7 OF THE MOST COMMON QUESTIONS ASKED BY A NEW OR POTENTIAL WORKER’S COMPENSATION CLIENT AND OUR RESPONSE
1) How long will it take before my case is settled?
Depends on the healing process than anything and when the treating physicians feel your condition has plateaued/stabilized. Typically the case can’t be settled until your condition has stabilized to the point that the physicians can evaluate your permanent impairment.
Quite frankly, we are at the very beginning of this case – it is too premature to even give a reasonable estimate.
2) Can I work while my case is pending or before my case has settled?
Certainly. There is not a single W/C settlement that makes up for a lost job. This is in part due to the fact that W/C cases do not compensate injured workers for pain and suffering, lost wages, loss of future wages or loss of earning capacity.
The best thing you can do for yourself and your family is return to the work force as soon as possible or practical given the status of your recovery. You will still get a settlement based upon your disability.
3) I have a doctor that wants me to return to work, but I’m not ready – what do I do?
Until we get an opinion that takes you off work entirely, you need to try to return to work. That is, approach your employer and see if they can accommodate you. If they can accommodate you by providing a modified job consistent with the doctor’s recommendations, try to do the job even if it’s only an hour or two, a half day or a couple of days – whatever you can tolerate without further harming yourself.
Make a good faith effort to do the modified work, but don’t hurt yourself. You know your body better than anyone – if something is making your condition worse, stop before you further injure yourself and tell your supervisor or employer.
If you merely choose to ignore the doctors’s opinion and not even try to return to work you risk an employer taking the position that you have abandoned the job. So, it’s better to at least give it a try, without making your injury worse and then, if the activity is too much for you ask to return to the doctor. At that point and if not done already, we may recommend treating with a new physician entirely.
4) What are the main benefits provided to me as someone who is injured on the job?
(a) First there is temporary disability, (usually temporary total disability) that is paid to you while you are unable to work based upon a physician’s opinion. This is paid at the rate of 2/3’s of your average weekly wage, up to a state maximum or, if your earnings are such, or at a certain minimum weekly figure. These benefits are paid typically for a maximum of 104 weeks. This sounds like a long time unless you have catastrophic injuries, multiple injuries with a protracted recovery period or multiple surgical procedures.
(b) Permanent disability/impairment. At some point the doctors in your case will be at the opinion that your condition has plateaued or stabilized. It will be their opinion, at least at that point, that you will not be getting worse or better for a period of time and that your recovery has stabilized. This does not mean you will never get better, or for that matter, worse – it’s just that there is no immediate medical care or treatment that is likely to change the status of your condition.
At that point, based upon the medical reporting, a determination is made, by agreement or through trial what your level of disability/impairment is at that point. The range is 0% to 100%. At 0% your injuries do not affect the way you do your Activities of Daily Living in any way. Whereas, at 100%, you are typically considered to be permanently totally disability and/or unable to work in the labor market.
The higher the percentage, the higher the permanent disability and the higher the settlement. Permanent disability, like temporary disability, is paid bi-weekly, but the vast majority of the time at a much lesser rate.
Future Medical Care. This is typically a lifetime award of future medical care for those injuries or conditions which were caused or aggravated by your work injury or exposure.
5) Why is permanent disability paid at a lower rate than temporary disability? Before I was only on temporarily disabled, and now I’m permanently disabled.
Temporary disability is paid based upon the fact that on a temporary basis you are essentially “totally disabled”. You are unable to do any job – your usual and customary job or any other job in the workforce.
Permanent disability is most often paid as “permanent partial” disability. Meaning you are only partially disabled by your industrial injury or condition and you are able to return to the Labor market often in a modified (sometimes significantly) capacity. In this instance, you are able to work and make a living. When you are temporarily totally disabled you cannot.
6) Are there other type of benefits/monies I can apply for?
The most common is State Disability Insurance (SDI). We tell all clients to file this right away if they are out of work whether or not they are already receiving bi-weekly checks from workers’ compensation. The reason for this is that, by doing this, they establish a claim date such that if they stop receiving benefits from Workers’ Compensation in the future, they can apply at that time and the claim will relate back typically to the filing date and they will have SDI monies in their account based upon the earnings prior to the industrial injury of exposure.
The second significant benefit usually comes into play with more serious injuries where an individual is unable to engage in any substantial gainful employment for a period of time. That benefit is Social Security Disability Insurance (SSDI). This is available even if you do not yet quality for your regular Social Security benefits due to your age.
7) How is a Worker’s Compensation case settled? Can I only get payments?
There are two primary ways of settling your Workers’ Compensation matter.
First is by Stipulation. This is when you settle leaving open medical care. In this instance, the parties typically try to agree to a certain level of disability/impairment, on a percentage basis, with open medical care on certain specified injuries, parts of body or conditions. With Stipulations, all or part of settlement (or Award) is typically paid by bi-weekly payments at a maximum rate of $290/week (currently), paid bi-weekly at $580/2 weeks. However, part (and in rare cases, all of the payments can be paid as a lump sum should the parties agree or the WCAB determines that they should have been paid starting at or earlier date – if not paid in part already.
The second most common way of settling your case is where you settle by Compromise and Release. In this instance you settle your case typically by a larger lump sum that not only pays you based upon the level of your permanent impairment, but also pays you additional money to close your future medical care. Closing your future medical care would mean that the employer and/or workers’s compensation insurance carrier would no longer be responsible for your further medical care – you would be. This would be either out-of-pocket or by whatever other resources (typically insurance) you might have available to you.