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The short answer
Possibly a great deal — find out whether your contract has a carve-out.
California lets unions and employers negotiate an alternative workers' compensation system with its own doctors, its own ombudsman, and its own arbitration. If yours has one, most of what you read elsewhere does not apply to you.
What a carve-out is
Labor Code § 3201.5 permits a carve-out in the construction industry. Labor Code § 3201.7 extends it to other industries under defined conditions.
Where one exists, the collective bargaining agreement can establish:
- An exclusive list of medical providers — negotiated between the union and the employer, and generally a much shorter list than an ordinary medical provider network.
- An agreed medical evaluator process that replaces the usual panel QME route.
- An ombudsman to help resolve disputes informally.
- Mandatory arbitration before anything reaches the Appeals Board.
Your underlying benefits are not reduced. Temporary disability, permanent disability, and medical treatment are still what the Labor Code provides. The process for getting them is different, and so are some of the deadlines.
How to find out if you have one
Ask your union representative directly: "Do we have a carve-out under section 3201.5 or 3201.7?" That phrasing gets a real answer.
Read the workers' compensation article of your collective bargaining agreement. If it names specific doctors, an ombudsman, or arbitration, you have one.
And ask your employer's HR for the carve-out documents. They exist in writing.
Why this matters more than it sounds
The most common way carve-out cases go wrong is that nobody realizes there is a carve-out until a deadline in the CBA has already passed — one that does not appear anywhere in the Labor Code.
And the provider list is genuinely narrower. If you were sent to a doctor and told you had no choice, that may actually be correct here, in a way it would not be in an ordinary claim. How medical provider networks normally work.
What is the same
Your right to file. No agreement can waive it.
The statute of limitations under § 5405 still runs.
The presumptions and penalties — the 90-day presumption, the automatic 10% for late payment, serious and willful, § 132a — are statutory and are not bargained away.
And you can still have a lawyer. A carve-out process is not a reason to go through it alone.
If you are a public safety member
That is a different and much more favorable set of rules — full salary under § 4850 and presumptions that shift the burden to your employer. Firefighters. · Police and deputies.
Sources
Labor Code § 3201.5 (construction carve-outs) · § 3201.7 (other industries) · § 3201 (agreements otherwise void) · 8 CCR § 10202 et seq. (carve-out program administration).
General information about California law, not legal advice about your case.
Law Offices of Solov & Teitell, APC · (213) 380-9310 · 24/7 (213) 463-6469
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