Benefits and Awards

If you have been injured at work, you may be entitled to medical treatment, job retraining, temporary disability and permanent disability payments/benefits. Treatments to relieve the effects of the work injury are available at no cost to you. Treatments can be medical, surgical, internal, chiropractic, dental, psychological, and any other necessary specialty; this includes hospitalization, medicine, and medical supplies. And you are entitled to travel reimbursement for all medical appointments.

If your work injury interferes with your current occupation, you may be entitled to assistance in finding other employment including job retraining. For injuries sustained on or after January 1, 2004, you may in some instances qualify to receive a Supplemental Job Displacement Voucher to attend school or a vocational program, limited from $4,000.00 to $10,000.00. The voucher can be used at the school of your choice depending on several factors such as school accreditation.  As of January 2014, the new Workers’ Compensation Supplemental Job Displacement Voucher per the reform introduced in SB 863 now offers a flat rate of $6,000.00 that must be awarded once permanent disability is established. This voucher expires within two years if it is not taken and in five years if it is not used.

While you are injured, you are also entitled to some disability payments if you are unable to return to full capacity work. There are two types of disability payments. First, you may be eligible for Temporary Total Disability (TTD) payments. The amount of TTD payments is based upon two thirds of your average weekly wages up to the maximum statutory limit that changes from year to year. You can receive TTD payments if you are unable to work during your medical treatment and you must be restricted from returning to work by your primary treating physician through workers compensation. If your physician returns you back to work and/or you return to any employment, these benefits will be interrupted. For all injuries occurring after 01/01/04, you are limited to a maximum of 104 weeks of TTD payments which must be used within a five year period from the date of your initial injury.

Second, you may be entitled to Permanent Disability (PD) payments once an injury has become “permanent and stationary” (P&S) or you are determined to have reached “maximum medical improvement” (MMI), both of which essentially mean your medical condition has stabilized and is not expected to get better or worse over the next one year. It does not mean you are cured or relieved of your injuries. The amount of permanent disability for your injury is “rated” based on medical reports from your treating doctor, a qualified medical examiner, and/or the Agreed Medical Examiner. Permanent Disability is based on several factors largely on whether you are able to return to gainful employment and what job restrictions you may have. For injuries occurring before 01/01/2004, we use what is coined the old rating schedule which bases disability on a person’s work restrictions and ability to compete in the open labor market. For injuries after 01/01/2004, we consider a person’s’ diminished future earnings capacity and the AMA Guidelines which is a textbook guideline for giving whole person impairments for a specified body part. Permanent Disability will also take into account your age, occupation, and in particular the types of injuries you have sustained.

As your attorneys, we will help you obtain all of the workers’ compensation benefits which you are entitled to. These are complicated calculations of disability, complicated medical records, and simply put, a complicated system that is evolving each year. Insurance companies have adjusters, doctors, and attorneys working on their behalf. It is important that you have a Law Firm and Attorneys who are ready to fight for you. Benefits are on a case by case basis, so please call us to discuss helping you receive the maximum benefits under California Law.

Successful workers’ compensation claims typically settle in one of three ways. A Compromise and Release (C&R) is a cash-out settlement generally available to injured workers no longer working for the company in which the injury was sustained. The C&R calculates any unpaid temporary disability, permanent disability, future medicals including medications and any future surgeries, and any unpaid benefits. The injured worker is awarded a large sum of money and controls his/her own future medical care. This type of settlement closes the case forever and will not provide for future treatment on an industrial basis. Note that if you are on Social Security, other considerations may have to be included such as a Medicare Set-Aside Trust.

Two other typical settlement types are which are very similar are: (1) Stipulation (Stip) with request for Award and, (2) Findings and Award. In both scenarios, the injured worker will receive a permanent disability award weekly as well as any unpaid benefits, and all future injury-related medical treatment will be covered. A Stip and Award is court approved and is generally a pre-trial settlement. A Finding and Award, on the other hand, is the judge’s decision on the case after trial. These awards may also be eligible for a Lump Sum Payment by commutation whereby a judge commutes part or your entire permanent disability award into a lump sum payment. Another advantage to this type of award is that your right to petition for new and further benefits is preserved should your condition worsen within five years of the original injury date.

Dependents of workers who die as a result of a work injury may be entitled to compensation including death benefits, medical treatment costs, and burial expenses.