Workplace injuries leave employees facing medical treatment, time away from work, and ongoing uncertainty about their financial stability. California Workers’ Compensation law provides a framework of benefits that address these concerns. These benefits are designed to cover medical costs, wage replacement, rehabilitation, and long-term care when necessary. However, many employees face delays or denials after applying for benefits.
What Types of Medical Treatment Are Covered?
Workers’ Compensation provides payment for reasonable medical treatment directly related to a job injury or illness. This includes hospital visits, surgery, prescription medication, diagnostic tests, and therapy. Workers may also have access to specialized care, such as chiropractic services or acupuncture, when prescribed. The goal is to allow an injured employee to recover and, when possible, return to the workplace.
Are Wage Replacement Benefits Available?
When an injury prevents an employee from working, temporary disability benefits provide partial wage replacement. These payments are generally calculated as a percentage of the worker’s average weekly wages, up to a state-imposed maximum. Payments continue until the employee can return to work or reaches maximum medical improvement, whichever occurs first.
What if the Injury Causes Permanent Impairment?
If a worker suffers a lasting impairment that reduces their ability to perform job duties, permanent disability benefits may apply. The amount depends on the severity of the impairment, age, occupation, and other factors. These benefits are structured to compensate for diminished earning capacity, even if the individual is able to continue working in some capacity.
Is Job Retraining or Education Available?
When an injury prevents an employee from returning to their previous job, supplemental job displacement benefits may be provided. These benefits take the form of a voucher that can be used for education, retraining, or skill development programs. The intent is to help the worker transition into a new line of employment that accommodates their limitations.
How Long Do Benefits Last?
The duration of benefits depends on the type of compensation awarded. Temporary disability benefits generally last until the worker recovers or reaches medical stability; permanent disability payments may continue for years, depending on the impairment rating. Death benefits may continue for dependents according to statutory guidelines, often until children reach adulthood or a spouse remarries.
Do Workers Have a Choice of Doctors?
Initially, the employer or their insurance carrier usually directs medical care through a network of approved providers. However, under certain circumstances, an employee may be able to choose a personal physician if the request is made in advance of the appointment. In some cases, the worker may switch doctors within the network if treatment is not progressing as expected.
Can Psychological Conditions Be Covered?
California law recognizes that job-related psychological conditions, such as stress or trauma, can arise from the workplace. These claims are subject to specific requirements, and the worker must demonstrate that employment was a significant factor in the condition. When approved, benefits include medical treatment and wage replacement similar to those provided for physical injuries.
What Happens if a Claim Is Denied?
If a Workers’ Compensation claim is denied, the employee has the right to appeal through the state’s administrative process. This may involve hearings before a Workers’ Compensation judge, where both sides present evidence. The appeals process provides an opportunity for an injured worker to seek benefits if an initial claim is rejected.
Our Experienced Sacramento Workers’ Compensation Lawyers at Walters & Zinn, Attorneys at Law Will Clarify Your Entitled Benefits
If you need to speak with a lawyer about your benefits, contact our Sacramento Workers’ Compensation lawyers at Walters & Zinn, Attorneys at Law. For a free consultation, call today at 916-610-4706 or contact us online. With office locations in Folsom and Fairfield, California, we proudly serve clients in the surrounding areas.