Workers' compensation insurance is a basic income guarantee that workers can count on in California. Employers must have workers' compensation insurance or their own insurance plan.

The payments make up for the injured or ill Californian's loss in their ability to earn income.

Injured and Ill Workers

The work losses California workers' compensation covers happen after a worker experiences an injury or illness caused by work. The work experience that breaks the regular work schedule happens either during a single event, such as a fall that breaks an arm, or during repeated exposures to harm, such as daily driving in a delivery truck seat that bends the back out of shape. Either way, productivity becomes limited, or stops.

Workers' compensation claims are filed with the Division of Workers' Compensation using DWC Form 1.

Injuries and illnesses that happen while the worker is not on the job do not count for workers' compensation.

Benefits

The benefits both replace some of the income lost and help keep a worker healthy. Medical benefits pay for emergency medical treatment and treatment during the period a Californian recovers. A treating doctor, who can be the regular doctor, decides the treatment needed to cure or relieve the harm done.

During the recovery period, a worker can get disability benefits that replace their lost income. There are two kinds, temporary and permanent. Workers that need to build up ability or strength to return to a job might get additional benefits that pay for the activities done to become fit to work again.

Temporary Disability Benefits

When work abilities are lost for a period of time, the benefits that replace income losses during the period are temporary disability benefits. Anyone that asks for the benefits has to get told by a treating doctor they can not work for at least 3 days or spend an overnight stay in a hospital.

Californians prevented from doing their regular job can get either temporary total benefits that give them an income while out of work or temporary partial benefits that give them an additional income while they stay on the job and do some of their work. The payments replace two-thirds of the lost gross income. But, not everyone gets the two thirds. There is a minimum amount that no worker will get less than and a maximum amount that no one will get more than.

Weekly payments begin 14 days after an employer hears about the injury or illness. The payments can last up to 2 years. The time limit is the end of the disability benefits for workers injured after April 19, 2004.

Three things end disability benefits. The treating doctor says the Californian can return to work. Their employer offers a suitable job at regular wages. Or, the worker returns to work at regular wages.

Return to Work Benefits

If an employer does not give their worker a job, they can get Supplemental Job Displacement Benefits they can use to pay for retraining or skill improvement. Workers not fully recovered can get the benefits even if the employer offers a job. A claims administrator hands out a voucher.

Californians injured before 2004 do not get SJDB. They can ask for vocational rehabilitation benefits that pay for job placement counseling, job searches, and training.

An offer of work, even one that is turned down, makes the worker ineligible to get the return to work benefits.

Permanent Disability Benefits

Workers that never will have the same work abilities get total disability benefits. The money payments replace income lost because the worker can not compete for a job as well, or at all, and earn the same living. They do not have to lose their job. If they can do some of their work, the benefits are permanent partial disability benefits. If they can not work, the benefits are permanent total disability benefits.

A treating doctor has to diagnose that their patient is not getting better or getting worse. The condition is called permanent and stationary (P&S). The doctor writes up a P&S report describing the medical condition and the work that can get done. The report also says whether the worker can return to their job. One important judgment the doctor makes that affects the amount of benefits the worker gets is how much disability was caused by the job.

A claims administrator uses the P&S report and the worker's occupation to decide the disability rating. They then look up the rating in a benefits schedule to calculate the amount of disability benefits. When the 2005 ratings schedule is used, the claims administrator also reviews the future earnings capacity. A 100 percent rating is total disability. The benefits can last for life. A rating from 1 to 99 percent is a partial disability. Payments of an award amount are spread over a number of months.

Payments begin 14 days after a final temporary disability benefit.

A job offer from their employer lowers the amount by 15 percent. When there is no job offer by their employer, the amount increases by 15 percent.

They can still cash in on the other benefits used to pay for medical care and return to work efforts.

Death Benefits

Spouses and children can get death benefits when a worker dies from a work injury. The amount is based on the number of dependents that the worker had when they died. In addition, burial expenses are paid.

Secure Income

Income does not stop when an injured or ill worker gets workers' compensation payments. The necessary costs a Californian has to pay to live can get paid.

Source:

California Commission on Health and Safety and Workers' Compensation, Workers' Compensation in California: A Guidebook for Injured Workers (Third Edition, November 2006).