What Benefits Are Available for Injured Or Sick Workers?

November 17, 2021 | 6:00 am


California adopted workers’ compensation laws to help and protect workers if they become ill or injured as a direct result of their jobs. But many people don’t realize the different benefits available to them today.

Chain | Cohn | Stiles work injury lawyer Beatriz Trejo highlights in a new video the five basic benefits available to injured workers. These five benefits are spelled out below.

But first, it’s important to note that workers’ comp. is based on a no-fault system, which means that an injured or ill employee does not need to prove that the injury or illness was someone else’s fault in order to receive workers’ compensation benefits. And employers in California are required by law to pay for workers’ compensation benefits.

For more detailed information, please see the “Workers’ Compensation in California” guidebook, which is meant to help workers with job injuries understand their basic legal rights, the steps to take to request workers’ compensation benefits, and where to seek further information and help if necessary. And if you believe you have a case, please contact the work injury lawyers at Chain | Cohn | Stiles for a free consultation.

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1) Temporary Disability

Temporary disability benefits are payments you get if you lose wages because your injury prevents you from doing your usual job while recovering. It pays two-thirds of your pre-tax wages you lose while you are recovering from a job injury. These payments begin when your doctor says you can’t do your usual work for more than three days or you get hospitalized overnight. Generally, temporary disability stops when you return to work, or when the doctor releases you for work, or says your injury has improved as much as it’s going to. If you can do some work while recovering and your employer offers you this type of work, you can receive temporary partial disability payments if your wages while recovering are below a maximum limit set by law.

 

2) Medical Treatment

California workers’ compensation law requires claims administrators to authorize and pay for medical care that is reasonably required to cure or relieve the effects of the injury. The doctors who treat you must follow treatment guidelines referred to as the medical treatment utilization schedule. If it’s an emergency, your employer must make sure that you have access to emergency treatment right away. For non-emergency care, the claims administrator is required to authorize treatment within one working day after you file a claim form. While investigating your claim, he or she must authorize necessary treatment up to $10,000

 

3) Permanent Disability

Most workers recover from their job injuries, but some workers continue to have health problems. If your treating doctor says you will never recover completely or will always be limited in the work you can do, you may have a permanent disability, and this means that you may be eligible for permanent disability benefits. And you don’t have to lose your job to be eligible for these benefits. When you reach a point where your medical condition is not improving and not getting worse, your condition is called “permanent and stationary”. This is referred to as the point in time when you have reached maximal medical improvement. Click here to learn more about “P&S”.

 

4) Job Displacement Voucher

A claims administrator must offer you a supplemental job displacement benefit if your injury causes permanent partial disability, or your employer does not offer you regular, modified, or alternative work within 60 days after the claims administrator receives a voucher report. A supplemental job displacement benefit is a voucher that promises to help pay for educational retraining or skill enhancement, or both, at eligible schools. You can use the voucher to pay for tuition, fees, books, tools, or other expenses required by the school for retraining or skill enhancement, and for licensing or professional certification fees, related examination fees, and examination preparation course fees. Up to $600 of the voucher money may be used to pay for services of a licensed placement agency, a vocational or return-to-work counselor (a person who helps injured workers develop their goals and plans for returning to work), and resume preparation. Up to $1,000 may be used to purchase computer equipment. Up to $500 of the voucher money may be used upon request for miscellaneous expenses without receipts or other documentation. Learn more about the voucher system here.

 

5) Death Benefits

Death benefits are payments to a spouse, children or other dependents if an employee dies from a work-related injury or illness. This includes burial expenses. The amount of the death benefit depends on the number of total and/or partial dependents. In the case of one or more totally dependent minors, death benefits will continue until youngest minor’s 18th birthday. Learn more about death benefits, including amount limits, by clicking here.

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Failing workers’ compensation system ‘adding inequality to injury’

March 10, 2015 | 10:25 am


Note: The following article was written by Chain | Cohn | Stiles senior partner James A. Yoro, who manages the Bakersfield-based law firm’s Workers’ Compensation* Department, for publication into The Bakersfield Californian’s “Community Voices” section. You can the full article in the Kern County Journal here

By James A. Yoro

One of the most important protections that employees have is a workers’ compensation system that is supposed to provide them with minimum necessary benefits when they suffer an injury on the job.

This system was predicated on a “Grand Bargain” that was initiated during the Industrial Revolution to deal with the rising tide of work-related injuries and death. The injured worker gave up the right to sue the employer for civil damages. In exchange, the employee would receive medical treatment and a sufficient amount of monetary benefits to help them get by during their recovery period. If their injuries caused some permanent limitation or restriction on their ability to function, additional benefits were paid to reflect their level of disability. If they were unable to return to their usual and customary job, they would be provided retraining to help them adjust to other more suitable employment within their limitations.

Workers’ compensation was a progressive idea that came to fruition at a time when we as a society recognized that it was not fair to treat injured workers as if they were nothing more than a piece of broken machinery – something to be discarded and replaced. Human capital is a valuable commodity that contributes to the success of our economy. Therefore, when workers get injured, they should be helped and cared for and not marginalized. Originally, this was the goal of the Workers’ Compensation system. At the beginning of the 20th century, all 50 states adopted such a system in accordance with this philosophy.

But in the last 15 years, things have gone horribly awry for the injured worker.

Within the last week, two investigative reports and several news articles – including by OSHA and the U.S. Department of Labor, National Public Radio and The Washington Post – reveal how poorly injured workers are now being treated in the Workers’ Compensation system and the effect this cost shifting of the burden has affected our economy and our society.

The Department of Labor report titled, “Adding inequality to injury: The costs of failing to protect workers on the job,” summarized its findings as follows:

“The costs of workplace injuries are borne primarily by injured workers, their families, and taxpayer-supported components of the social safety net. Changes in state based workers’ compensation insurance programs have made it increasingly difficult for injured workers to receive the full benefits (including adequate wage replacement payments and coverage for medical expenses) to which they are entitled. Employers now provide only a small percentage (about 20 percent) of the overall financial cost of workplace injuries and illnesses through workers’ compensation. This cost-shift has forced injured workers, their families and taxpayers to subsidize the vast majority of the lost income and medical care costs generated by these conditions.”

The study concluded that the “failure of many employers to prevent millions of work injuries and illnesses each year, and the failure of the broken workers’ compensation system to ensure that workers do not bear the costs of their injuries and illnesses, are truly adding inequality to injury.”

I have represented injured workers for more than 25 years and I’ve seen firsthand this slow deterioration in the system and how it has affected those most vulnerable in our society – the injured, the handicapped and disabled – in their struggle to obtain the benefits they deserve and achieve some measure of dignity. At times, my level of frustration is overwhelming as I gaze into the eyes of my clients and see the look of quiet desperation in their eyes as they struggle to avoid near poverty, bankruptcy and sometimes divorce simply because they got injured on the job.

Franklin Roosevelt once said, “The test of our progress is not whether we add more to the abundance of those who have much; it is whether we provide enough for those who have too little.”

If this is the measure for progress then the workers’ compensation system is in a period of regression. The “Grand Bargain” is no longer a bargain.

– James A. Yoro is a certified workers’ compensation attorney with nearly 40 years of legal experience, and partner at the Bakersfield-based law firm Chain | Cohn | Stiles.

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Learn more about the recent reports on the workers’ compensation system:

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If you’ve been hurt while on the job, contact the Bakersfield workers’ compensation attorneys at 661-323-4000. Also, visit Chain | Cohn | Stiles’ specialized workers’ compensation website — for frequently asked questions and answers, and other information — by clicking here.

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*NOTICE: Making a false or fraudulent Workers’ Compensation claim is a felony subject to up to 5 years in a prison or a fine of up to $150,000 or double the values of the fraud, whichever is greater, or by both imprisonment and fine.

Wondering if you’re eligible for Social Security Disability benefits? Find out here

April 21, 2014 | 2:07 pm


Have you stopped working because of a physical or mental health problem? Has the problem lasted for a year or more, or will it?

If you said “yes” to either question, Social Security Disability may be able to pay you and give you medical insurance.

So what is Social Security Disability? It’s a federal government program that provides assistance to people with disabilities. The process to apply can be long and confusing. Chain | Cohn | Stiles has developed a “fast facts” sheet to figure out if you may be eligible for Social Security Disability benefits. Slide through the pictures in this blog to read them and learn more.

The Bakersfield Social Security lawyers at CCS have also compiled a list of frequently asked questions and answers related to Social Security Disability.

Q: Why should I apply for benefits? 

A: Entitlement to Social Security Disability allows you to receive monthly disability benefit checks for you and, in some cases, your family. In most cases, you will also receive a large lump sum payment for back benefits owed to you. 

You can become eligible for Medicare after two years of entitlement to disability benefits.

Even if you are getting Workers’ Compensation and/or long-term disability (LTD) benefits, your total present income may increase and you may be entitled to hundreds or thousands of dollars in back benefits.

Even though many group LTD policies offset other disability benefits, most policies do not offset Social Security’s annual cost of living increases. In addition, some policies only offset your individual benefits and not your family’s, and many policies have a minimum benefit payment that is not offset.

Your Social Security payments may be tax free depending on your other income, whereas LTD benefits are often taxable.

Q: Who is eligible for Social Security Benefits?

A: If you have worked long enough at a job where you pay Social Security taxes and have become disabled, you are probably eligible for disability benefits.

Even if you’ve never worked or haven’t earned very much money at your jobs, you may be eligible to get Supplemental Security Income (SSI) payments, that are for low-income people with disabilities.

Q: What does “Disabled” mean?

A “Disability” can be physical, emotional, mental, or a combination. The condition has to be serious enough to keep you from working and earning enough money for at least one year.

Q: I can’t do the job I used to do – am I disabled?

A: The test isn’t whether you can go back to a job you’ve lost. The test is whether you are physically and emotionally capable of doing a job that is generally available in the everyday work place.

Q: I am too old and no one will hire me – can I get disability?

A: Not necessarily.  The test isn’t whether you’ve been able to find a job recently or the chance that someone would hire you. There are some special rules called the Medical-vocational Guidelines that can help older people qualify for disability more easily. A knowledgeable attorney can help you make sense of those rules.

Q: I have a disabling condition but I’m not seeing a doctor – can I get disability?

A: You must have a doctor say that you are disabled “by medically acceptable clinical and laboratory findings.” Unfortunately, many genuinely disabled people can’t get benefits because they aren’t getting the right kind of medical treatment.

Q: I have a disabling condition and my doctor says I should be getting disability – why did I get denied benefits?

A: Unfortunately, many genuinely disabling conditions are difficult to diagnose or prove. In cases like that, it is up to your legal representative to present your doctor’s reports properly, and to convince the government that you deserve your benefits.

 

For several more Frequently Asked Questions and answers, go HERE, or visit our specialized web site dedicated to Social Security Disability.

And if you have any questions related to Social Security Disability, please call CCS. The attorneys at CCS — including Erica Scott and James Yoro — offer a free in-person consultation to discuss eligibility and there is no charge to speak to us on the phone.