Andrew L. Shapiro | July 2, 2024 | Workers' Compensation
This article is informative. JUSTICENTER Personal Injury Lawyers do not handle workplace accident cases. For assistance, please consult a workers’ compensation specialist.
Workers’ compensation provides benefits to injured employees. You can receive medical care for your injuries and the loss of income benefits. You may also receive vocational and rehabilitation benefits if you cannot perform your duties. The length of time you receive workers’ comp benefits depends on the facts of your case, including the type of benefits and the severity of your injuries.
How Long Will I Receive Benefits for a Workers’ Comp Claim in California?
Compensation for medical treatment and loss of wages are the two most common types of workers’ comp benefits. The length of time you receive these benefits varies.
Medical Benefits
Workers’ compensation pays for your medical treatment after a workplace injury, such as a concussion or other traumatic brain injury (TBI). Medical benefits include, but are not limited to:
- Doctor’s appointments
- Surgeries
- Hospitalizations
- Medications
- Physical therapy
- Medical devices
- Diagnostic tests
- Medical specialists
A workers’ compensation claim does not have a time limit for medical benefits. You should receive medical benefits until your doctor states you have healed from your injuries. Medical costs can continue as long as they are considered necessary, reasonable, and authorized by the workers’ compensation insurance company.
Temporary Disability Benefits
If you cannot work during your recovery because of a work-related injury, you can receive temporary disability benefits. The benefits pay you a portion of your lost wages.
In California, workers’ comp replaces 60% to 70% of your average weekly wages. The amount is subject to state minimum and maximum amounts.
Temporary total disability benefits are paid when you cannot perform any of your job duties. Temporary partial disability benefits are paid when you can return to work, but your work hours and/or job duties are limited.
California law limits temporary disability benefits in workers’ compensation cases to 104 weeks. However, workers with severe injuries that do not result in permanent disability can receive up to 240 weeks of temporary disability benefits.
Permanent Disability Benefits
A work-related injury may result in a permanent impairment or disability. If you are unable to work because of your work injury, you may qualify for permanent disability benefits. These benefits are paid to workers who sustain a permanent impairment.
Total permanent disability benefits are paid when the worker cannot perform any work. The disability benefits may continue for the rest of your life.
Permanent partial disability payments are intended to compensate an injured worker for an impairment that could impact their ability to work, but the impairment is not a totally disabling condition.
Permanent partial disability payments may continue for several years or the person may settle the claim for a lump sum payment. The benefits are based on the impairment rating assigned for your injury by a medical professional.
How Do They Determine the Severity of an Impairment for a Workers’ Compensation Claim in California?
An impairment rating is assigned based on the functional loss caused by your work-related injury. An impairment rating of 0 means that you have no impairment and can return to full work duties. On the other end of the scale, an impairment rating of 100 means you are entirely disabled and cannot perform any type of work.
A medical provider may use the American Medical Association (AMA) Guidelines for the Evaluation of Permanent Impairment to assess the severity of permanent disabilities and impairments. The worker’s primary treating physician or a qualified medical evaluation assigns the impairment rating based on the criteria in the AMA Guidelines.
The AMA Guidelines are supposed to provide an objective and standardized framework to assess impairments for workers’ compensation. It is based on medical evidence and has been adapted several times to reflect advances in the medical field.
The workers’ compensation insurance provider may require you to have an independent medical examination (IME) to confirm your disability rating. You could lose your workers’ compensation benefits if you refuse to attend the IME.
Preparing for an Independent Medical Examination for a Workers’ Comp Claim
Your attorney will discuss how to prepare for an IME. Some things to keep in mind include:
- Never exaggerate your injuries. Be honest and tell the examiner the truth about how your injuries impact your life.
- Wear comfortable clothing for the evaluation.
- Arrive on time for your examination.
- Do not hesitate to say something hurts as you complete the examination.
- Recognize that the medical provider evaluates you from the moment you arrive until you leave. The doctor may watch you leave the office and go to your vehicle.
- Be brief but thorough with your answers without answering questions the doctor does not ask. Only elaborate if the doctor asks you to do so.
- If possible, do not take pain medications before the IME. Pain medications can mask symptoms and reduce pain levels so that it appears you can do more without pain than you can.
- Always assume you are on video. Act normally, but be aware that your every action may be recorded.
Your IME is an essential step in the process of obtaining your workers’ compensation benefits. If you have questions about a claim, set up a free consultation with an experienced workers’ compensation lawyer.
Contact the Encino Personal Injury Lawyers of JUSTICENTER Personal Injury Lawyers for Help Today
Please contact an experienced Personal Injury lawyer at JUSTICENTER Personal Injury Lawyers for a free initial consultation today at (833) 852-3600.
Our main office is in Encino, CA, but we serve all through Los Angeles County.
JUSTICENTER Personal Injury Lawyers
16633 Ventura Blvd suite 1011,
Encino, CA 91436
