CALIFORNIA WORKERS' COMPENSATION
Your right to workers' compensation benefits is mandated by the California Constitution. In accord with this, the legislature has enacted a multitude of laws governing the administration of workers' compensation benefits. Courts of limited jurisdiction called the Workers' Compensation Appeals Board or WCAB have been created to resolve disputes involving work injuries. There are currently approximately seven different sets of laws which apply to workers' compensation cases. The date of your injury determines which set of law the WCAB will apply. However, the basic benefits have remained somewhat stable over time. It is very important to understand that the workers' compensation system provides for limited benefits for a work related injury.
...The first obligation of your employer and it's insurance carrier is to provide you with medical care without any deduction. You should never see a bill. You are entitled to all medical care which is reasonable and necessary to cure or relieve you from the effects of your industrial injury. At the conclusion of your case, your lawyer may be able to get an award of lifetime medical care from a Workers' Compensation Appeals Board judge.
...If you miss time from work, you are typically entitled to receive a wage loss benefit called temporary disability. This is paid at two thirds of your average weekly wage up to certain maximums. It is important to understand that California workers' compensation is a system of limited benefits. As of April 19, 2004 temporary disability is limited to a period of two years. The temporary disability is tax-free. Payments are not made for the first three days you are disabled unless you are hospitalized or unless you are unable to work for more than fourteen days. Once your doctor releases you to return to work or declares your condition to be stable, the temporary disability benefit stops.
...If your doctor gives you some restrictions, then it is up to your employer to accommodate those restrictions. If they can accommodate the restrictions, then you simply return to work within the modifications. The law previously provided for vocational retraining. However in 2004, the law changed and the vocational retraining program was eliminated.
...If the injury or illness results in a permanent handicap, then you may also be entitled to a recovery for permanent disability. Again, this is a very limited benefit. Again the law change in 2004 severely limited this benefit (the benefits were slashed by about 60%) This is a standard of recovery which is unique to workers' compensation. It is important to note that you are not entitled to a recovery for pain and suffering. Your recovery is based upon the disability described by the doctors who evaluate you. The Workers' Compensation Appeals Board, the insurance company, and your lawyer all interpret the medical evidence to determine the percentage of disability that you have. Once the percentage is established, then the recovery amount is rather simple as it is scheduled in the labor code. Simply put, a certain percentage will relate to a certain dollar recovery under the labor code. You must understand that workers' compensation law is somewhat politically driven. The insurance company has a lot more money to lobby the lawmakers. Wtih this in mind, you can imagine how fair the system is to injured workers. In sum, the sooner you accept that the workers' compensation system is more concerned with saving insurance companies money than with providing you beneftis, the sooner you will understand why the system works so poorly for injured people.
...If the injury or illness results in death, then a benefit will be paid to your surviving dependants. If you have questions about your rights and you do not wish to consult a lawyer, you should contact the State Office of Benefit Assistance and Enforcement. They can be reached toll free at 1-800-736-7401.
Potential Additional Rights
...Depending on the facts of your particular case, you may be entitled to additional rights. For example, if your injury was caused through the fault of another person, or by a faulty piece of equipment, you may be entitled to a "third party lawsuit". In such a situation, you may recover pain and suffering damages, as well as other general damages. If you believe that there is the possibility of a third party case, you should discuss the situation with an additional lawyer immediately (the time limits on such actions are limited and varied).