...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. If your employer cannot accommodate the restrictions, then you may be entitled to vocational rehabilitation. If you go into vocational rehabilitation, then the insurance carrier will provide you with retraining benefits. As with temporary disability, the retraining benefit is severely limited. For injuries after January 1, 2004 vocational rehabilitation has essentially been elminated. For injuries before January 1, 2004 there is a cap of $16,000.00 on the entire retraining process. All expenses including schools, counselors, and supplies, are counted against the cap. During the vocational retraining, you are entitled to a vocational rehabilitation maintaince allowance or "VRMA". This is paid at the rate of $246.00 per week and is subject to the cap of $16,000.00. There is a 12% withholding which is set aside to pay your lawyer.

...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. You are entitled to recover the percentage of ability you have lost to compete in the open labor market. 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 ability you have lost to compete in the open labor market. 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.

...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).

...Information about The Carlo Law Group, Workers' Compensation law and Social Security Disability can also be obtained by downloading our Information Publication for New Clients (PDF format).

...We urge all our clients to become members of VotersInjuredatWork.org, an organization of injured workers that is providing an independent voice and representation in Sacramento. Download their Membership Form (PDF format).

...Please note: The information presented on this web site is for general informational purposes only. Nothing contained in this site should be considered legal advice. You should speak to a lawyer to address any specific questions about your particular California workers' compensation or federal social security disability case.

...Law Notice: "Making a false or fraudulent workers compensation claim is a felony subject to up to 5 years in prison or a fine of up to $50,000 or double the value of the fraud, whichever is greater, or by both imprisonment and fine."