Who are primarily responsible for ensuring fair treatment of injured workers in claims?

In the context of California Workers Compensation, the primary responsibility for ensuring fair treatment of injured workers in claims lies with employers and insurers. Employers are required by law to provide a safe working environment and to carry workers’ compensation insurance, which covers medical treatment and wage loss for employees injured on the job. Insurers, on the other hand, are tasked with processing claims, determining benefits, and ensuring that injured workers receive the appropriate medical care and compensation in a timely manner.

Both employers and insurers have a legal obligation to act in good faith and handle claims with fairness, adhering to the regulations set forth by the California Division of Workers' Compensation. This includes undertaking a thorough review of the claims submitted and communication with injured workers about their rights and benefits.

While medical professionals provide necessary care, workers' unions advocate for worker rights, and legal representatives can assist injured workers in navigating the claims process, their roles are more supportive. They do not hold the primary responsibility for the overall management of claims, as that duty lies primarily with employers and insurers. This clear delineation reflects the overarching framework designed to protect the rights and interests of injured workers within the workers' compensation system.