Understanding Wage Loss and Disability Payments After Suffering A Work Injury
June 16, 2023 Posted In Work-related injury
Sustaining a work injury can be a life-altering event, leading to physical pain, emotional distress, and financial hardships. The California workers’ compensation system is designed to protect employees who are injured on the job. It provides various benefits, including wage loss compensation and disability payments.
Temporary Disability Benefits
Temporary disability (TD) benefits are intended to replace a portion of lost wages while an employee is unable to work due to their injury. These benefits are typically calculated at two-thirds of the worker’s average weekly wage, subject to certain caps. TD benefits are paid until the worker either returns to work or reaches maximum medical improvement.
Permanent Disability Benefits
If a work injury results in a permanent impairment, the worker may be eligible for permanent disability (PD) benefits. PD benefits compensate workers for the long-term effects of their injuries and the resulting limitations on their ability to perform their job. The amount of PD benefits is determined by evaluating the nature and extent of the disability, using a formula specified in state law.
Partial Temporary Disability Benefits
When an injured worker is still able to perform some work activities but at a reduced capacity, they may be entitled to partial temporary disability (PTD) benefits. PTD benefits bridge the gap between the worker’s pre-injury earnings and their reduced post-injury earning capacity.
Vocational Rehabilitation
If a work injury prevents an employee from returning to their previous job, vocational rehabilitation may be an option. These services help injured workers with career guidance and acquiring the skills and training necessary to secure alternative employment and regain financial independence.
Supplemental Job Displacement Benefits
Supplemental job displacement benefits (SJDB) assist injured workers who are not offered suitable alternative employment by their employer. These benefits come in the form of a non-transferable voucher that can be used for education-related retraining, skill enhancement, or job placement services.
How are Disability Payments Determined After a Work Injury?
The determination of disability benefits in California is made through a comprehensive evaluation process. Several factors are taken into account to assess the extent of a worker’s disability and the corresponding benefits they may be eligible for. Here is an overview of how benefits are decided:
Medical Evaluation
The injured worker is typically examined by a qualified medical professional who evaluates the impairment, functional limitations, and the impact on the ability to perform work-related tasks.
Rating of Impairment
The evaluating physician assigns an impairment rating based on guidelines established by the American Medical Association (AMA) and the California Division of Workers’ Compensation (DWC). The rating reflects the severity of the impairment and its impact on the individual’s ability to perform specific activities.
Permanent Disability Rating
The impairment rating is then used as a basis to calculate the permanent disability (PD) rating. The PD rating is determined by considering various factors, such as the injured worker’s age, occupation, pre-injury wages, and future earning capacity. The PD rating is expressed as a percentage, which represents the level of permanent impairment.
Disability Payments Calculation
The PD rating percentage is multiplied by a formula that takes into account the worker’s average weekly wage, the duration of the disability, and other statutory factors. This calculation is the amount of disability payments the injured worker is entitled to receive.
Total Permanent Disability
In cases where the worker’s injury is severe and results in a total permanent disability (TPD), the disability payments may be calculated differently. TPD benefits provide lifetime compensation at the permanent disability rating percentage.
Apportionment
Sometimes, a disability can in part be attributed to pre-existing conditions or prior injuries. In such cases, the disability payments may be adjusted accordingly to account for the portion that can be attributed to the prior condition.
In situations where there is a dispute regarding the medical evaluation and disability rating, either the injured worker or the insurance company may request an independent medical evaluation (IME). An IME involves obtaining an opinion from a different physician to resolve any conflicts or discrepancies.
Since wage loss is a significant concern after a work injury, it is critical to consult an experienced San Bernardino Work Injury Lawyer. They can ensure that your disability benefits are accurately calculated and you receive the appropriate compensation based on your specific circumstances.