How Much Money Will You Receive for Workers’ Compensation in California?
Determining workers’ compensation payments can become quite complex, but there are some general rules that an injured worker should know. Here’s how workers’ comp payments are calculated in California.
Workers’ compensation will cover all medical bills associated with the injury. For temporary disability (TD), workers’ comp payments will generally be two-thirds of the individual’s average weekly wage for the period of time that the individual cannot work. Permanent disability (PD) payments are more complicated and depend on whether the permanent disability is partial or total.
Can I Receive Workers’ Compensation?
In California, employees are entitled to workers’ compensation for an injury sustained while on the job that requires medical treatment beyond first-aid (California Labor Code Section 3600). Exceptions include self-inflicted injuries, injuries sustained while intoxicated, and injuries from a fight started by the injured individual.
Related: What to Do if Injured at Work in California
The injury in question may be a sudden injury or one acquired over time, such as via repeated exposure to noxious chemicals. This type of injury is known as a cumulative injury, and those suffering from cumulative injuries may receive workers’ compensation just like an individual who was hurt on the job in any other manner.
Related: Workers’ Compensation: File and Prove a Claim
Medical Treatment
As soon as the workers’ comp claim is filed, the employer is required to provide payment for medical treatment up to $10,000 until the claim is either accepted or denied (California Labor Code Section 5402). If the claim is accepted (or not denied within 90 days), the injured worker is then entitled to workers’ comp benefits.
Among these benefits are payments for all medical treatment that is “reasonably required to cure or relieve” the injury or its effects (California Labor Code Section 4600). The statute notes that this includes hospital treatment, acupuncture, chiropractic, and more.
Temporary Disability (TD)
Some injuries result in the employee’s inability to perform their job. For example, a construction worker may break their leg on-site and therefore not be able to work until fully recovered. In situations like this, workers are entitled to temporary total disability benefits for the period of time that they are unable to work.
According to California Labor Code Section 4653, temporary total disability benefits are two-thirds of the average weekly wage of the employee. However, there are minimum and maximum weekly benefits depending on the year. In 2021, the minimum weekly benefit for temporary total disability is $203.44, and the maximum is $1,356.31.
However, not all injuries result in an employee’s complete lack of ability to work. Perhaps the construction worker merely breaks their toe instead of their leg, and as such are able to perform some tasks for their job but not all. Cases such as this are referred to as temporary partial disability. California Labor Code Section 4654 states that the disability payments are two-thirds of the weekly wage loss during the period of disability. The wage loss is calculated by finding the difference between the average weekly wage pre-disability and the wage that is received while working with the disability.
Permanent Disability (PD)
Permanent disability benefits arise when a worker’s injury has been treated for a sufficient period of time after which the doctor believes that progress has plateaued and as such is unlikely to improve further. Individuals with a permanent disability are presumed to be unable to work at full capacity going forward, and as such are entitled to extended benefits.
Just like temporary disability, permanent disability can be either total or partial. Unlike temporary disability, whether or not permanent disability is total or partial depends on a rating system that assigns a percentage signifying how disabled the worker is. How the specific number is calculated is somewhat complicated, but suffice it to say that the more severe and limiting the disability is, the higher the percentage will be. If you believe that your PD rating is too low to account for your disability in its entirety, you should contact a workers’ comp attorney to help you argue for a higher number; this rating is very important in determining benefits and the process is complicated, so hiring an attorney can be critical.
In cases where the PD rating is 100% (meaning the worker is expected to be unable to work at all in the future), the injured worker is entitled to permanent total disability. The associated benefits are essentially the permanent version of temporary total disability benefits; that is, two-thirds of the worker’s average weekly wage indefinitely. The minimum and maximum rates still apply, in addition.
In cases where the PD rating is less than 100%, the worker is entitled to permanent partial disability. The length of time that the individual will receive weekly benefits is determined by their PD rating. To calculate the length of time, refer to the tables in California Labor Code Section 4658. There are multiple tables, each referring to injuries sustained during different time periods. For example, if the injury occurred during or after 2013, then refer to the table in subdivision ‘e’. Essentially, the PD ratings in column 1 are associated with a certain number of weeks in column 2. That number of weeks is multiplied by the percentage number to determine the number of weeks that the individual will receive benefits for. For example, if a person injured in 2015 has a PD rating of 55%, then they will receive benefits for 440 weeks because 55 multiplied by 8 equals 440. However, the maximum weekly payment is far lower than that for temporary disability because the individual is presumed able to work in some capacity.
FAQs About How Workers’ Comp Payments Are Calculated in California
Do workers’ comp payments cover medical expenses?
Workers’ comp benefits include payment for all medical expenses related to treating/curing the injury.
How large are weekly payments for temporary disability?
For temporary total disability, the weekly benefits will be two-thirds of the average weekly wage prior to disability (up to $1,356 per week). For temporary partial disability, the benefits will be two-thirds of the average weekly wage loss.
How large are weekly payments for permanent total disability?
Permanent total disability weekly payments are the same as temporary total disability payments, only indefinitely. Thus, they are two-thirds of the average weekly wage.
How large are weekly payments for permanent partial disability?
The payments are two-thirds of the weekly wage, but there is a smaller maximum.
How long do weekly payments last for permanent partial disability?
Refer to the tables in California Labor Code Section 4658. Multiply your PD rating with the associated number of weeks.
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If you have any more questions about how workers’ comp payments are calculated in California, contact us. We’ll get you in touch with the most qualified attorneys for your unique legal matter. Get your free consultation with one of our Work Injury Attorneys in California today!