How California Workers' Comp Works for City of Los Angeles Employees

I Work for the City and Got Hurt on the Job. Who Actually Pays My Workers' Comp?

The City self-insures its own workers' comp program instead of buying an insurance policy. Depending on your department, Sedgwick or Intercare actually processes your claim, though some claims stay in-house.

California lets every employer cover workplace injuries with an insurance policy or a state-issued certificate to self-insure. A county, city, or other public agency can qualify for that second path under Labor Code section 3700, subdivision (c), by showing the state it can properly administer and pay workers' compensation claims on its own. Our page on how California's employer self-insurance rules generally work explains the general rule.

The City's Personnel Department, checked November 10, 2026, confirms a complete, permissibly self-insured workers' compensation program run by its Workers' Compensation Division, using a mix of in-house staff and two outside claims administrators rather than one single company.

Since July 1, 2022, Sedgwick Claims Management Services has handled Fire Department and "conflict" claims, at (855) 238-1500, PO Box 2450, Brea, CA 92822. Intercare Holdings Insurance Services has handled Police sworn and civilian claims since August 1, 2022, at (888) 434-0414, PO Box 4387, Glendale, CA 91222. Other departments should use the contact information on their own claim letters; the City does not name one administrator for every claim.

This page covers general City department employees. The Department of Water and Power, Los Angeles World Airports, and the Housing Authority have their own certificates, shown above. The County of Los Angeles is a separate government with its own certificate and process.

What Should You Do Right After a City Work Injury?

Let your supervisor know the same day if you can, then request the City's claim form. State law allows up to 30 days to report in writing, but the City owes you the form within one working day once it knows.

Written notice is due within 30 days under Labor Code section 5400. Section 5402 treats the City's knowledge of your injury from any source, including a supervisor told in person, as the same as written notice. Once the City knows you lost work time or needed care beyond first aid, Labor Code section 5401 then gives the City just one working day to hand you that paperwork. The City calls the form the DWC-1, covered in depth on our claim-form page. The Personnel Department's published forms, checked November 10, 2026, also include a separate Employer's Report of Occupational Injury or Illness, Form 5020, which your supervisor must file.

How Long Does the City Have to Accept or Deny Your Claim?

The clock on the whole claim runs 90 days. Within one working day of filing, though, whoever handles your file already owes you up to $10,000 in treatment while that decision is still pending.

Both deadlines trace to Labor Code section 5402. Treatment up to $10,000 must start the working day after you file, and continue until your claim is either accepted or turned down. A full decision on the claim itself is due within 90 days of your filing date, or 75 days for a firefighter or police officer under one of the injury presumptions in Labor Code sections 3212 to 3213.2, such as a heart trouble or cancer claim. Past that point, the law treats your injury as covered, and only facts the administrator turns up after that window ends can undo the result. Our 90-day claim rule page goes through the details.

Separately, Title 8 regulations require a real investigation: section 10109 obligates the claims handler to keep investigating as new facts surface, not stop once it has enough to deny you. Under section 9812, a notice warning you that a decision will be delayed must also explain both rules above: the 90-day presumption and the $10,000 interim-treatment rule.

What if a Disability Payment From the City Is Late?

Count 14 days from when the City learns you are hurt and off work; that is your deadline for a first disability check. Miss it, and an automatic 10 percent gets added. A delay the City cannot justify can cost it even more.

That 14-day clock comes from Labor Code section 4650. A late check automatically grows by 10 percent, with nothing for you to request, unless you are already being paid full wages under a qualifying salary continuation plan. Our 14-day payment deadline page covers the exceptions.

A delay or refusal that crosses the line into unreasonable, not just late, opens the door to a second, larger penalty under Labor Code section 5814. That penalty can reach one-quarter of the unpaid amount, capped at $10,000, whichever figure is smaller. Catching the mistake within 90 days lets the City instead pay a flat 10 percent penalty, rather than risk the bigger number. Our late-payment penalty page explains how the two rules interact.

Your Treatment Request Was Denied. What Are the Next Steps?

Utilization review looks at a denied or changed treatment request first. A result that still disagrees with your doctor can be challenged through Independent Medical Review, generally within 30 days.

Labor Code section 4610 governs that review. A complete request gets a decision within five normal business days, and no later than 14 days after your doctor recommended the treatment. Urgent or ongoing care gets a faster, 24-hour decision and notice. Our utilization review page walks through the process.

A medical-necessity denial or change triggers Independent Medical Review rights under Labor Code section 4610.5. The denial notice must include a one-page request form and a postage-paid return envelope, though you may file electronically instead. You generally have 30 days from that notice to send the request; a missing piece of the notice can pause that clock, and a separate, unresolved dispute over your claim can extend it. Our Independent Medical Review page covers the full process.

Where Can You Get Free Help With a City Workers' Comp Dispute?

Most workers start with the DWC's Information and Assistance Unit, which helps for free and favors no side. For a whole claim that was turned down, filing an Application for Adjudication of Claim is usually the formal next move.

Dial 1-800-736-7401 to reach the Information and Assistance Unit, free to any California worker. When the City, Sedgwick, or Intercare turns down your entire claim rather than one treatment, taking it to the Workers' Compensation Appeals Board is usually the next formal move. Labor Code section 5500 sets the pleading rules for that filing, known as an Application for Adjudication of Claim. Our denied-claim page covers what comes after.

Hiring an attorney does not skip a step. Labor Code section 4906 puts fee approval in the hands of a workers' compensation judge before any amount changes hands, and the usual request runs fifteen to eighteen percent of the award. For how approval works, read our breakdown of California workers' comp attorney fees.

Yazdchi Law P.C. is independent of, and unpaid by, the City, Sedgwick Claims Management Services, Inc., and Intercare Holdings Insurance Services, Inc.

Everything above states what the law requires, not how Sedgwick, Intercare, or the City's Division handles any one file. Every claim still gets the firm's own individual look; accepting one is never automatic.

Maybe a check came late, a treatment request got denied, or the City rejected the whole claim outright. Call (661) 273-1780 or use the contact form and walk us through what happened: your role with the City, the date you were hurt, and where your claim sits right now.

Other Pages for City Employees

• What happens, step by step, after you file a claim?
• What does a self-insurance certificate mean for any employer?
• What does a workers' comp attorney actually charge?
• What is an Application for Adjudication of Claim, and when do you file one?