Program Information

For Union Members - Facts for Injured Workers

Workers’ Compensation Benefits & Alternative Dispute Resolution

The Laborers Health and Welfare Trust for Southern California (the Trust) has entered into a Workers’ Compensation Agreement for the benefit of its members. The Workers Compensation Agreement is described below.

Workers’ Compensation insurance is required by law and the UNION is working to ensure that you obtain ALL the benefits to which you are entitled.

By working together, controlling Workers’ Compensation costs and overhead costs, Union Contractors are able to remain competitive. The contractor can continue to provide jobs and benefits in order to pursue our common goal.

An employee working under the Laborers Health and Welfare Trust Fund Workers’ Compensation Program can be covered by workers’ compensation provided under Labor Code §3201.5. This law replaces much of the cumbersome administration of the traditional workers’ compensation system with a method of ALTERNATIVE DISPUTE RESOLUTION. This website provides you with basic information about the program and system so that you may gain an understanding and make an informed decision should you have a work-related injury. All benefits for workers’ compensation under the Laborers Health and Welfare Trust Fund Workers’ Compensation Agreement are equal to, or are an improvement to, the traditional system.

Workers’ Compensation is an insurance required by law, which provides benefits to workers who are injured or become ill due to employment. It also provides death benefits to dependents in the event of the worker’s death.

Program Information

An ombudsperson is a designated neutral person who provides confidential and informal assistance in resolving concerns and disagreements. An ombudsperson investigates complaints, reports findings, and mediates fair settlements, especially between an individual or group of individuals and an institution or organization. As an independent, impartial, and confidential party, the ombudsperson serves as an alternative means of dispute resolution by which issues may be raised, considered, given appropriate referral, and/or resolved.

When you participate in our ADR program, our ombudsperson is available to help you during the life of your claim.

Barbara Shogren Lies has been the Ombudsperson for the Laborers’ Workers’ Compensation Trust since 2001. She is bilingual in English and Spanish and has worked in the workers’ compensation field since 1983. She may be contacted for questions, concerns, or assistance in resolving disputes. Her job is to provide information and assistance to both employees and employers in the ADR program.

Ombudsperson

Barbara Shogren Lies
Shogren Services, LLC
7177 Brockton Ave., Suite 101
Riverside, CA 92506

(800) 905-7595
Fax: (951) 788-0320
barbara@shogrenservices.com

Questions & Answers

Am I covered under the Benefit, and how does it apply to me?

Yes, whenever your job causes you to have an injury or illness, you will be covered. This includes everything from first aid, to serious injuries, to work-related illnesses as long as your employer carriers workers’ compensation coverage that as required by California state law.

When does this coverage begin for me?

Employees are covered from their first day of work.

What benefits are available in the workers’ compensation policy?

Workers’ Compensation policy includes five basic benefits:

Medical Care necessary to cure or relieve the effects of your injury is provided at no cost to you. You may pre-designate a treating provider or treat with the provider offered by the employer or insurance carrier. If you are not satisfied with your treating provider, you may select a medical provider who is a participant of the Laborers Health and Welfare Trust for Southern California’s plan.
Temporary Disability Benefits are provided if you are unable to work for more than three days because of your on-the-job injury or illness.
Permanent Disability – additional benefits are available.
Death Benefits
• When worker is fatally injured on the job.
• Reasonable burial expenses – maximum set by law.
• Qualified surviving dependents may receive benefit payments.
Supplemental Job Displacement Voucher – if you are unable to return to your regular work and your employer cannot offer permanently modified or alternative work, you may qualify for a non-transferable job displacement voucher.
• Voucher ranges from $4,000 to $10,000 – allowance depends on your level of permanent disability.
• Voucher may be used for re-training or enhancing your skills.
• Voucher can also be used towards tuition, books and fees associated to your educational costs.
• If you prefer, a counselor may assist with selecting appropriate training facility – counseling fees may not exceed 10% of the voucher allowance.

What can I do if my employer discriminates against me for filing a workers’ compensation claim?

• The law forbids an employer to discriminate against an employee for filing a workers’ compensation claim because of a work-related injury or illness.
• Contact the Ombudsperson if discriminated against.
• Employers are subject to the Americans with Disabilities Act (ADA) or Fair Employment Housing Act.
• You may also call the Equal Employment Opportunity Commission at 1-800-669-4000.

How much will I receive and when does temporary disability begin?

• Temporary disability benefits are based on two-thirds of your average weekly wage.
• Maximums set by law.
• For injuries after January 1, 2008, the maximum TTD rate is $1,619.15 per week.
• A letter of explanation will be mailed to you outlining which day of the week your check will be mailed.
• During the qualification period, insurance companies mail checks automatically every two weeks.
• Expect a check within 14 days if your claim is filed right away.
• You are not paid for the first three days, unless you are in the hospital or unable to work for more than 14 days.

What is the first step in reporting a work-related injury or illness?

• First, contact your foreman or supervisor.
• Contact person will send you to the approved industrial clinic.
• Then, a Claim Form will be given to you that should be completed by you and returned as soon as possible.

How does the Alternative Dispute Resolution (ADR) Program work?

If you experience any problems with your workers’ compensation claim or benefits, there are three steps available –
Ombudsperson / Mediation / Arbitration to replace the traditional judicial system.

• Alternative Dispute Resolution (ADR) Program with the assistance of the Ombudsperson reviews your claim, or...
• If unable to resolve your matter, Ombudsperson will assist you with proceeding with a Mediator, or...
• Ombudsperson will assist you with going through Arbitration if Mediation is unsuccessful.

What is Arbitration?

Arbitration is like a court hearing. If mediation is not successful, you may request arbitration. An Arbitrator will be assigned to hear your case. A hearing will be scheduled; evidence will be presented and the Arbitrator will render a decision. The decision of an Arbitrator has the same authority as a workers’ compensation judge.

What will going to Arbitration accomplish?

Because the Arbitrator has the same powers and authority as a workers’ compensation judge, disputes are normally resolved faster and with reduced cost. Although the employee has the right to be represented by an attorney, the need for an attorney on either side is also reduced.

Questions & Answers

Am I covered under the Benefit, and how does it apply to me?

Yes, whenever your job causes you to have an injury or illness, you will be covered. This includes everything from first aid, to serious injuries, to work-related illnesses as long as your employer carriers workers’ compensation coverage that as required by California state law.

When does this coverage begin for me?

Employees are covered from their first day of work.

What benefits are available in the workers’ compensation policy?

Workers’ Compensation policy includes five basic benefits:

Medical Care necessary to cure or relieve the effects of your injury is provided at no cost to you. You may pre-designate a treating provider or treat with the provider offered by the employer or insurance carrier. If you are not satisfied with your treating provider, you may select a medical provider who is a participant of the Laborers Health and Welfare Trust for Southern California’s plan.
Temporary Disability Benefits are provided if you are unable to work for more than three days because of your on-the-job injury or illness.
Permanent Disability – additional benefits are available.
Death Benefits
• When worker is fatally injured on the job.
• Reasonable burial expenses – maximum set by law.
• Qualified surviving dependents may receive benefit payments.
Supplemental Job Displacement Voucher – if you are unable to return to your regular work and your employer cannot offer permanently modified or alternative work, you may qualify for a non-transferable job displacement voucher.
• Voucher ranges from $4,000 to $10,000 – allowance depends on your level of permanent disability.
• Voucher may be used for re-training or enhancing your skills.
• Voucher can also be used towards tuition, books and fees associated to your educational costs.
• If you prefer, a counselor may assist with selecting appropriate training facility – counseling fees may not exceed 10% of the voucher allowance.

What can I do if my employer discriminates against me for filing a workers’ compensation claim?

• The law forbids an employer to discriminate against an employee for filing a workers’ compensation claim because of a work-related injury or illness.
• Contact the Ombudsperson if discriminated against.
• Employers are subject to the Americans with Disabilities Act (ADA) or Fair Employment Housing Act.
• You may also call the Equal Employment Opportunity Commission at 1-800-669-4000.

How much will I receive and when does temporary disability begin?

• Temporary disability benefits are based on two-thirds of your average weekly wage.
• Maximums set by law.
• For injuries after January 1, 2008, the maximum TTD rate is $916.33 per week.
• For injuries after January 1, 2009, the maximum TTD rate is $958.01.
• A letter of explanation will be mailed to you outlining which day of the week your check will be mailed.
• During the qualification period, insurance companies mail checks automatically every two weeks.
• Expect a check within 14 days if your claim is filed right away.
• You are not paid for the first three days, unless you are in the hospital or unable to work for more than 14 days.

What is the first step in reporting a work-related injury or illness?

• First, contact your foreman or supervisor.
• Contact person will send you to the approved industrial clinic.
• Then, a Claim Form will be given to you that should be returned as soon as possible.

How does the Alternative Dispute Resolution (ADR) Program work?

If you experience any problems with your workers’ compensation claim or benefits, there are three steps available –
Ombudsperson / Mediation / Arbitration to replace the traditional judicial system.

• Alternative Dispute Resolution (ADR) Program with the assistance of the Ombudsperson reviews your claim, or...
• If unable to resolve your matter, Ombudsperson will assist you with proceeding with a Mediator, or...
• Ombudsperson will assist you with going through Arbitration if Mediation is unsuccessful.

What is Arbitration?

Arbitration is like a court hearing. If mediation is not successful, you may request arbitration. An Arbitrator will be assigned to hear your case. A hearing will be scheduled; evidence will be presented and the Arbitrator will render a decision. The decision of an Arbitrator has the same authority as a workers’ compensation judge.

What will going to Arbitration accomplish?

Because the Arbitrator has the same powers and authority as a workers’ compensation judge, disputes are normally resolved faster and with reduced cost. Although the employee has the right to be represented by an attorney, the need for an attorney on either side is also reduced.

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