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Have You Been Injured on the Job?
If you’re injured on the job in California, or if you’re diagnosed with a work-related illness, you probably qualify for workers’ compensation benefits, but to receive these benefits, you may need the legal advice and services of an Inland Empire workers’ compensation attorney.
Workers’ comp in California doesn’t require an injured worker to prove that an employer was negligent. Instead, to obtain workers’ compensation benefits, an injured worker in this state only needs to prove that an injury happened within the “course and scope” of his or her job duties.
What Workers’ Comp Benefits Are Available in California?
Workers’ compensation benefits for California employees with job-related injuries and illnesses in most cases involve the following benefits:
- medical treatment and care to help workers recover from a work-related injury or illness
- temporary disability benefits as a partial replacement for wages lost while a worker recovers from a work-related injury or illness
- permanent disability benefits for employees who do not recover fully from a work-related injury or illness
- vocational rehabilitation or career retraining for a worker medically unable to return to full, unrestricted employment duties.
Injured workers are entitled to all of their reasonable and necessary medical treatment including surgeries, medications, hospital stays, and doctor visits. Workers’ comp also provides vocational rehabilitation, and it offers death benefits to surviving family members of fatally injured workers.
What is a Permanent Disability Rating?
Workers’ comp benefits for permanently disabled California workers are determined by a rating. A rating is a percentage that indicates how extensively a disability restricts someone’s ability to earn income. The rating also determines the dollar amount of the permanent disability benefits.
Permanent disability ratings in the California worker’s comp system are based on these factors:
- The worker’s medical condition as diagnosed by an independent medical professional or a doctor approved by the employer’s workers’ compensation insurance company.
- The worker’s age and the date the worker was injured.
- How much of the disability was caused by the job itself compared to how much of the disability was caused by other factors. (This is referred to as “apportionment.”)
A 100 percent rating represents a total permanent disability, which is extremely rare. A rating from one percent to 99 percent indicates a partial permanent disability.
How Are Permanent Disability Benefits Calculated?
Depending on your average weekly wages when you were injured, your permanent disability rating qualifies you for a specific dollar amount.
However, California also sets minimum and maximum permanent disability benefit amounts. As of 2024, the minimum payment for permanent disability benefits in this state is $160 per week, while the maximum payment is capped at $290 per week.
If someone is permanently disabled and cannot return to his or her previous work, that person may qualify for vocational rehabilitation training for a different job or a career change. Job training, job placement, and other types of vocational assistance are available.
Take These Steps if You Are Injured at Work
It is imperative to report an injury to your employer and to seek medical care immediately. If you are diagnosed with an illness or injury related to your work, you should also report that diagnosis to your employer as quickly as possible and within at least thirty days.
Your employer will give you a workers’ comp claim form (a “DWC-1” form). Complete the form quickly and accurately. This initiates the workers’ comp claim process. Your employer will file the form with the insurance company that provides the employer’s workers’ comp coverage.
How is Your Workers’ Compensation Claim Processed?
The insurance company should inform you within fourteen days about the status of your claim, but up to $10,000 may be authorized for immediate medical treatment even while your claim is being processed. This lets you receive the care you need while you await approval of your claim.
If your workers’ comp claim is rejected, you will probably receive a rejection letter within ninety days. If your claim is denied, or if you receive no approval or denial of your claim within ninety days, contact a Southern California workers’ compensation lawyer to discuss your case.
Who is Eligible for Permanent Disability Benefits?
In California, to qualify for permanent disability benefits, your doctor must state that you have recovered as much as you are going to recover, even if you have additional treatment. This stage is referred to as “maximal medical improvement” or MMI.
When you reach the MMI stage, temporary disability payments cease. If you have fully recovered and you can return to work without limitations, you will not qualify for permanent disability benefits.
However, if your injury or illness has permanently disabled you and restricted the work you can do, your doctor will classify the injury or illness as “permanent and stationary,” and you will probably qualify for permanent disability benefits.
What Else Should You Know About Permanent Disability Ratings?
Your permanent disability rating plays a key role in determining the amount of workers’ comp benefits you receive, so it’s essential to understand the rating and – if you believe the rating is inaccurate – challenge it with help from an Inland Empire workers’ compensation attorney.
Carefully read your medical reports and locate any mistakes in the description of your injuries, physical restrictions, or complaints about fatigue or pain. If you disagree with your disability rating, the insurance company must be informed in writing.
A letter from your lawyer should be sent within twenty days after you receive your rating. If you don’t have a lawyer, you must respond with a letter within thirty days, but the rating process is complicated, and it’s difficult to challenge – or even to understand – without a lawyer’s help.
Espinoza Law Group Will Fight for Your Workers’ Compensation Benefits
At Espinoza Law Group, Southern California workers’ compensation lawyer Ruben R. Espinoza represents injured and disabled workers, fights for the workers’ compensation benefits they are entitled to, and provides quality legal representation to every client.
Espinoza Law Group has recovered millions of dollars in benefits for those who have been injured in Southern California, and we know what it takes to win the benefits you deserve and need.
If your workers’ comp claim is denied or if you disagree with your disability rating, contact Espinoza Law Group at once by calling 213-667-0701. We provide free case screenings, and we proudly serve clients throughout Southern California. Se habla español.
