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Workman Comp Stress Leave California

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  • Workman Comp Stress Leave California

    I have an employee, that has filed workman comp leave, due to stress. She has been out on stress leave for 5 weeks now. I am in CA, and we have 5 employees. I have to hire more employees to replace the one that is out on leave. My office is running behind and her absence is effecting our practice. Her case is pending workman comp, but she has filed SDI and is receiving money from that. We are still paying her health insurance and her family's. Under her employment at our office we paid her ins, but she paid her family ins. Do we have to contue paying her health insurance, and can we terminated her, because we have to fill her job, so our office an function? Her family doctor has now, continued her leave any other 2 weeks. What are the employers rights???? We would like to terminated her and give her the options of cobra insurance.
    Last edited by Suzann; 10-28-2006, 08:12 AM.

  • #2
    Originally posted by Suzann View Post
    Her family doctor has now, continued her leave any other 2 weeks.
    You are in California, which has weird rules, but, we can insist that an employee claiming a work related illness or injury see our preferred medical provider, at least for the first ten days. The doctors of an employee will be more than willing to give out lost time. Costs them nothing, they get paid for the work they do and everyone, but the employer and its carrier, is happy.

    This person, if allowable under your laws, should be seen by someone else,

    If deemed unable to fulfill all the duties she usually did, find out just what she could do and accomodate those light duty restrictions. Lost time will cost you a lot in increased mod and premiums.

    Your WC carrier needs to be involved in this and you, or someone working for you, needs to be involved in the management of the claim.

    She may not be taking you for a ride, but you need someone on your side (not the carrier) looking out for your interests. (sometimes, the carriers don't care, since you are a hostage and any costs a claim incurs will be collected in the form of increased premiums in the future).
    Senior Professional in Human Resources and Certified Staffing Professional with over 30 years experience. Any advice provided is based upon experience and education, but does not constitute legal advice.


    • #3
      CA has weird rules for choosing a medical doctor (go figure). Did this employee pre-designate their physician? If not, the employee would have to go to the doctor you designate for the first 30 days. I would be on my carrier's case about this one if it has been 5 weeks and they haven't either acceped or denied compensiblity. When was this claim filed? It would need ot be accepted or denied within 90 days of being filed.

      As this employee does not qualify for FMLA, you are not obligated to hold her job or continue her insurance at your cost.
      You can not fire her for filing a claim and it is a very poor idea to do so because she suffers from a medical condition, but if you do not offer LOAs for others and can not afford to extend this additional time to her, then you can term. I would run it by the carrier and legal counsel but you should be ok.

      If you do extend her LOA, you can require she pay the full premium for the health insurance. So long as you do this for others who are out on extended leaves, it is perfecctly legal. That at least takes some of the financial sting out of the absence.
      I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.