How does workman’s comp work?

If you get hurt on the job, your employer is required by California law to pay for workers’ compensation benefits. You could get hurt by:

• One event at work. Examples: hurting your back in a fall, getting burned by a chemical that splashes on your skin, getting hurt in a car accident while making deliveries.
• Repeated exposures at work. Examples: hurting your hand, back, or other body part from doing the same motion over and over, losing your hearing because of constant loud noise.

Workers’ compensation also covers some, but not all, stress-related injuries caused by your job. However, workers’ compensation may not cover an injury that is reported to the employer after the worker is told he or she will be terminated or laid off.

Workers’ compensation benefits can include:

• Medical Care. Paid for by your employer, to help you recover from an injury or illness caused by work. This includes doctor visits and other treatment services, tests, medicines, equipment, and travel costs necessary to treat your injury.
• Temporary Disability Benefits. Payments if you lose wages because your injury prevents you from doing your usual job while recovering.
• Permanent Disability Benefits. Payments if you don’t completely recover and your injury causes a permanent loss of physical or mental function that a doctor can measure.
• Supplemental Job Displacement Benefit. A voucher to help pay for retraining or skill enhancement if you are eligible to receive permanent disability benefits, your employer doesn’t offer you work, and you don’t return to work for your employer.
• Death Benefits. Payments to your spouse, children, or other dependents if you die from a job injury or illness.

If you get hurt at work or develop a work-related medical problem, report the injury or illness to your supervisor or someone else in management as soon as possible. If your injury or illness developed gradually (like tendinitis or hearing loss), report it as soon as you learn or believe it was caused by your job. Reporting promptly helps avoid problems and delays in receiving benefits, including medical care. If your employer does not learn about your injury within 30 days, you could lose your right to receive workers’ compensation benefits.

As soon as an injury occurs, you should also contact a workers’ compensation attorney to prevent any ramifications. There are many deadlines for specific paperwork, and missing these deadlines or improperly filing paperwork could jeopardize your benefits. An experienced California workers’ compensation attorney can ensure your rights are protected.

How do I file a workers’ comp claim?

In California, your employer must give or mail you a Workers’ Compensation Claim Form (DWC 1) within one working day after you report your injury or illness. Fill out and sign the “employee” portion of the form, and return the form to your employer. This is called “filing” the claim form. Do this right away to avoid possible problems with your claim.

Your employer must fill out and sign the “employer” portion of the form and give the completed form to a claims administrator. This person handles workers’ compensation claims for your employer. Your employer must give or mail you a copy of the completed form within one working day after you filed it.

How do workers’ comp lawyer fees work?

Workers’ compensation cases, like most personal injury cases, are generally handled on a contingency fee basis. This means many attorneys handle cases for a percentage of the lump sum offered to settle the case. They don’t get paid unless and until you win your case. There is never an out-of-pocket cost to you for attorney fees.

How much does workers’ comp pay?

The actual monetary amount you receive from workers’ compensation depends on several factors, especially the nature and extent of your injury.

If your injury prevents you from doing your usual job while recovering, you may be eligible for temporary disability (TD) benefits. As a rule, TD benefits are two-thirds of the gross (pre-tax) wages you lose while you’re recovering from a job injury. However, you can’t receive more than a maximum weekly amount or less than a minimum weekly amount, as set by California law.

If your treating doctor says you will never completely recover from your illness or injury, you may be eligible to receive permanent disability benefits or a supplemental job displacement benefit.

Permanent disability (PD) benefit amounts are set by law. The claims administrator will determine how much to pay you based on several factors:

• Rating of your disability.
• Your date of injury.
• Your wages before you were injured.

If you have a permanent partial disability, you may be eligible to receive a supplemental job displacement benefit (SJDB). A SJDB is a voucher that promises to help pay for educational retraining, skill enhancement, or both, at eligible schools. The voucher is redeemable up to $6,000.

How long can you receive workers’ compensation benefits?

The length of time for which you can receive workers’ compensation benefits in California depends on whether you have a partial disability benefits status or a total disability benefits status.

Temporary disability benefits end when:

• Your treating doctor says you can return to your usual job (whether or not you actually return to work); or
• You return to your usual job or to modified or alternate work at your regular wages (or at wages associated with a maximum limit on TD payments); or
• You have reached a point where your condition is not improving and not getting worse (when this happens, your condition is called “permanent and stationary”).

When TD payments end, the claims administrator must send you a letter explaining why the payments are ending. This letter must be sent within 14 days after your final TD payment.

If you have a permanent partial disability, you are eligible to receive the total amount of your PD benefits spread over a fixed number of weeks. If you have a permanent total disability, you are eligible to receive PD payments for the rest of your life. PD payments end when you reach the maximum amount allowed by law or settle your case and receive a lump sum.

For supplemental job displacement benefits, the voucher expires two years after the date the voucher is furnished to you or five years after your date of injury, whichever is later.