attached form to file a workers’ compensation claim with your employer. NBSIA is responsible for handling your claim and will notify you as to whether your claim is accepted or whether additional information is needed. (DWC-1 Form)
A medical provider network (MPN) is an entity or group of health care providers set up by an insurer or self-insured employer and approved by DWC's administrative director to treat workers injured on the job. Under state regulations, each MPN must include a mix of doctors specializing in work-related injuries and doctors with expertise in general areas of medicine. MPNs are required to meet access to care standards for common occupational injuries and work-related illnesses. The regulations also require MPNs to follow all medical treatment guidelines established by the DWC and allow employees a choice of provider(s) in the network after their first visit. Additionally, MPNs must offer an opportunity for second and third opinions if the injured worker disagrees with the diagnosis or treatment offered by the treating physician. If a disagreement still exists after the second and third opinion, an injured worker in the MPN may request an independent medical review (IMR). The MPN program became effective Jan. 1, 2005 and employees can be covered by an MPN once a plan has been approved by the DWC administrative director. Please read the following Employee Notification regarding Medical Provider Network. You may visit our Medical Provider Network at www.nbsiampn.com.
The following School Districts and County Offices have adopted a Medical Provider Network which is administered by Networks By Design, Inc. on behalf of North Bay Schools Insurance Authority. Click the link below and enter your zip code to find a Designated Medical Clinic near your home or work place.
Please read Info Regarding MPN for additional information Medical Provider Networks.
NBSIA has a medical provider network (MPN) with physicians in every specialty for which you must seek treatment with. However, if you have pre-designated your own physician PRIOR to your injury, you may treat with your own doctor; otherwise, you must treat with a physician in our network.
Pre-designation of a personal physician is a one-time process by which an employee provides the employer with the name of a personal physician, in writing, who is then designated as the treating physician if you are injured on the job. Without pre-designation, you would go to a provider in the medical provider network (MPN). For a pre-designation form please contact your HR department.
Yes. Medical treatment that does not fall within the American College of Occupational and Environmental Medical guidelines will be reviewed to determine medical necessity as set forth by the State Division of Workers’ Compensation. Your Claims Examiner does not have the authority to modify or deny medical treatment.
Workers' Compensation insurance provides five basic benefits:
Your local I&A officers listed on https://www.dir.ca.gov/dwc/I&A.html are a great resource and their services are free. They are not there to act on your behalf as an attorney would, but they'll help you understand how to act on your own behalf. Attend a free seminar for injured workers at a local DWC district office for a full explanation of workers' comp benefits, your rights and responsibilities. You can also make an appointment with an I&A officer and speak to them privately at your convenience.
If you are eligible for Industrial Accident Leave, you will receive your full salary in your regular paycheck up to 60 days. If you are not eligible Industrial Accident Leave, NBSIA will issue payment to you directly every 14 days.
For medical appointments, you will be required to use your sick leave. Lost time from work due to a workers’ compensation injury is only compensated when your treating physician declares you “temporarily disabled” and therefore unable to work.
No, workers' comp benefits aren't considered "earned income," so you don't pay taxes on those benefits.
Health insurance claim number refers to the number assigned by the Social Security Administration and an individual for the purpose of identifying him/her as a Medicare beneficiary. Liability insurers are required by law to report specific information about Medicare beneficiaries who have other insurance coverage. Claimants will be requested to complete the (Health Insurance Claim Number (HICN)/Social Security Number (SSN) verification form).
After you make a claim for workers’ compensation benefits, your medical records will not have the same level of privacy that you usually expect. If you don’t agree to voluntarily release medical records, a workers’ compensation judge may decide what records will be released. HIPAA compliant Authorization to Use or Disclose Protected Information Medical Release form
If you have to travel to get treatment for your work injury, you are entitled to re-payment of your travel costs. The current mileage rate (effective July 1, 2022) is 62.5 cents ($0.625) per mile. Mileage for reasonable travel to the pharmacy, parking, bridge tolls, public transportation and other travel-related costs are also included. Complete the Medical Mileage Expense Form and attach receipts, then send the original to NBSIA and keep a copy for your records.