What are Workers’ Comp Benefits?

You may be entitled to benefits depending upon your individual situation. However, if you’ve been injured at work, you will receive all medical treatment necessary to cure or relieve you from the effects of a work-caused injury or illness. This includes physician’s services, hospitalization, physical restoration, dental care, prescriptions, X-rays, laboratory studies, and all other necessary and reasonable care ordered by your physician. There are no deductibles — the total cost of medical care is paid directly by the employer or its insurance carriers as a workers’ compensation benefit.

If the work-related injury or illness results in death, benefits may be paid to qualified surviving dependents. The maximum death benefit is $115,000. There is a separate allowance for reimbursement of reasonable burial expenses, up to $5,000.

What if my Employer Has No Insurance?

If your employer does not have workers’ compensation insurance and is not self-insured, your benefits may be paid by the Uninsured Employers Fund of the State Department of Industrial Relations. It’s important that you contact an information and assistance officer immediately if you suspect that your employer is illegally uninsured.

Types of Workers’ Compensation Benefits

• Medical Treatment

Workers are entitled to medical treatment if they’re injured or become ill on the job. This could include chiropractic, medical, dental, psychological, or other forms of treatment necessary to improve the worker’s condition or cure the injury/illness sustained in the course of employment (also known as Industrial Injury). This treatment should be provided to the worker at no cost.

• Temporary Disability (TD) Payments

These are monetary payments meant to compensate the worker while are injured/ill and unable to work. A doctor must declare the worker Temporarily Disabled in order to collect money while receiving medical treatment and regaining their health. Usually, these payments will be roughly two/thirds (67%) of regular pay.

• Permanent Disability (PD) Payment

This is a monetary payment that compensates the worker for residual injuries, unresolved conditions, and incurable physical complaints, received after a doctor has declared the worker has reached Permanent and Stationary (P&S) or Maximum Medical Improvement (MMI). This is usually at the closing stages of the case, although if the condition unexpectedly worsens after the claim is concluded, the claim may be re-opened.

• Vocational Rehabilitation Training (Voc Rehab)

If the doctor determines that the worker can’t return to their regular type of employment because of permanent injuries, the worker might be entitled to Vocational Rehabilitation benefits. These benefits help retrain the worker for a job that they are capable of performing and are interested in doing.

• Death Benefits

If a person were completely or partially dependent on a person whose death was a result of an on-the-job injury, the dependent may be entitled to certain benefits, such as funeral/burial expenses or other monetary compensation.

In certain situations, a worker may also be entitled to other benefits or compensations, such as Subsequent Injuries Benefits, Discrimination benefits under Labor Code 132(a), Employer’s Serious and Willful Misconduct, State Disability, Social Security, or Life Pensions, to name a few.

Get more information from your local WCAB Information and Assistance Officer, or contact us to guide you through the red tape of workers’ compensation forms and procedures.