Workers' compensation is a crucial system to support employees who suffer from injuries or illnesses directly related to their jobs. Whether a singular incident or cumulative exposures at work, the program enables affected workers to receive the necessary financial and medical support during their recovery. Employers are mandated by law to provide these benefits, shielding employees from the double hardship of injury and financial strain.
Recognizing the benefits available through workers' compensation is vital for every employee. Depending on the nature and severity of your injury or illness, you may be eligible for various forms of support. These include medical care, temporary disability, permanent disability, and supplementary job displacement benefits. In unfortunate cases where an injury or illness results in death, workers' compensation also provides benefits to your dependents.
Securing these benefits is not always straightforward. A claims administrator may deny or limit your benefits, posing significant challenges during a difficult time. Thus, understanding your rights and the scope of workers' compensation is crucial. An attorney can provide invaluable guidance, helping to navigate the complexities of your claim and advocating for your rights to pursue the full benefits you are entitled to.
If you’re an injured worker in Glendale or the surrounding areas, please schedule a consultation with the Law Offices of Wax & Wax to discuss your situation and paths forward.
Medical Care Benefits
Workers' compensation helps employees who are injured or fall ill due to their job receive the necessary medical treatment without bearing the financial burden. Understanding how medical care benefits are managed within the workers' compensation system is crucial for anyone navigating this process.
Coverage of Medical Expenses
Medical care benefits under workers' compensation cover expenses reasonably required to treat a work-related injury or illness. Associated costs include doctor visits, hospital stays, physical therapy, medication, and other necessary medical interventions.
The Medical Treatment Utilization Schedule (MTUS) provides guidelines for determining reasonable and necessary medical care. These guidelines are applicable to current and future medical treatments related to the injury.
Sometimes, a treating physician may recommend treatments outside the MTUS. In such cases, the claims administrator is still obligated to cover these treatments, provided they adhere to scientifically based guidelines recognized by the national medical community.
Disability Benefits
Understanding disability benefits within the framework of workers' compensation is crucial for employees who have been injured or have fallen ill due to workplace activities. These benefits provide financial assistance during recovery or for lasting impairment. Knowing the types of disability benefits available can help you navigate the process and allow you to receive the support you're entitled to.
Types of Disability Benefits
Disability benefits under workers' compensation are categorized based on the duration and extent of the impairment caused by the workplace injury or illness. These benefits are primarily divided into two categories: temporary and permanent disability.
Temporary Disability Benefits
Temporary total disability (TTD) applies if you are completely unable to work while you recover. TTD benefits are crucial for recovering workers who cannot perform work duties due to injuries. These benefits are typically calculated as two-thirds of your pre-tax wages lost due to your inability to work. TTD benefits commence within 14 days after your injury is reported and your doctor confirms that you cannot perform your job duties due to the injury.
Temporary partial disability (TPD) applies if you can perform some, but not all, of your job duties. This situation often arises when your employer can offer you alternative work that you can perform despite your injury, which might not pay as much as your usual job. TPD benefits help make up the difference in your earnings.
Permanent Disability Benefits
Permanent total disability (PTD) is provided when you are given a 100% disability rating, indicating that you will never fully recover or return to any form of employment. PTD benefits are paid for the remainder of your life, reflecting the severe impact of the injury on your capacity to earn a living.
Permanent partial disability (PPD) applies if your injury results in a permanent disability that is not total and you receive a disability rating between 1% and 99%. This rating determines the duration of the benefits, which are paid for a fixed number of weeks. The amount of PPD benefits you receive is calculated based on your pre-injury wages and the degree to which your ability to work has been impaired.
Supplemental Job Displacement Benefits
Supplemental job displacement benefits (SJDB) are vital in the workers' compensation system, offering crucial support for employees who need to adapt to new vocational realities following an injury. This benefit covers educational retraining or skills enhancement, providing a pathway to employment in a new field if you cannot return to your previous job due to injury.
SJDB help pay for necessary educational retraining or skill enhancement expenses.
These expenses can include the following:
- Tuition
- Fees
- Books
- Other costs associated with approved training programs
One feature of SJDB is that it provides a fixed amount of $6000, which is available regardless of your disability rating as long as you meet the eligibility criteria.
To qualify for SJDB, you must have a permanent partial disability, and your employer cannot offer you work that accommodates your disability. The availability and specifics of SJDB can also depend on the date of your injury and whether your employer has made a suitable offer of work that you can perform, given your medical condition.
Death Benefits
Death benefits under workers' compensation provide crucial financial assistance to the families of workers who have tragically died due to work-related injuries or illnesses. These benefits alleviate some financial burdens dependents face after losing a loved one.
Death benefits are available to the dependents of a deceased worker, which typically include the spouse, children, or other family members who were financially dependent on the worker at the time of their death. Eligibility is contingent upon the death resulting from a work-related injury or illness.
The coverage provided under death benefits includes compensation for funeral expenses and ongoing financial support for the dependents. Specifically, workers' compensation provides for reasonable burial expenses, which are capped at $10,000.
The Value of Legal Advice in Workers’ Comp Cases
Navigating workers' compensation claims can be challenging, especially when dealing with the intricacies of claim administration and disputes. Consulting with an attorney can provide several advantages, including insightful guidance, vigorous advocacy, and personalized support.
Law Offices of Wax & Wax in Glendale provides the support and guidance injured workers need. Call us at (818) 946-0608 or contact us online today.