The most pressing question on most injured workers minds is how much they will get in workers’ compensation benefits. Many injured workers need to take time off from work and wonder how they will pay their bills. This article explains what kinds of benefits you can receive in California and how much each benefit might be worth. (To get an idea of what workers are currently receiving overall, see Workers’ Compensation Settlements and Awards: How Much Will I Get for My Injury or Illness?)
Temporary Disability Benefits
If you need time off work to recover from your injury, you can receive temporary disability benefits. These payments, made on a biweekly basis, are intended to compensate you for a portion of your lost wages. In California, you can receive two-thirds of your average weekly wages before the accident, up to a maximum of $1,128.43 per week (in 2016).
If you’re able to return to work, but you’re earning less than usual—for example, because the work is part time or light duty—you can still receive temporary disability benefits. However, you will receive two-thirds of the difference in your earnings, up to the weekly maximum stated above. For example, if you were earning $900 a week before the accident, and you now earn only $600 per week, you can receive $200 in weekly temporary disability benefits (two-thirds of the $300 difference in earnings).
You will continue to receive these benefits until your doctor has found that your condition has improved as much as it’s going to with treatment (this is called “maximum medical improvement” or MMI). However, benefits will typically end after two years, even if you haven’t yet reached MMI.
Permanent Disability Benefits
Many workers recover from their injuries completely and go back to their normal jobs. However, some workers suffer from permanent impairments that affect their ability to work and earn a living. Once you reach MMI, your doctor will evaluate you and give an opinion as to whether you have such a permanent impairment. If you do, you will receive a disability rating, stated as a percentage from 1% to 100%.
If you receive a 100% disability rating, you will receive permanent total disability benefits. Permanent total disability benefits are paid at the same rate as your temporary disability benefits rate, for the rest of your life. These benefits are paid only to workers who have serious impairments and can’t work in any capacity.
If you receive anything less than a 100% rating, you will be entitled to permanent partial disability benefits. Like temporary disability benefits, permanent partial disability benefits are paid at a rate of two-thirds your average weekly wages. However, these payments are subject to much lower weekly maximums. For example, for injuries on or after January 1, 2014, the weekly maximum is $290 for permanent partial disability benefits.
How long you will receive these benefits depends on your disability percentage and date of injury. For example, if you were injured on January 1, 2014 and you have a 10% disability, you will receive benefits for 30.25 weeks. If you’re entitled to the maximum weekly payment of $290, you will receive a total of $8,772.50 ($290 × 30.25).
Workers with disabilities of 70% to 99% can get an additional weekly sum called a life pension. These benefits start once your permanent partial disability payments have been paid out. However, life pensions are relatively small sums. For example, the current maximum for someone with a 99% disability is a little over $300 per week.
In California, all reasonable and necessary medical treatment related to your work injury will be covered by workers’ comp. Because your health care providers will bill the insurance company directly, you usually won’t see any of these payments. However, if you’re forced to pay for medical treatment that the insurance company wrongfully refused to authorize, you can receive reimbursement. You can also receive a sum for the cost of future medical care in an award or settlement.
If you’re not able to return to your job, and your employer doesn't have another position to offer you, you can receive vocational rehabilitation benefits. For injuries after January 1, 2013, these benefits come in the form of a $6,000 voucher, which you can use to pay the costs of school tuition, training programs, and related materials and tools. A portion of the funds can also be used to purchase computer equipment and to pay for vocational counseling or job placement services.