Sacramento Workers’ Compensation Lawyers

Workers in California who are injured on the job are entitled to a variety of benefits designed to cover medical costs, lost wages, and ongoing care. These include:

• Temporary Disability (TD): TD is paid while you are recovering and cannot work due to your injury. Payments end when you return to work or when your condition is considered “permanent and stationary” (P&S). Returning to work includes light-duty, modified, or full-duty positions. TD benefits are calculated as two-thirds of your gross weekly income, up to a maximum benefit rate determined by law. There is a three-day waiting period before benefits begin. If your disability extends beyond 14 days, the insurance company must start TD payments or send a “Delay Letter” indicating the claim is being investigated. Late payments may result in penalties, so it’s important to track your checks and payment periods carefully. In most cases, TD benefits last up to two years, though certain serious injuries may allow for extended payments.
• Permanent Disability (PD): PD benefits compensate you for long-term or permanent limitations caused by your injury. Your PD rating depends on your level of disability and income, and benefits are not paid until your condition reaches P&S. You may receive PD advances while your case is pending, which will later be credited against your final settlement. Procedures for determining PD vary by date of injury:
  • Pre-1991: The treating doctor evaluates your level of disability. Evaluating doctors may also be involved.
  • 1991–1993: PD is determined by a Qualified Medical Evaluator (QME). If you are unrepresented, you will receive a Panel QME list and select one doctor. This decision is binding unless you hire an attorney.
  • Post 1/1/94: Your treating doctor assesses PD. Disagreements may require seeing a Panel QME. Once you have seen a Panel QME, you are generally bound by their decision, making early attorney involvement important.
• Medical Treatment: You have the right to select your treating doctor if proper procedures are followed. Do not begin seeing a doctor on your own without requesting a physician change in writing. Initially, your first request is usually approved, but further changes may require justification. If your employer has a Medical Provider Network (MPN), you may be required to select a doctor within the network. Injured workers previously treated outside the MPN may be forced to switch. Understanding your rights within an MPN can be complex, and an attorney can provide guidance.
• Mileage and Related Expenses: You are entitled to reimbursement for travel related to your medical care at a rate of up to 58 cents per mile. Keep detailed records of travel to appointments, physical therapy, or prescriptions, as well as related expenses like parking or tolls.
• Future Medical Expenses: If your case is resolved by Stipulation and Award, Compromise and Release, or trial, future medical treatment may be covered. A Compromise and Release may limit future benefits, while other resolutions allow for ongoing care. Awards can be reopened within five years if your disability worsens.
• Vocational Rehabilitation: If you are a Qualified Injured Worker (QIW), you may be entitled to job retraining or educational vouchers. To qualify, you must be permanently or likely to be permanently unable to perform your previous job. Requests must be made within five years of injury or one year of settlement, whichever is longer.