California Workers Compensation Benefit Categories

Workers compensation law involves injuries connected with employment. It can be specific injuries or disabled condition or a disease. Employer is liable for paying workers compensation insurance.

Actually, there is need for an attorney to represent the employee making claims but the insurance company and employer will be represented by experienced claim adjuster or even an attorney. You will be at serious disadvantage, especially in case of dispute.

Benefits available under workers compensation law

Under the California workers compensation law, an employee has a right to specific benefits that fall under the following categories.

Medical benefits

All the hospital and medical benefits practically necessary to relieve or cure injury effects including travel to and from the clinic.

  • If the employer’s insurance provider has no Medical Provider Network [MPN] then the employer has a right to send their employee to a medical provider of their choice for first 30 days but the employee holds the right to change doctors under certain conditions.
  • If there is an established MPN and you are told about the network then you will be needed to get medical care from within this grid but you have a right to change doctor within this network.
  • In case you are unaware about the MPN then you can select doctor outside this grid.

Therefore, read letters from claim administrator and employer very carefully to find out if there is a Medical Provider Network.

Temporary disability

Work-related injury that needs hospitalization or missing work for over 3 days means, you are eligible to get temporary disability benefits. It is paid at 2/3rd of your AWE [average weekly earnings]. This benefit duration is limited to 2 years.

Permanent disability

Work-related permanent disability determination is complex. The doctor defines the percentage of disability and that percentage is lowered or raised on the basis of your occupation and age.

Current weekly rates for 1% is $290 and for 99% is 897.25. If your employer offers an alternate or modified job that pays maximum 85% of usual job then you get 15% reduction in permanent disability benefit even if you don’t accept the job. If job is not offered then you get 15% increase in weekly rates.

Compensable consequences

Initial work-related injuries can cause other damages like fractured wrist because of a fall due to an industrially injured feet giving way or back injury due to industrial knee limps. These subsequent injuries are eligible for compensable consequences.

When you get injured notify your employer that this condition is work-related. Ask for claim form and fill in lines 1 to 7 and on the 8th line sign. The employer will take care of the rest.

If employer does not give claim form then consult an attorney. You are eligible to re-open case even after 5 years from date to injury in case your conditions get worse after receiving some benefits.

Never hesitate to approach an attorney!

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