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Types of Workers’ Compensation Benefits


Types of Workers’ Compensation Benefits

I’m Ed Smith, a Sacramento workers’ compensation lawyer. Workers’ compensation is a type of insurance that covers an employee when they are injured on the job. It is mandatory for employers in the state to carry workers’ comp, and serious penalties ensue if this obligation is not met. It is important for every worker to understand what, workers’ compensation, benefits are available. 

Five Basic Benefits

There are five types of workers’ compensation benefits. They are:

Medical Benefits

Workers are eligible for evidence-based medical treatment for illness or injury related to their jobs. Such treatments are those that are specifically proven to help alleviate symptoms or cure the problem. The state provides medical treatment utilization schedules (MTUS) that tell physicians whether a treatment is effective, the frequency with which the treatment is needed and the extent and duration of treatment.

All treatment must be either approved or denied within 24 hours by a medical claims adjuster. If the adjuster takes longer to investigate the claim, you are able to begin treatment after this, however, the cost is capped at $10,000. Once your claim is approved, you are able to receive appropriate treatment for as long as is deemed necessary by your doctor. Disagreements, such as returning to work, can be settled in a variety of ways.

Some treatments such as chiropractic, occupational therapy and physical therapy are limited to 24 visits. Medical treatment is given by selected physician groups, individual doctors or a predesignated physician. In the latter case, the predesignated doctor is one chosen by you before the injury or illness occurred and was approved for this purpose. Some stipulations apply.

Temporary Disability

Temporary disability payments are provided if you are unable to work due to the work-related illness or injury. The types of temporary disability are:

  • Temporary total disability: This type is provided when you are totally not able to work.
  • Temporary partial disability: This is provided when you can work but not on a full time basis.

Temporary disability pays ⅔ of your normal, pre-tax income. The total income incorporates all types of income such as wages, tips, lodging, commission, bonuses, overtime and income from other jobs. Taken together, it can not be more than an absolute amount allowed by law. If the doctor does not permit you to return to work for more than 72 hours or if you are admitted to the hospital overnight, temporary disability begins. You will receive the benefit every 14 days until you can return to work. For those injured after 2008, temporary disability payments can be received for 104 weeks within a five-year period. TD is not taxable. This includes local, state and federal taxes, Social Security, retirement fund payments or dues to the union.

Permanent Disability

Permanent disability is a benefit you can receive if your earning ability has been lowered even if you have improved but continue to have medical issues. In such cases, the physician must determine if no further improvement is anticipated, although your condition is considered stable. This is called maximal medical improvement. The doctor also determines whether a pre-existing condition is adding to your disability. Based on the the calculations made by the claims adjuster, you will receive a payment in 14 days after TD payments cease. If any payment is late, you will receive an additional 10 percent.

After PD is configured, you may be awarded a settlement approved by a workers’ comp judge. You may receive a compromise and release lump sum payment, which means you are responsible for any further treatment yourself. Alternately, you may be given a stipulation or stip payment, which means you receive payments over time, and your subsequent medical care for the condition is covered.

Death Benefits

If you die as a result of your injury or illness, your family may be eligible for death benefits. Burial expenses of $10,000 are covered. Minor children are paid until they reach 18. A disabled child is paid for life. Payments are at the temporary disability level but must be at least $224 each week.

Supplemental Job Displacement Benefits

If a worker has permanent partial disability and his or her workplace does not have a job they can do, they may be eligible for retraining in another job. This must be done within two months after a doctor has freed the worker to return to work. The worker will receive a $6,000 voucher to retrain. This can be done at a public educational institution or other certified training venue. The money can help the worker buy tools or other study aids or pay for licenses and certification in a particular field. Six-hundred dollars can be used for a vocational counselor.

Sacramento Workers’ Compensation Lawyer

I’m Ed Smith, a Sacramento workers’ compensation lawyer. The workers’ compensation benefits process is fraught with deadlines and complexities. Having an experienced lawyer at your side is a good idea so that you receive what you are guaranteed by law. Call me anytime for friendly and free advice. You can reach me at (916) 921-6400 or (800) 404-5400. I am also available online on my website, which I established and own.

Some trial lawyers win verdicts and settlements of $1 million for their clients. They are asked to join the Million Dollar Advocates forum, a nationwide group. I was inducted as a member from  California.

In the past 35 years, I’ve practiced injury law, in Sacramento, helping clients in wrongful death and other catastrophic claims secure just compensation.

To learn about my legal team and the way I practice the law, visit Yelp, Avvo and Google to see reviews and comments.

You can view some settlements/verdicts I obtained on my verdicts and settlement page.

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