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How Are Workers’ Compensation Benefits Calculated in California?

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Every state approaches workers’ compensation differently. If you are injured on the job in California, understanding the payment structure can help you make decisions about your future. It can also alert you to unfair assessments by your employer or a claims adjuster. Increase your payout and get the benefits you deserve by understanding how benefits are calculated for a workers’ compensation settlement amount.

What You Are Entitled to Under Workers’ Compensation Insurance

After you have suffered an on-the-job injury, your employer should present you with paperwork for workers’ compensation within the first 24 hours. This benefits program from their insurance company will cover your medical expenses, rehabilitation, transportation to and from treatment, income replacement through temporary or permanent disability, and death benefits to surviving family members. A settlement offer can result in a payment plan or a lump sum.

The California Division of Workers Compensation (DWC) regularly holds seminars for those interested in learning more about coverage after a workplace injury, and the Department of Industrial Relations website is also a great resource for questions you have about compensation.

Calculating the Medical Benefits

The benefits you receive through a workers’ comp settlement is for your medical bills. Workplace injuries are completely covered by the policy. You will not pay a deductible or other out-of-pockets costs. The coverage for curing or relieving the effects of the injury may include medication, hospital expenses, office visit bills, medical equipment, and physical therapy needs. You will be covered up to $10,000 in compensation until your comp claim has been accepted or denied.

Wage replacement costs are calculated according to the amount of time you spend away from work. You do not have to use personal time off to recover from your injury. If you miss 3 or more days or you are hospitalized overnight, you will be entitled to receive temporary disability, which will cover 2/3 of your weekly income. If you suffer from an injury that permanently reduces your earning capacity, you may be entitled to receiving extended benefits through a permanent disability program.

Permanent disability is calculated based on the extent of your injury, the date, and other factors. In addition to wage replacement benefits, you may also be entitled to an SJDB (Supplemental Job Displacement Benefits) voucher, which may include $6,000 in compensation for vocational retraining, skill training, and more.

During 2015, travel reimbursement for treatment is calculated at $.575 per mile. This benefit covers trips to the doctor, therapy, hospital visits, and to the pharmacy. Death benefits to surviving family members include $10,000 for burial, a range of compensation from $250,000-$320,000 for surviving dependents, and annual support capped at $250,000 for partial dependents.

Additional Considerations That Affect Compensation

Even reviewing benefits calculations online can be confusing. Your unique circumstances will govern how your benefits are calculated. For instance, you may disagree with your physician and need to get a second option that may completely change your compensation amount. Deadlines for filing paperwork can also affect your ability to receive maximum compensation.

What About Disability Benefits?

If your work injury restricts your ability to perform your work at the level you were able to before, you may be entitled to a permanent partial disability award.

Seeking Legal Counsel

While it is not always necessary to secure an attorney for workers’ compensation claims, every case is different. Labor laws in California are complex, and an attorney can help you understand your rights and advise you on legal action if you are concerned your physician, claims administrator, or employer is treating you unfairly. Workers’ compensation attorneys in California will never charge you directly for their services. Instead, they are paid through workers compensation benefits.

If you are interested in learning more, contact the Orange County workers comp attorneys at DiMarco | Araujo | Montevideo. We always offer a free consultation which may help you decide whether or not to take legal action. We can help you find competent medical treatment, maximize your compensation, and help you heal so you can move forward with your life.

Covid 19 Update: We are accepting new cases and we handle everything electronically and remotely, so our clients never have to leave their homes.