How Workers’ Comp Payments are Calculated in California
Injured workers have rights guaranteed to them by California law. This is especially true when workers are injured on the job in California. Understanding the workers’ compensation payment structure allows you to plan appropriately for what’s next.
Understanding California workers’ compensation law can also help to make sure your employer and insurance company are making fair assessments of your damages. Every state has a different way of handling workers’ comp claims, and the Grossman Law Offices can help each injured worker understand what makes California’s workers’ compensation insurance unique.
California’s Workers’ Compensation Process
If you’ve recently filed a claim for workers’ compensation with your employer, the California Division of Workers’ Compensation offers free seminars for people who are interested in finding out more about workers’ compensation coverage after an on-the-job injury.
California’s Department of Industrial Relations provides information on death benefits, mileage rates, modification to whole person impairment, state-wide average weekly wages (SAWW), the return-to-work supplement program (RTWSP), permanent or temporary disability benefits, and supplemental job displacement benefits.
After you’re injured on the job, your employer is required to provide the documentation necessary to begin your workers’ comp claim. This documentation should provide injured workers with the information they need on transportation to treatment, workers’ compensation insurance, rehabilitation, income replacement through permanent or temporary disability, and medical care.
Each injured worker is entitled to medical treatment or death benefits, if applicable, for surviving family members. In some cases, medical bills can pile up when you’ve had an injury. Fortunately, California’s no-fault laws can make it easier to recover benefits. Consult with an injured worker law firm to understand the full extent of benefits you’re entitled to.
Calculating Workers’ Compensation Benefits in California
If you are injured on the job in California, you are entitled to receive two-thirds of your pretax gross wage. California statutes provide for a maximum allowable amount. This amount is adjusted annually and can change each year.
You could be in luck if your employer offers an additional “Disability Leave with Pay” program. Although it is not required by California law, it can help make up the difference in your salary so that you receive your entire income. Your employer’s insurance company will take what the state pays and provide additional payment on top to fully supplement your pre-injury income.
If you want to calculate your regular weekly wage, which is the amount used to calculate your California workers’ compensation, divide your annual salary by 52. If you have a permanent disability, you may also be eligible for Supplemental Job Displacement Benefits (SJDB).
SJDB includes a voucher in compensation for vocational skills training and more. You could also be eligible for California workers’ compensation benefits for medication, hospital expenses, doctor’s office visits, and physical therapy until the time when your claim is accepted or denied.
Calculating your workers’ compensation benefits can be confusing, especially in the aftermath of a severe injury. There may also be special circumstances that affect how your benefits are calculated. Your medical conditions and the opinions of different physicians can change the amount you’re entitled to.
It also can be bewildering trying to meet all of the various deadlines. That’s why the Grossman Law Offices are here to offer continual support to you and your loved ones if you need a death benefit. Consult with us today about how we can help maximize your disability payment and workers’ compensation benefits.
What is the maximum payout for workers’ compensation in California?
The amount of temporary total disability an injured worker receives is two-thirds of their average weekly wage (AWW). After calculating the temporary disability rate, your employer’s insurance company will check to see if it is below the minimum or above the maximum level.
The maximum and minimum amount of temporary disability a hurt worker can receive changes yearly based on a calculation of what California employers are paying their employees. Speak with a California workers’ compensation benefits attorney today about the maximum payout you’re eligible for.
Temporary and Permanent Disability Benefits
If you’re temporarily unable to do any part of your job because of your work-related injury or illness, you’re entitled to temporary disability (TD). TD payments won’t begin until you’ve missed three days from work. There’s no waiting period for temporary disability if you’re entitled to them.
TD benefits provide compensation to replace some of your lost wages. If you’re considered temporarily disabled and unable to perform the necessary functions of your employment, you’ll generally receive two-thirds of your average weekly wages.
Your average wage per week is the pre-tax gross amount that you were earning at the time of the injury, including overtime and the market value of job perks. If you’re eligible to continue receiving TD payments after two years, then the amount you’re eligible for will increase to a higher rate.
Partial Temporary Disability
If your doctor finds that you can continue work, but with limited hours, you can receive a partial temporary disability payment. This entitles you to two-thirds of your weekly wage loss, which is calculated as the difference between your average weekly wage (up to the maximum discussed above) and the amount you are earning for part-time employment.
Temporary disability benefits can stop and start again if you went back to work but then had a flare-up of pain or needed surgery. There’s also no limit on how long your benefits will continue. There are limitations on how long you can receive temporary disability benefits within five years from the time you were first injured.
Some exceptions apply if you’re suffering from certain serious conditions like HIV, hepatitis B or C, or some forms of lung disease. (Cal. Labor Code § 4656 (2020).) If you require temporary disability payments or permanent disability options, and are interested in additional supplemental job displacement benefit packages, contact the Grossman Law Offices right away.
California’s Permanent Disability Benefits
When on-the-job injury or illness leaves you with any permanent limitations and impairments that will affect your ability to earn a living, you have the right to receive permanent disability payments.
Before you can receive benefits, your medical report will need to conclude that you’ve reached Maximum Medical Improvement (MMI). Your doctor will need to evaluate you and give an opinion about the level of permanent impairment you face. Then you will be assigned a permanent disability (PD) rating (stated as a percentage from 1% to 100%) based on a formula that includes your age and occupation, as well as your impairment level.
Your PD rating determines how much you’ll receive in permanent disability benefits, and how long those benefits will last. Grossman Law Offices is prepared to assist injured workers who are suffering from a permanent impairment.
Permanent Partial Disability Benefits
If your PD rating is below 100%, you’re entitled to permanent partial disability benefits for several weeks as determined by the percentage of your rating. This weekly amount is based on two-thirds of your pre-injury wages. The maximum amount is much lower than for temporary disability ($290 per week in 2022).
If your PD rating is at least 70%, but less than 100%, you can also receive a “life pension.” Your life pension will start once you’ve reached the weekly limit for regular permanent partial disability benefits. These payments can be quite low, but every little bit helps when you can no longer work like before your injury.
Permanent Total Disability Benefits
When injured employees receive a 100% disability rating, this means that they can’t work in any capacity and are entitled to permanent total disability workers’ comp benefits. In California, you can receive these benefits for life at the same rate as your temporary total disability benefits. (Cal. Labor Code § 4659 (2020).)
What can I do if my benefits claim is denied?
Insurance companies might deny California workers’ compensation claims for the following reasons:
- Your injury did not require medical treatment
- There was insufficient proof that you suffered an injury
- Your injury was not related to your employment or didn’t happen on the job
- Your injury is not preventing you from returning to work
If your claim gets denied, you can file an appeal with the Workers’ Compensation Appeals Board. A workers’ compensation attorney can help to file your appeal and ensure that your rights are protected.
Grossman Law Offices Can Help With Workers’ Comp
If you need help filing or appealing your compensation claim, we are here to assist you.
Injuries are serious and you could be experiencing a lot of pain. Our law firm can offer our assistance during these hard times, while you focus on making the maximum recovery possible.
Since every workers’ comp case is unique, you may not immediately require an attorney. However, if you are concerned about your employer, workers’ compensation premium specifics, insurance company, or claims administrator treating you fairly, a workers’ compensation attorney will help you.
If you are interested in a free consultation, please contact our workers’ comp law firm at Grossman Law Offices. We can review all of the details of your claim and help you decide on what action might be most beneficial for you. We want to maximize the total amount of compensation you receive so that you can get proper medical treatment.