Workers' compensation is the oldest social insurance program; it was adopted in most states including California, during the second decade of the 20th century. It is a no-fault system, meaning that injured employees need not to prove the injury was someone else's fault in order to receive workers' compensation benefits for an on-the-job injury.
The City is transitioning to two new Third-Pary Administrators (TPAs), Sedgwick Claims Management Services (Sedgwick) and Intercare Holdings Insurance Services (Intercare) for workers' compensation claims administration effective July 1, 2022, and August 1, 2022, respectively. City employees with open claims will receive a letter in the coming days with the name and contact information of their new claims adjuster. Please note during the transition period, there should be no disruption to workers’ compensation benefits.
Effective July 1, 2022, Sedgwick will be handling the processing of Fire and conflict claims. These will include all claims from the prior TPAs, Acclamation Insurance Management Services (AIMS), and partial claims from Elite Claims Management, Inc. (Elite). Please direct all future communication as of July 1, 2022, to Sedgwick as follows:
Effective August 1, 2022, Intercare will be handling the processing of Police sworn and civilian claims. These will include all claims from the prior TPAs, Tristar Risk Management, and partial claims from Elite. Please direct all future communication as of August 1, 2022, to Intercare as follows:
Workers' Compensation Division aims to:
Workers’ compensation is the oldest social insurance program; it was adopted in most states, including California, during the second decade of the 20th century. It is a no-fault system, meaning that injured employees need not prove the injury was someone else’s fault in order to receive workers’ compensation benefits for an on-the-job injury.
The workers’ compensation system is premised on a trade-off between employees and employers. Employees are supposed to receive the prompt delivery of defined statutory workers’ compensation benefits for on-the-job injuries, and in return, the defined workers’ compensation benefits are, for the most part, the exclusive remedy for injured employees against their employer, even when the employer negligently caused the injury.
The Workers’ Compensation Division (WC Division) operates and monitors a complete permissibly self-insured workers’ compensation program ensuring the full provision of benefits under the law to employees whose injuries arose in the course and scope of employment. This program oversees the administration of approximately 15,000 workers’ compensation claims.
Currently, the City of Los Angeles utilizes a combination of in-house staff and contracts with private firms for the administration of workers’ compensation claims. These firms are called workers’ compensation third party administrators. The WC Division provides continuous on-site workers’ compensation third party administration contract monitoring. Additionally, the WC Division provides customer service designed to assist injured workers and departments to resolve workers’ compensation claim issues by providing subject matter expertise.
If you would like to report a work-related injury or illness, please click on the following button to learn what the proper steps are for doing so:
learn moreIf you have a COVID-19-related illness, please review the following material on how to proceed:
learn moreOnce a need for reasonable accommodation arises, the law requires an employer to engage the employee in a timely, good faith, interactive process to determine how to overcome the job-related limitations. A reasonable accommodation is a change in the work environment or in work processes that enables a qualified individual with a disability to enjoy equal employment opportunities. View the steps of the Reasonable Accommodation Process:
learn more