First Aid Treatment Insurance
Workers Comp First Aid Treatment
First aid treatment is part of medical care and it is required coverage for all employees. In addition to being a required care provision, the employer is mandated by law to file specific forms to report the injury or illness.
According to The Department of Industrial Relations, the Division of Workers Compensation and the California Department of Insurance (CDI), all employers, doctors and insurance carriers – including self-insurers – must comply with Section 6409(a) of the California Labor Code.
Section 6409(a) of the California Labor Code states that it is mandatory to submit a “Doctor’s First Report of Injury” (DFR) for all work-related illnesses and injuries. This filing is required even when first-aid was administered and there was no lost time from work. The DFR must be filed by the treating physician to the claims administrator.
There are no “first-aid” exceptions for filing the DFR. The Labor Code allows exceptions for first-aid events on Form 5020 and DWC-1, the Employers Report and the Employee Claim form respectively, but there is no exception for the Doctor’s First Report of Injury form. Insurance carriers or employers who are self-insured must forward all DFR forms to the Department of Industrial Relations.
The Section 6409(a) statute exists to help prevent fraud of insurance premiums or fraud in the form of workers compensation denial to qualified injured workers. The CDI and the Department of Industrial Relations believe that some medical providers and employers have improper agreements in place that allow an employer to determine how a workplace injury should be classified. Sometimes an employer will ask the attending physician to send the DFR to the employer only instead of to the insurance agency. Sometimes this happens even when an employee’s injuries are obviously beyond the need of simple first aid services. An arrangement of this type is often marketed as a cost savings measure, because it helps employers keep the cost of premiums lower. This type of marketing practice is improper and the actions taken as a result may be criminal or fraudulent in nature. It can also cause legitimately injured employees to be denied for workers compensation benefits.