Overview of Worker’s Comp in California
California requires employers to provide workers with insurance coverage, known as “worker’s compensation.” Compensation is given to workers who are injured on the job or suffer from work-related injuries.
A worker’s comp injury can be caused by a single event (such as a slip and fall or a car accident related to the worker’s job), or an injury caused by repeated exposure (such as doing a repetitive motion or heavy lifting at work). The injuries could also include mental or psychological injuries caused by the job. Other examples of work-related injuries are:
• An accident in a construction site
• An orthopedic injury to the lower back or neck caused by heavy lifting
• An injury resulting from machinery at the workplace
• A work-related car accident
• An occupational disease such as high blood pressure, heart condition, stomach problems, carpal tunnel syndrome, or hearing loss
• Psychological and stress-related injuries caused by the worker’s job
• Other serious injuries such as traumatic brain injuries, spinal cord injuries, or severe injuries that result in the worker’s wrongful death
The primary purpose of California’s worker’s comp laws is to insure that an injured worker and his/her family are provided for while the worker is unable to work. Additionally, the laws are aimed at promoting the worker’s quick recovery, so that he/she can return to work and be productive.
No Recovery, No Fee
Worker’s comp cases work on a percentage basis (contingency) only and the client does not pay anything to the attorney if there is not recovery in the case. If there is a recovery and the worker receives compensation, the attorney’s fees will be deducted from the worker’s benefits. The fee ranges from 9% to 15% of the benefits awarded, depending on the complexity of the case the approval from the Worker’s Compensation Appeals Board.
According to the California Labor Code, attorneys should not charge up-front attorney’s fees for worker’s compensation cases. Additionally, attorney’s fees are decided by an administrative law judge and, by law, must be paid by the employer – at which time they are then deducted from the final settlement or award. If, for any reason, the worker’s compensation lawyer that you retain – including one from our firm – is not successful in obtaining benefits, you owe nothing to your attorney.
California created the Uninsured Employers Benefits Trust Fund (UEBTF) to ensure compensation for injured workers that work for employers without worker’s comp insurance, as required by law. Employers without worker’s comp insurance could be assessed penalties by the Appeals Board and be required to pay for the worker’s attorney’s fees.
The Types of Worker’s Compensation Benefits
1. Medical Care – Paid by the employer to help the worker recover from a job injury. This includes doctor visits and other medical treatments, including tests, medicines, equipment, and travel costs.
2. Temporary Disability Benefits – Payments for workers who lose wages because of a job injury. Payments are normally 2/3 (two thirds) of the worker’s pay.
3. Permanent Disability Benefits – Payments for workers who don’t recover completely for an injury that causes a permanent loss of physical or mental function (measurable by a doctor).
• Permanent disability payments are set by law and are based on several factors:
• Disability rating (determined by a doctor according to a schedule)
• Date of the injury
• Wages before the injury
• Weather the employer offers work or not
• Delays in permanent disability payments may result in penalties (10% – 25%) for each late payment.
4. Supplemental Job Displacement Benefit– Retraining or skill enhancement for workers who receive permanent disability benefits, and the injury prevents the worker from returning to his/old job or the employer doesn’t offer the same work.
5. Death Benefits – Payments to the worker’s spouse, children, or other dependents for the worker’s death resulting from a job injury or illness.
Settling the Worker’s Compensation Claim
After the rating of disability, there may be a settlement offer for the injured worker. There are two ways to settle a worker’s compensation claim:
1. Stipulations with Request for Award – both sides agree on the level of the permanent disability based on medical reports. Disability payments are then paid until the entire amount is paid, minus the 15% for the attorney’s fees.Future medical treatment is left open only for the injured body parts.
2. Compromise and Release (C & R) –This is a lump sum payment to the injured worker that is negotiated between the attorney and the insurance carrier. The amount of the settlement is based on the level of permanent disability based on by medical reports and an estimate of future medical care that the worker may need (less 15% attorney’s fees). A worker’s comp Judge must approve the settlement. However, if a settlement cannot be reached, the judge could decide what the benefits will be. After the C&R, the case will be closed forever and the worker will not receive any more future medical care.