According to the Department of Industrial Relations (DIR), workers’ compensation protects employees in California by providing medical care, temporary wage replacement, permanent disability benefits, supplemental job training, and death benefits for families of fatally injured workers.
The Primary Benefits of Workers’ Compensation
Five of the primary benefits of workers’ comp include:
Medical Care for the Treatment of the Worker’s Qualifying Injury or Illness
If you get hurt at work or develop an illness because of your job, you could receive free medical treatment to help you heal and return to work. You should notify your employer immediately and get the list of approved medical providers who participate in your employer’s workers’ compensation program network.
Be sure to let all healthcare service providers who treat you know you are there for treatment of an injury or illness covered by workers’ compensation so that they do not bill your regular health insurance or send you a bill. The injured worker should not receive a bill for medical care if they follow all the rules that apply to a workplace accident or illness.
Temporary Wage Replacement
If you cannot work while recuperating from a workplace injury, you might be eligible for wage replacement through Temporary Disability payments. According to the DIR, this benefit sends you a check for two-thirds of your regular gross (pre-tax) wages, with some limits.
If you can complete your usual duties while recuperating, you will be eligible for medical benefits under workers’ compensation, but not temporary disability benefits. Sometimes, people have temporary work restrictions that decrease the amount of their paychecks while recuperating.
Temporary partial disability benefits can cover two-thirds of the difference in your previous pay and the lower amount you earn while recuperating. Again, there are limits to this benefit.
Permanent Disability Benefits
According to the DIR, permanent disability benefits are available for workers who can never fully recover from their injuries and return to their previous job at full capacity.
To be eligible for permanent disability benefits, the worker must complete their prescribed treatment regimen and achieve the maximum medical improvement (MMI) their treating doctor expects, but they still have lingering impairments.
A physician will examine the worker and assess a disability rating from zero to 100 percent. The disability rating measures the employee’s permanent loss of function that impacts their ability to earn a living and accounts for their age and occupation.
A disability evaluator or judge will calculate your permanent disability rating and determine how much compensation you qualify for. You can request a second opinion if you disagree with the disability rating.
Supplemental Job Displacement Benefits
If you have a permanent disability from your illness or injury that prevents you from returning to your previous job, you might be eligible for job skill retraining benefits. You could receive a job displacement voucher to help pay for education or training.
Workers’ Compensation Death Benefits
If a worker dies from an injury or illness that would qualify for California workers’ compensation benefits, the worker’s surviving dependents could be eligible for death benefits. The deceased employee’s spouse, children, or other eligible dependents could receive payments from the program, according to the DIR.
Benefits could include up to $10,000 for burial expenses and up to $320,000 in death benefits, depending on the number of qualifying dependents.
An Overview of the California Workers’ Compensation Program
According to Forbes, the California workers’ compensation system began in the 1910s and has provided valuable benefits for people who suffer injuries or develop illnesses due to their job duties.
Unlike a standard personal injury claim, workers’ compensation in California is a no-fault system, meaning the employee does not have to prove that negligence caused their injury or illness.
If you get hurt on the job in California, you almost certainly qualify for workers’ compensation benefits because our state requires every employer with one or more workers to carry this valuable insurance.
Exceptions to the California Workers’ Compensation Program
You might be ineligible for workers’ comp benefits in California if you fall within one of these exceptions:
- You are a federal employee covered by the federal workers’ compensation program.
- You are an independent contractor. Be aware, however, that you are not necessarily an independent contractor just because your employer calls you one. There are strict objective tests to determine who is an employee and who is an independent contractor in California, per the DIR.
- The injury did not happen at work. People often incorrectly assume they are “on the job” while commuting to the workplace, but that is not the case for workers’ compensation.
Some additional factors might make a worker ineligible for workers’ compensation benefits in California. If your boss or their workers’ comp insurance carrier denies your request for benefits, you should talk to a lawyer to learn about your legal rights.
The Hidden Workers’ Compensation Benefit of Mileage Reimbursement
Your boss and their insurance carrier are unlikely to inform you you are entitled to mileage reimbursement for driving to your medical appointments and picking up prescription medications.
Over a long recovery, this item could add up to a considerable amount. Be sure to keep track of your mileage and discuss claiming this benefit with your lawyer.
Get Help from a Workers’ Compensation Lawyer Today
In a perfect world, workers’ compensation would be straightforward, and all workers would receive the benefits they deserve without a fight. However, that is not always the case. The insurance company may deny or undervalue your benefits. Your employer may misclassify you as an independent contractor or deny your injury is work-related. A third party may have caused your injury, leading to confusion about what type of claim to file.
In these cases, working with a workers’ compensation lawyer at KJT Law Group may greatly benefit your case and your ability to recover the benefits you deserve. It’s easy to get started with a free consultation. Contact us by calling (818) 507-8525 today.