How are Workers' Compensation Benefit Payments Calculated in California?

Workers' Compensation Benefits.

A workplace accident can change your life in an instant. If your injury is severe, you may need to stay in the hospital and take time off work to heal. Meanwhile, you still need to pay your bills and provide for your family. Workers’ compensation relieves the financial burden of recovery by providing benefits that pay for medical expenses and missed wages while you’re off the job.

If you were injured at work and have filed for workers’ compensation benefits, you’re probably wondering what payments you’re entitled to receive – and how much. While you won’t collect the same income you would be making if you were still working, your average weekly wage provides a basis for the benefits you are entitled to. If you work in California, here’s a look at how your workers’ compensation benefit payments will be calculated:

Medical benefits

Under California law, workers are entitled to all medical treatment necessary for recovery. Unlike health insurance, workers’ compensation provides treatment without having to meet a deductible or pay any out-of-pocket costs. Expenses that fall under the umbrella of medical benefits include doctor visits, surgeries, hospital bills, prescription drugs, and adaptive medical equipment.

California workers are also entitled to up to 24 chiropractic sessions and 24 visits with a physical therapist for rehabilitation. Under state law, an employee is required to see a doctor within his or her employer’s medical provider network to receive payment for healthcare expenses.

Payment for lost income

Being unable to work for any length of time can put a strain on your finances. Fortunately, the California workers’ compensation system provides temporary disability benefits to replace some of the wages lost while you’re off your feet. Under state law, workers who can’t work at all receive total temporary disability (TTD). Workers classified as TTD are entitled to two thirds their average weekly wage. Regardless of how much you make, the average weekly wage is subject to a maximum of $1,164.51 (for 2017).

You are locked into the maximum weekly wage for two years from the date of your injury. If you’re still unable to work two years after your accident, your rate will increase to the new highest rate in effect. If your doctor determines you are permanently disabled and unable to return to the job you had prior to your injury, you will be eligible for permanent disability benefits.

Permanent disability benefit

Permanent disability benefits are significantly less than temporary disability benefits. For 2017, the permanent disability weekly maximum rate is $290.00. The amount you receive depends on your impairment level as determined by your doctor, which is expressed as a percentage. The length of time you receive benefits, from three weeks to life, is also dependent on your level of impairment.

The formula used to determine your permanent disability benefit takes your age and occupation into account. You can choose to receive weekly payments, or your workers’ compensation attorney can settle your claim so that the entirety of your permanent disability benefit is rolled into one lump sum. The advantage of the latter option is that you can ask for the cost of any anticipated future medical expenses to be included in your settlement.

Supplemental job displacement benefit

The supplemental job displacement benefit isn’t a cash benefit, but rather a voucher you can use for education training so you can find a new job. The voucher is worth $6,000 and it can be used on anything from tuition to textbooks. You are eligible to receive the supplemental job displacement benefit if your employer doesn’t offer you modified work that accommodates your disability and if you don’t return to work for that same employer within 60 days of your temporary disability benefits ending.

Death benefits

If an employee dies from a work-related injury or illness, his or her spouse, children, or other dependents are entitled to death benefits. For injuries on or after January 1, 2013, dependents will receive $10,000 to pay for burial expenses. In addition, surviving dependents collect a lump sum ranging between $250,000 and $320,000, depending on the number of dependents. Children also share a weekly death benefit equivalent to the worker’s temporary total disability payment until they turn 18.

Contact a San Diego workers’ compensation attorney at Gerald Brody & Associates

As you can see, the way workers’ compensation benefits are calculated relies on complex formulas that involve many variables. Luckily, you don’t have to do the math on your own. At the Law Office of Gerald Brody & Associates, we have more than 45 years of collective experience helping injured workers make sense of their cases and collect maximum benefits for their injuries. If you’ve been hurt on the job and are looking for answers, give us a call to schedule a free consultation.