What benefits am I entitled to?

There are four workers’ compensation benefits:

Temporary Disability -Temporary total disability is wage replacement tax free amount paid at a rate of 2/3 of your average weekly wage. This amount is calculated by looking at the past 52 weeks of earnings and dividing by 52 weeks.  There are arguments to be made for an increase in this benefit depending on if you have one or more jobs in addition to the job where you were injured. In addition, the calculation can be complicated depending upon whether you are paid cash, work overtime, or receive other benefits as part of your job.  Temporary total disability is paid when the doctor take you off work or if you have restrictions but the employer does not have modified work available.  If you are working part time because of your restrictions, you will be entitled to temporary partial disability or wage loss.  Payments made as temporary disability does not count against the money you receive for your settlement.  The statutory maximum received depends on the date of your injury and the law for how long you can receive this benefits also depends on the date of injury.  For most injuries after 2003/04, the most you can receive is two years. If benefits run out, you may be entitled to state disability  insurance and/or social security disability insurance. (see FAQ on EDD and SSDI)

Medical Treatment – medical treatment “should” be provided for the accepted body parts subject to UR/IMR (See FAQ on UR/IMR).  If you settle your case by Stipulated Award, you will be entitled to lifetime medical care for those body parts included and spelled out in the settlement document, subject to treating doctor opinions, UR and IMR.

Permanent Disability – Once your condition becomes (P&S) permanent and stationary/(MMI) maximum medical improvement (a place where we don’t expect your injury to get much worse or much better but does not mean you are 100% better and don’t need treatment) you should receive a PR-4 report from the primary treating physician.  This permanent and stationary report should outline you permanent work restrictions, permanent impairment (which gets translated into permanent disability by using a formula), needs for medical treatment in the future, whether you can return to the job you were doing when you were injured and how much of your disability is due to the work injury and how what percentage is do to other factors.  If the primary treating doctor can’t or won’t prepare this report there are options on who can, including a Qualified Medical Evaluator/Agreed Medical Evaluator (if represented by an attorney only) or consulting doctor.  Once the report has been rated for disability, the permanent disability percentage has a dollar value assigned by the state of California.  Your date of injury and whether the employer has offered you a job after injury may determine the amount you receive. Any disability benefit paid to you once you become P&S/MMI is an advance of your settlement and will be deducted from your final settlement.  Keep in mind you are paid at a much lower rate for permanent disability than temporary disability.  Check with EDD to see if they will pay the difference between your permanent disability rate and temporary disability rate (differential).

Supplemental Job Displacement Voucher – if you are unable to return to the job you were doing when you were injured, you will be entitled to a voucher. It is not cash but can be settled out in some cases. The voucher is be used to get retraining or education classes.  It is a good idea to use a vocational expert to come up with a plan and help use the voucher.  They receive a small part of this voucher but are well worth it.  We recommend the following programs/experts to help use the voucher.

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