Please ensure Javascript is enabled for purposes of website accessibility Are You Eligible for Worker’s Compensation? - Pride Legal

California law protects employees when they become injured or ill while working in the workplace. There are a few requirements an employee must meet to be eligible for worker’s compensation benefits. Some benefits include medical treatment for the injury, paid time off, permanent loss of function, or loss of disability benefits. Before benefits are paid out to an employee, an insurance company must decide that the employee has actually been injured while working.

What is covered under worker’s compensation?

Depending on the injury and circumstances, an employee could be entitled to several different benefits. The most basic coverage includes payment for medical treatment due to workplace injury. However, to receive medical payment benefits, an employee must visit a doctor in the Medical Provider Network. After visiting the doctor, that doctor must then send the request over to an independent physician who will either approve, deny, or modify the doctor’s requests. The employee would be eligible for mileage reimbursement, for medical appointments, or for getting prescriptions.

There are two types of worker’s compensation. The most common is “Stipulated findings and awards.” Payments are given out on a bi-weekly basis to the employee. The rate of disability benefits is calculated by paying out 2/3rds of the employee’s weekly paycheck. For example, if an employee makes $1,000 every week, they would receive $667 in disability benefits. In 2018, the bi-weekly maximum is $1,214. The insurance company would also cover medical costs, and in most cases mileage reimbursement.

The other type is “Compromise and release.” This is when an injured worker is paid a lump sum at once to settle the claim. This would release the insurance company and the employer for any future medical expenses or issues. A judge would still need to approve the settlement before any payment is made.

What are temporary disability benefits?

Temporary disability benefits are granted to employees who have lost wages due to a workplace injury. These benefits are only given once an insurance company investigates and decides that the injury or illness was due to being in the workplace. The employee must report to a physician every 45 days to be reevaluated. Payments will end once the employee returns back to work, or if the physician believes that the employee is healthy enough to work. Temporary disability benefits are also capped at 104 weeks.

What are permanent disability benefits?

Permanent disability benefits grant a worker loss of wages and loss of future earning capacity due to a permanent workplace injury. A doctor would evaluate the employee, and deem them 100% disabled, which would entitle the employee to permanent disability benefits. If this is the case, the employee would be entitled to their temporary disability benefit payments for the rest of their life. If an employee is less than ‘100% disabled,” that employee would be granted a pension for life. If an employee is deemed 100% disabled, that employee would be entitled to lifetime pension, wages, and loss of future earnings. There is no set amount when deciding on future earnings. Contact one of Pride Legal’s many employment attorneys to help maximize your payment.

F.A.Qs:

Q: Do all employers need to have worker’s compensation?

 

A: In California, yes, all employers need to have worker’s compensation. In some states like Texas, employers are not legally required to have worker’s compensation.

 

Q: Are there statutes of limitations when filing a worker’s compensation claim?

 

A: Yes, the statute of limitations for worker’s compensation claims is 1 year from the date of injury. To find how much your case is worth, click here.. If the worker is under 18, the statute of limitations would start after the employee turns 18. There are some extensions that could be given as well. For example, if the injury is due to repetitive stress, that employee could be given an extra year extension from when they were aware of the injury.

 

Q: Could a person lose worker’s compensation benefits?

 

A: Yes, an employee could absolutely lose their benefits. An employee could lose their benefits by not showing up to their physician’s appointments, lying about their condition, or even forgetting to file a report.

Contact Pride Legal

If you or a loved one has been involved in an Uber or Lyft accident, we invite you to contact us at Pride Legal for legal counseling or any further questions. To protect your rights, hire someone who understands them.

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