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What Are the 5 Basic Types of Workers' Comp Claims?

Workers’ compensation exists to protect employees by compensating them for injuries they sustained at work. Since 1910, the goal of this program in California is to ensure that workers don’t have to take on medical debt or lose all of their income because of an accident on the job.

When an employee is injured, they may be entitled to workers’ comp benefits. In California, there are five basic types: Medical care, temporary disability, permanent disability, supplemental job displacement, and death benefits.

Medical Care

When an employee is injured, they are entitled to receive any and all medical treatment reasonably required to relieve or cure a work-related injury or illness. This includes anything from the services of a physician to hospital care, physical therapy, diagnostic services, and any other kind of care deemed reasonably necessary by the treating physician.

This physician is an individual associated with the employer’s Medical Provider Network, which is affiliated with the workers’ comp insurer. The insurer receives and reviews all requests for medical treatment, which it can allow, change, or deny. Should the insurer deny treatment, the injured employee can challenge the decision with an independent medical review.

Temporary Disability

Workers who are so injured by an accident at work that they are unable to return within three days may be entitled to temporary disability benefits. These benefits provide partial wage replacement compensation, which is about two-thirds of the employee’s normal pay up to a statutory maximum.

A physician must determine that an employee is temporarily disabled to confer eligibility for these benefits, which end when the physician determines the employee is no longer disabled. Alternatively, a physician can determine that an employee is permanently disabled, which confers eligibility for a new class of disability benefits.

Permanent Disability

The purpose of permanent disability benefits is to compensate employees for lost wages when they are permanently unable to work. If a worker becomes permanently disabled, the benefits they can receive are calculated based on the worker’s occupation, the extent of their injury, the worker’s age at the time of the accident, and when the accident occurred.

From these and other factors, a benefits amount is determined within the minimum and maximum parameters set by California law.

Supplemental Job Displacement

Supplemental job displacement benefits provide compensation to workers who are either unable to return to their former occupation or their employers didn’t offer alternative or modified work.

These benefits come in the form of a voucher that may be used at a state-accredited school, where the injured employee can receive education and training in a new occupation. Regardless of the extent of a permanent disability, a voucher can be redeemed for up to $6,000.

Death Benefits

The families of workers fatally injured on the job can file for workers’ compensation death benefits. This can be used to compensate for reasonable burial expenses up to the statutory limit.

For a period of time after death, the decedent’s dependents can also receive support payments at the same weekly rate as the maximum temporary disability benefit. How much of this support workers’ compensation will provide depends on how many dependents the decedent had, as well as whether they are completely or partially dependent.

Helping Clients with Workers’ Comp Claims

No matter the type of workers’ compensation claim you need to file, you can trust Smolich and Smolich to support you all the way. Our attorneys understand the workers’ compensation process, which can be daunting for first-timers. With our guidance, however, you can rest assured that an experienced professional you can trust is looking out for your interest.

If you want to learn more about how Smolich and Smolich can help, contact us online.