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How Workers’ Compensation Payments are Calculated in San Francisco, California

Workplace injury or illness can happen at any time, in California or elsewhere. The sad reality is, it can happen to anyone. Thanks to the workers’ compensation scheme, the recovery journey can be less tough. If you or your loved one sustain an injury that’s work-related in California, you no doubt have plenty of questions, especially about the benefits you deserve.

This article addresses these questions and more.

Among other things, it’s a good idea to know how workers’ comp payments are calculated to ensure you are not cheated. In addition, many people get the services of experienced San Francisco injury lawyers to get the best outcome for their claims. It’s one of the best decisions you could make during such trying times as you need all the help you could get.

Workers’ Compensation and What It Covers in California

In all US states, employers are mandated to have insurance coverage for their employees for work-related injuries. You don’t have to be injured in your company premises before an injury is tagged work-related. You could be running errands or engaging in field works outside your company.

As long as your engagement is work-related when the injury happened it is a work-related injury and must be covered by the workers’ compensation benefit scheme. In California and many states, employers are not allowed to hide under “employee negligence.” So don’t worry, your employer will still be liable to pay.

If for some reason, your employer doesn’t have insurance in place, again, you don’t have to worry as the state will step in. The following are the basic benefits an employee may be entitled to under the workers’ comp scheme.

  • Medical care benefits
  • Temporary disability benefits
  • Permanent disability benefits
  • Supplemental job displacement benefits
  • Death benefits

How Workers’ Comp Payments Are Calculated

Here is how different types of workers’ compensation benefits are calculated.

Medical Care Benefits:

As soon as you report your injury and file a workers’ compensation claim, the insurance company of your employer is liable to begin paying for your medical treatments. Whether your claim has not been fully assessed and may even be denied, you are legally entitled to medical treatment valued at $10,000 or enough to cure or relieve your injury effects.

These usually include hospital bills, doctor’s bills, prescribed medicine, medical equipment, an appointment with a therapist, etc. What’s more, if your employer’s insurer doesn’t reject your benefit claim after 90 days of filing, California state law (Cal. Labor Code § 5402) assumes that you are entitled to all your claims from the insurance company.

Temporary Disability Benefits:

This benefit comes into play immediately after your doctor confirms that the injuries sustained will hinder you from discharging your duties. It usually kicks in once you have missed work for three consecutive days.

Note that temporary disability benefits are for compensating for some of your lost wages. Meaning, you are only entitled to two-thirds of your average weekly wages. The amount you’ll get is the pre-tax gross amount you were earning at the time of your injury, which includes overtime.

Note that temporary disability payments are adjusted based on the state’s average weekly wage. So, there’s a minimum and maximum you can earn. Since Jan 2021, the maximum and minimum temporary benefit payment you can receive in a week is $1,356.31 and  $203.44, respectively.

However, if you are a firefighter, paramedic, juvenile counselor, etc., your temporary disability benefit might be your full salary.

Partial Temporary Disability Benefits:

If your injuries are not extreme and doctors confirm you can work for limited hours, you may be entitled to partial temporary disability benefit according to the California state law (Cal. Labor Code § 4657).

Partial temporary disability benefit means you’ll get only two-thirds of your weekly wage loss. It is calculated as the difference between your average weekly pay (up to the maximum) and the pay you were earning for the limited work your doctor recommends.

Permanent Disability Benefits:

Again, if your doctors establish that a work-related illness or injury has left you permanently incapacitated, you’ll be given a permanent disability rating, considering your age, job function, and the severity of the disability. So, the amount may not be a straightforward percentage or fraction.

Supplemental Job Displacement Benefits:

In California, if your employer doesn’t offer you any modified alternative job after your doctor certifies you can work for limited hours, you may be entitled to this benefit. It consists of vouchers not above $6000. Again, the amount of vouchers you may receive depends on your condition.

Death Benefits:

This benefit is received by the deceased’s dependant. The amount may be based on the number of the deceased’s survivors that are eligible to receive the benefit.

Let Us Assist You With Your Claims.

Work-related injuries or illnesses can happen at any time and to anyone. If you or your loved one are in this boat, you need all the help you can get. It’s best to let allow experienced San Francisco injury lawyers to handle your claims. You will not only get personalized service if you need them to come to your home but also the best outcome for your claims.

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