Collecting Workers Compensation if Your Employer is Self-Insured

It can be startling – and worrisome – when you are injured at work and your employer tells you they do not have a Workers Compensation Insurance company because they are “self-insured”.  If you have been injured or made ill on the job, you may be wondering what having a “self-insured” employer means for your Workers Comp benefits.

What Is Self-Insured Workers Compensation?

First, let’s understand what “self-insured” Workers’ Compensation is. “Self Insured” or “Self Funded” refers to an employer who pays the cost of each Workers Comp claim ‘out of pocket’ (out of their own money) – rather than paying monthly premiums to a Workers Compensation Insurance carrier, who would pay any claims for them.

California actually has the largest workers’ compensation self-insurance program in the entire country – with more than 9,000 California employers currently operating self-insured Workers Comp programs.

Employers generally choose to self-insure their Workers’ Compensation liability for two reasons:

  1. To save money on Workers’ Compensation insurance premiums; or,
  2. To be able to exercise greater control over granting or denying workers compensation claims.

In order to legally to operate a self-insured workers comp program, an employer must go through an application process, meet certain financial requirements, and ultimately be approved by the Director of the Department of Industrial Relations.

Can Employees of a Self-insured Company get Workers Comp?

Remember, it is the law that all employers must have Workers Compensation coverage – either through an insurance company or “self funded”. So if you were injured oir made ill in teh workplace you ARE covered by Workers’ Comp, even if your employer is self-insured.

But, as experienced workers compensation attorneys for several decades, we have handled thousands of workers compensation cases against self-insured companies – as well as against workers comp insurance carriers. In our vast experience, we can tell you that self-insured employers often fight Workers Comp claims more aggressively than employers who have workers comp insurance.

This makes perfect sense, because the carrier-insured employer is paying a fixed premium, regardless of what the insurance company is paying out in a claim. (Although premiums do rise with increased claim frequency). But a self-insured company personally pays out of their pocket every cent that is paid out in any and every workers compensation claim. In other words, it’s their money paying the claim – so they often fight harder to deny claims.

Our attorneys have found that self-insured employer bias is particularly strong against medical conditions that are difficult to objectively prove – including pain – if they cannot be verified by x-rays or other tangible test. Additionally, many employers chose not to recognize Workers Comp claims for cumulative trauma injuries – such as carpal tunnel syndrome or lumbar back issues.

Our Attorneys Handle Self Insured Workers Comp Cases

If your employer is self-insured and is denying your workers compensation abenefits, it is essential that you discuss your case with an experienced workers compensation attorney. Whether or not your employer believes that you are legitimately injured is irrelevant. It is your right to have time off work and receive the medical treatment you need!

Our aggressive and knowledgeable workers comp attorneys can fight to get you the maximum compensation to which you are entitled – whether your employer is self-insured or insurance-carrier-insured. We have helped thousands of injured workers get the compensation they deserve in greater Los Angeles and Southern California.

Call our Workers Compensation Attorneys for a FREE CONSULTATION: 562-622-4800.