Workers Compensation

Workers’ Compensation is a state-mandated system designed to protect employees injured during the course of their employment, and to help the employee recover so they can return to work as soon as possible. 

Through your employer’s workers’ compensation insurance carrier, the system provides medical care, temporary disability benefits, permanent disability benefits (if you do not fully recover), supplemental job displacements (if you are unable to return to work), and death benefits for your spouse and children (if you die from your work-related accident or illness).

If you injure your back from heavy lifting or a fall, if you get burned in an explosion or a chemical spill, if you are in an accident while making deliveries, if you suffer a repetitive motion injury, or loss of hearing from constant noise, you may be entitled to workers’ compensation.  Benefits are payable regardless of fault, with exceptions: if your injuries are a result of horseplay, fighting, violating company policy, breaking the law – or if they occurred outside the scope of your employment – you are not entitled to benefits.

When you are injured while on the job, obtain emergency treatment, if necessary – then report the injury to your employer as soon as possible, and fill out a claim form.  It should be noted that, due to recent changes in California law, most employees no longer have the right to request treatment from a doctor of their choice.  In most cases, you must now select a doctor from a list of medical providers in a network chosen by your employer.

Payments vary, according to your condition.  If your doctor determines that you are unable to return to work for more than three days, you are entitled to temporary disability payments.  If you cannot work at all, you will receive total temporary disability (TTD) payments.  If you can work on a limited basis during recovery – and your employer can accommodate your restrictions – you will receive temporary partial disability (TPD) payments.  

As a general rule, temporary disability payments amount to two-thirds of your pre-injury weekly wages.  Minimums and maximums do apply to the weekly benefit.  Your first check should arrive within two weeks and must be paid every two weeks as long as you are eligible.  Benefits will end when the doctor determines that you can return to work, or you choose to return to work on your own, or you have reached a “permanent and stationary” point, where your doctor determines that your condition is not improving or deteriorating.

Most employees recover from their injuries and are able to return to work.  Some will continue to have problems and never fully recover.  If your doctor determines that you will never completely recover, or will always be limited in what you can do at work, you may be entitled to permanent disability payments.  If you have a permanent partial disability, you are eligible to receive benefits over a fixed number of weeks, depending on the extent of your disability.  If you have a permanent total disability, you are eligible to receive payments for the rest of your life.

There are two types of settlements available to an injured employee.  One type of case can be settled through a “Stipulation with Request for Award.”  This includes an agreement as to when and how long you’ll receive permanent disability payments, and the amount of each payment.  This agreement will also include an agreement on your future medical care.

Another type of case can be settled through a “Compromise and Release.”  This usually involves a lump sum payment in exchange for a release of any future payments for permanent disability and future medical care.  In this case, you will not be able to go back and request more benefits at a later time.

In 2004, the insurance industry – with the help Governor Schwarzenegger – was successful in pushing through massive legislative changes to the workers’ compensation system.  The courts are still trying to interpret and apply these new laws.  These changes are devastating to the injured worker in California; workers’ rights have been significantly restricted and benefits have been severely reduced.  For example, physical and occupational therapy is now limited to 24 visits, temporary disability payments are limited to 2 years, and vocational rehabilitation has been completely eliminated.  Medical decisions are now made by employers and by doctors who are controlled by insurance companies.  These changes have created profound challenges for injured workers, their families, and for the attorneys representing an injured worker.

If you have been injured on the job, Maas & Marinovich will carefully guide you through every step of this complex system.