Workers’ Compensation Benefits

Benefits

There are four basic benefits in the California Workers’ Compensation: Medical Care, Temporary Disability(TD), Permanent Disability(PD) and the Rehabilitation Voucher.

Medical Care

The injured worker is to receive all the medical care necessary to reasonably cure or relieve the effects of the injury. Although the California Workers’ Compensation medical care use to be the best medical care available with no limitation for cost cutting reasons. There are now many restrictions and constraints on medical care. The new laws give the employers much greater control over the injured worker’s medical care with the implementation of the MPNs (Medical Provider Networks) and UR (utilization review). Statute link to SB899.

Temporary Disability (TD)

Temporary disability is a wage loss benefit that is paid at (2/3) two thirds your average weekly wage with a maximum benefit of $840 per week subject to COLA raises.

For injuries after 4/16/04 these benefits can only last for 2 years from the date it is first paid.

TD is paid to you while you are disabled from your injury. Payments begin after a 3 day waiting period, unless you are hospitalized, then payments begin immediately. Payments are made bi-weekly while you are off work or until you reach MMI (maximum medical improvement) or P&S(permanent and stationary) status.

Permanent Disability

Permanent disability is a monetary benefit provided to a disabled worker to partially compensate the individual for their future earning capacity the disability caused. The amount awarded is based on a complex formula combined of medical reports, disability charts, guidelines and schedules. There are tremendous variations from case to case depending on a multitude of factors.

Rehabilitation Voucher

For injuries between 1/1/2004 and 12/31/2008 the rehabilitation benefits is a voucher. Values as follows:

0%-under 15% = $4,000.00
15%-25% = $6,000.00
26%-49% = $8,000.00
50%-99% = $10,000.00

The funds are provided to the school in which you enroll, but is not paid until you go to school, and is not paid to you directly. There is no provision made for you to receive weekly benefits while in school, however, some of our clients have been able to obtain State Disability during this time.

The rehab benefit for disabilities before 1/1/2004 was much better and actually provided education, counselor services and disability payments.

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The rehabilitation benefit for injuries before 1/1/2004 included what most clients think of as vocational rehabilitation. Counselor services, income replacement and education were many of the options available to injured workers. However, these benefits were eliminated for all injuries after 1/1/2004.

IMPORTANT: The provision in the Labor Code, the law that governs workers’ compensation, that serves as the authority for rehabilitation sunsets at the end of 2008. Therefore, as it currently stands, for all injuries after 12/31/2008, rehabilitation of any kind, including vouchers are not an option. All injured workers are encouraged to request vocational rehabilitation from the insurance carrier immediately. Failure to do so may jeopardize your right to request such benefits after 1/1/2009, even if you had an earlier date of injury.