How Much Does Workers Compensation Pay?
A frequent question is just exactly how much does Workers’ Compensation pay? The amount available through Workers Compensation varies with the types of benefits in question. Other factors affecting the value of benefits include the type of work performed, age, as well as the nature and extent of injuries.
The various types of benefits available to injured workers include medical treatment, temporary disability, permanent disability. In certain case a “Supplemental Job Displacement Benefit” voucher may also be available if the injured worker is unable to return to their usual and customary work.
Medical Treatment
An injured worker is entitled to all medical treatment “reasonably required to cure or relieve the injured worker from the effects of the workers’ injury”. Cal. Labor Code LC §4600. These benefits are paid by workers compensation insurance. The injured worker is not responsible for the costs of these treatments.
In many instances an injured workers can get the bills of a self-procured medical provider, including their own doctor, paid for by the employer’s workers compensation insurance.
Temporary Disability
This benefit is essentially an “income replacement” if an injured workers is unable to work due to their injuries. This benefit is payable at the rate of 2/3 the average weekly earnings, with a few exceptions, for 104 weeks. An injured workers can get up to 240 weeks of temporary disability of they have suffered an amputation, severe burns, or a high velocity eye injury, among other selected injuries.
The minimum and maximum average weekly earnings amount for calculating Temporary Disability benefits is $346.45 up to $2,309.56. This results in a minimum benefit of $230.95 per week up to a maximum benefit of $1,539.71 per week.
Note: There are no Temporary Disability payment for the first three days unless the period of Temporary Disability exceeds 14 days or if the injured worker is hospitalized.
In cases where a case is denied and no Temporary Disability an injured worker found to have suffered a compensable injury may be entitled to “Retroactive Temporary Disability”,sometimes referred to as “back pay”. This will depend on the available medical reports.
Permanent Disability
Permanent Partial Disability is the residual disability existing after medical treatment which is unlikely to substantially change in the next year with, or without medical treatment. In such cases the injured worker is regarded as having achieved Maximum Medical Improvement (MMI), also known as Permanent and Stationary (P&S)
Permanent Partial Disability benefits are paid out based on an injured workers average weekly earnings at a maximum of $290.00 per week. The number of weeks for which payments are made depends on the Permanent Partial Disability, as expressed as a percentage.
The specific Permanent Disability values are arrived at through a formal evaluation by a doctor, in many cases a neutral doctor. This doctor will provide their “impairment values” based on a Guidebook published by the American Medical Association. (The “Guides”)
The doctor provided impairment values are first adjusted for a “Diminished Future Earning Capacity” multiplier of 1.4 pursuant to California’s rules. This value is then adjusted for occupation and age. A Permanent Disability value will increase for more physically demanding jobs as well as age above 39 years. Below 39 years the final rating will be reduced under the theory it is easier for a younger worker to train for a new job.
Examples of Permanent Partial Disability results
A 45-year-old warehouse worker with an 8% Whole Person Impairment to the lumbar spine would have a Permanent Partial Disability rating of 14% with a value of $13,412.50. (46.25 weeks)
A 25-year-old warehouse worker with the same injury would have a Permanent Partial Disability rating of 11% with a value of $9,932.50. (34.25 weeks)
A 45-year-old billing clerk with an 8% Whole Person Impairment to the lumbar spine would have a Permanent Partial Disability rating of 10% with a value of $8,772.50. (30.25 weeks)
A 25-year-old billing clerk with the same injury would have a Permanent Partial Disability rating of 7% with a value of $6,090.00. (21 weeks)
· Multiple body parts are combined using a non-additive” formula table. For example, a 20% PD Rating for one body part combined with a 5% PD Rating for another body part would result in a combined PD Rating of 24%, not 25%.
· If the injured worker had more than one employer at or about the time of the injury, the earnings are combined to calculate “average weekly wages”.
· Apportionment- A Permanent Disability rating is subjection to apportionment (reduction) for work related injury causation, as well as a reduction for a prior Permanent Disability rating with respect to the same body part.
· There is no increase in a Permanent Disability rating for “pain and suffering” as in personal injury cases such as car accidents. California Workers Compensation does provide for a 3% Permanent Disability “add on”. (By itself 3% is equal to $2,610.00, however the 3% add on can increase the Permanent Disability rating in substantially higher amounts as the “base rating” increases.
Supplemental Job Displacement Benefit Voucher
In situations where an injured worker in unable to return to their usual and customary work that worker may be awarded a voucher with a value of $6,000.00 for retraining at approved Vocational Rehabilitation school.
While the foregoing is not exhaustive of the benefits available to injured workers in California, it does highlight the most common benefits available. Injured workers should take great care to protect their interests by reporting injuries as soon as possible, obtaining medical treatment, either through their employer or on their own if necessary, and seek the help of an attorney should the employer question, or otherwise ignore a work-related injury.
