How to Pursue Workers’ Compensation in California

If you have been injured in a work-related accident and are unable to work, you may be under financial strain because of the resulting loss of income. Injured workers in California may be entitled to receive disability compensation from the state by complying with workers’ compensation procedures.

If you are an employee in the state of California and you have suffered an injury on the job, you may be confused by the complex laws and procedures involved with pursuing workers’ compensation benefits. While every case is different, there is a general outline of how a case normally proceeds through the workers’ compensation system. This process can go smoothly if an insurance company is willing to admit that an injury occurred, but disputes may still arise about the nature and extent of the injury. It is helpful to have the legal support of a professional attorney at your side during this time.

When an insurance company denies that an injury occurred, the injured worker will have to go through litigation and might be forced to take less than the maximum allowable benefits available under the law. You may qualify for temporary disability (TD) in California if your doctor says that you are unable to work due to your injury and if there is a chance of improving with medical treatment. Temporary disability compensation is paid at a weekly rate for the length of time that the doctor dictates the patient is unable to work, and the compensation rate is two-thirds (66%) of the employee’s gross earnings. However, the law limits the maximum amount that an injured worker can be paid for temporary disability at $490.00 per week. If you are unable to obtain temporary disability from your insurance company, you may still be able to receive disability payments called State Disability Insurance (SDI) benefits from the Employment Development Department.

An injured worker may be entitled to receive a permanent disability award from the state of California if a work-related injury causes any residual disability. If you have suffered permanent disability from a work-related accident, you will be able to receive payments once the doctor has stated that the medical condition has leveled off and will be permanent. You will not be eligible for permanent disability benefits if the doctor says that there has been a total recovery.

Once an injured worker has been seen by a doctor, arrangements need to be made to be examined by a medical specialist who deals with the specific type of injury sustained. A workers’ compensation attorney is especially helpful during this process and can recommend a specialist for the worker to go to. A lawyer can also make an agreement with the insurance company to utilize an agreed medical examiner (AME). If you are not represented by an attorney, then the insurance company will send you a list of doctors to choose from.

Overall, your worker’s compensation case will not be settled until all medical reports are prepared and mailed to all the required parties. The state of California will then rate the report and a percentage of disability will be assigned to the doctor’s opinion. The rating guidelines are uniform throughout the state, and these ratings will be converted to a monetary amount that will be given to you on a pre-set schedule. It is always wise to have the legal counsel of an experienced attorney during this process. A professional lawyer can help you file correctly, make sure you see the right doctor, and answer any questions you may have.

Disclaimer: While every effort has been made to ensure the accuracy of this publication, it is not intended to provide legal advice as individual situations will differ and should be discussed with an expert and/or lawyer. For specific technical or legal advice on the information provided and related topics, please contact the author.

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