How to Manage Your Claim

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Established in 1914 by the state legislature, State Fund is California's most reliable provider of workers' compensation insurance and a vital asset to California businesses. State Fund supports California's entrepreneurial spirit and plays a stabilizing role in the economy by providing fairly priced workers' compensation insurance, helping California employers keep their workplaces safe, and restoring injured workers.



How to Manage Your Claim

There are many different people involved in a claim, including your employer, your adjuster, and medical providers. The one thing they all have in common is you. By ensuring good communication throughout your recovery, you can help make sure you receive the best possible outcome.

Good communication can help make sure benefit payments and treatment begin quickly, and help you return to work sooner.

Communicate

Here are two things you can do to ensure good communication:

Make sure you proactively share information. Although it is true that your adjuster, employer, and medical providers will be in communication with each other, it will still benefit you to share information between each party. If you receive information from your medical providers or employer, share it with your adjuster. If your adjuster provides you information about returning to work, share it with your employer. This will ensure everyone has the most up-to-date information, so they can act quickly to manage your claim.

Please respond to communications timely. A claim can generate a lot of information. It will be sent to you over the phone, in the mail, and digitally. It can be a lot to process, and may seem intimidating at first, but it is important that you review and respond to these communications quickly. Your adjuster is available to answer any questions you may have and you may also reach out to the Information and Assistance Unit at the Division of Workers’ Compensation.

Focus on recovery

Attending all of your medical appointments and following your doctor’s treatment plan should be your focus throughout your claim. Our Provider Finder will help you find a primary treating physician, specialist, or urgent care provider when necessary. The medical providers in our Medical Provider Network are experts in workplace injury recovery.

Mileage to and from your medical providers’ offices is reimbursable as long as the travel is for authorized medical services. You can be reimbursed for trips to the pharmacy for authorized prescriptions prescribed by an authorized medical provider by providing the Express Scripts Pharmacy Registration Form to the pharmacist. Complete our mileage reimbursement form and submit it to your adjuster for review of your mileage reimbursement request.

Use available resources

Our Virtual Assistant is the easiest way to get your claim number and adjuster information when you need it. The process is simple and you will have your claim information in seconds.

Get your Claim Info from our Virtual Assistant

We have developed a number of resources to provide you more information about how claims are managed. These resources will help you to feel comfortable and informed as you navigate through the claims process with us. Here are some links to the most relevant information for you:

Videos

Articles

On Demand Webinars

Lastly, remember that our customer support staff and your claims adjuster are here to help you. They are dedicated to managing your claim towards the best possible outcome. If you ever have any questions about your claim, never hesitate to contact us.

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