Santa Rosa Workers' Compensation Lawyers

Workers' Compensation Benefits

Medical Benefits

Injured workers in California have the right to receive comprehensive medical care to address their work-related injuries or illnesses. These benefits cover a wide range of necessary treatments and services aimed at curing or alleviating the effects of the injury.

This includes:

• Doctor Visits: Injured employees can consult with medical professionals, including primary care physicians, specialists, surgeons, and other healthcare providers, to diagnose and treat their injuries.
• Surgeries: When surgery is medically necessary to treat the injury or condition, it is typically covered. This includes both major and minor surgical procedures.
• Prescription Medications: Workers' compensation may cover the cost of prescription medications prescribed to manage pain, treat infections, or facilitate recovery.
• Rehabilitation Services: Rehabilitation services such as physical therapy, occupational therapy, and vocational rehabilitation are often provided to help injured workers regain their physical abilities and return to work.
• Diagnostic Tests: Necessary diagnostic tests such as X-rays, MRIs, CT scans, and lab work are covered to help diagnose and monitor the progress of the injury.
• Durable Medical Equipment: Workers may receive coverage for durable medical equipment like crutches, wheelchairs, or prosthetic devices if they are needed for recovery.

It's important to emphasize that these medical benefits are not subject to deductibles or co-pays, and the injured worker should not have to pay out-of-pocket for these treatments.

Temporary Disability Benefits

Temporary disability benefits in California serve as a wage replacement program for employees who are temporarily unable to work due to their work-related injuries or illnesses. These benefits aim to provide financial support during the recovery period.

The key points include:

• The amount of temporary disability benefits is typically calculated as a percentage of the worker's pre-injury wages.
• Benefits are paid periodically, often weekly, and continue until the worker reaches maximum medical improvement (MMI) or returns to work.
• Temporary disability benefits are divided into two types:
  • Temporary Total Disability (TTD): This applies when the worker cannot perform any type of work due to the injury.
  • Temporary Partial Disability (TPD): This applies when the worker can perform some work but not at the same level as before the injury, resulting in a partial wage replacement.
• There are minimum and maximum benefit limits set by law, and these limits may change from year to year.

Permanent Disability Benefits

If a work-related injury or illness results in a permanent impairment that affects the worker's ability to perform their job or daily activities, they may be eligible for permanent disability benefits. These benefits compensate workers for the ongoing impact of the injury on their earning capacity.

Key points include:

• The amount of permanent disability benefits is determined by a rating system that assesses the severity of the permanent impairment.
• The disability rating is conducted by a qualified medical evaluator (QME) or an agreed medical evaluator (AME).
• Benefits are calculated based on a formula that takes into account the impairment rating, the worker's age, occupation, and future earning capacity.
• Permanent disability benefits can be paid as a lump sum or in periodic payments.

Death Benefits

If a worker's work-related injury or illness results in their death, their dependents may be entitled to death benefits. These benefits are designed to provide financial support to the surviving spouse, children, or other dependents who relied on the deceased worker for financial support.

Death benefits can include:

• Funeral and burial expenses.
• Ongoing financial support for the dependents, typically calculated as a percentage of the worker's wages.
• Vocational rehabilitation benefits for surviving dependents who were financially dependent on the deceased worker and need job training or education to support themselves.

Job displacement benefit

If the employer does have a suitable job to match your disability within 60 days of the end of temporary disability, you will be entitled to job displacement benefits. You will get a $6,000 voucher as a benefit for skill enhancement, which you can use to get ready for a new career! 

​Answer These 5 Questions to Find Out If You Need a Workers’ Comp Lawyer​​

1. What Is Your Case Status? 

Workers' Compensation exists to provide you with medical treatment and related expenses, plus lost wages, and an amount towards any resulting Permanent Disability. 

If your case has been denied or delayed, it is always wiser to hire an attorney. This situation can be harsh, so why not find someone to rely on? 

The fight to get medical treatment can be strenuous as insurance companies have the right to deny it. And if they do, you have limited options for appealing their decision.  

Are these scenarios familiar to you? Then you should hire an attorney. 

2. What Type of Workplace Injury Did You Suffer? 

Your employer is required to pay for Workers’ Compensation benefits if you get hurt on the job.  

A single event can cause an injury, such as falling at work. Or it can be caused thanks to repeated exposure (Cumulative Trauma), which arises after years of work, such as: 

• Carpal tunnel syndrome 
• Tendinitis 
• Hearing loss 
• Bursitis 

If you have Cumulative Trauma, you need an attorney. On the contrary, if you have a specific mild injury and your case is accepted, you might be able to handle your Workers' Compensation case yourself. 

3. How Severe Is Your Injury? 

If you have a Permanent Disability due to a workplace injury, you will need a Workers' Comp attorney. Otherwise, it would be totally demanding to negotiate with the insurance company's adjusters and attorneys.  

Don’t forget that these are professionals trained to make the insurance company pay out as little as possible. The best way to overcome this is to have a professional company that can negotiate and knows how to work around this system. 

And more importantly, you should focus more on your recovery, not the case process. 

4. Is Your Medical Treatment Accepted? 

Minor injuries can turn into critical injuries without prompt treatment. You must have medical attention as soon as possible after your injury. However, this treatment must be approved by the Utilization Review (UR) first. 

Medical treatment can be approved or denied. When approved, most insurance companies will send you to work-injury clinics, where you will find doctors who work for them. This means their interests are closer to these companies, not to the injured workers.  

And if it is denied, you need to handle this outcome and follow another process to get the medical treatment you require. Either way, hiring a lawyer amplifies your chances of having proper medical treatment and early recovery. 

5. Is Settlement Right for You? 

You can solve your case through an agreement with the claim administrator. It can also be solved when a judge issues an order about your payments and future medical care that will be provided to you. 

Workers’ Comp claims settle in two main ways: Compromise and Release (C&R) or by Stipulation with Request for Award (Stips). Find the pros and cons of both settlements in this article. 

People rarely see substantial monetary awards from Workers’ Compensation courts, which is why settlements are so frequent. Although attorneys can never guarantee an outcome, their experience can give them insight into what may happen. 

Experienced and respected attorneys can maximize a case through careful preparation and excellent negotiation. Don’t leave your future to chance; choose what is best for your health and well-being. You are not alone in this. 

Call us for a free consultation at (888) 740-6434.