Workers Compensation Archives

The Ins and Outs of Workers’ Comp Benefits in California

- August 6, 2018

In 2014, the Bureau of Labor Statistics revealed that over 460,000 workers’ compensation claims were filed in California.¹ Workers’ compensation insurance allows employees of a company to receive monetary benefits in the event that they become injured while at work. These benefits provide wage replacement, as well as funds for any medical care which may be required following injury.

A Brief History of Workers’ Compensation Law

Today’s California workers’ compensation laws actually originated in ancient times when Sumerian law stated compensation for injury to the body parts of a worker in 2050 B.C. Monetary compensation for specific injuries was also seen in the laws of China, Rome, and Greece. They went further, to outline the differences between an injury that impaired a worker’s ability to function, and one that caused a disability, a distinction which can be found in today’s laws.

The Industrial Revolution saw the creation of factories, where workers were exposed to a host of risks due to the extreme working conditions and many hazards that were typically present. In those days, workers rarely were awarded compensation for their injuries, thanks to incredibly restrictive laws that favored employers

It wouldn’t be until 1871 that a Prussian Chancellor would implement the Employers’ Liability Law offering employees of mines, railroads, quarries, and factories protection via social insurance. However, the most recent contributor to today’s compensation framework would be Bismarck’s adamant support of Workers’ Accident Insurance. Today, all businesses in California that have employees are required by law to purchase workers’ compensation insurance.

The Importance of Compensation

Thankfully, compensation is an absolute necessity for employees, and it is the law for employers. With the support of work comp attorneys, today’s employees are protected from the health and safety risks they face at work, and employers are protected from lawsuits from employees. The costs of living and medical care continue to rise, making it vital for employees to have the option of compensation in the event of injury.

What Do Workers’ Compensation Benefits in California Include?

Workers’ compensation in California can include several benefits, depending on the severity of neurological, heart, or other injuries an employee has sustained. Some of the California workers’ compensation rates are below.

Death Benefits

In the event that employees’ job injuries or illnesses result in their deaths, compensation may be paid to their spouses, children, or any others identified as dependents, as follows:

Up to $5000 for burial expenses if the injury occurred before 2013, and up to $10,000 if the injury occurred after 2013.
$320,000 total if the injury occurred in 2006 or later.

For children who are totally dependent at the time of an employee’s death, benefits are paid until they reach the age of 18. If children are mentally or physically incapacitated, their benefits will continue until their deaths.

Benefits for Supplemental Job Displacement

This compensation helps the employee pay for skills enhancement or retraining, and it is offered to employees injured in 2004 or later who:

Have been deemed eligible for permanent disability benefits.
Have not been offered work by their employer.
Have not returned to work for their employers.

Benefits from $4,000 to $10,000 can be offered to employees who became injured between 2004 and 2012. Employees injured in 2013 or later can receive $6,000.

Permanent Disability

Benefits are offered for employees who do not completely recover from their injuries and where an injury causes measurable loss of mental or physical function. The amount of compensation that an employee can receive depends on the following factors:

How much the employee earns per week prior to the injury.
Number of employees that were working for the employer at the time injury was sustained.
Age of the employee at the time of injury.
Type of occupation.
Location and severity of injury sustained.

Temporary Disability

Employees may be eligible for temporary disability benefits if they lost wages due to their recovery preventing them from doing their usual job. Although payment amounts are not yet available for 2017, the Department of Industrial Relations for the State of California’s Guidebook for Injured Workers states a maximum weekly payment of $1, 128.43 in temporary total disability in 2016.²

Medical Expenses

Workers’ compensation in California also covers medical care costs for employees. This compensation helps them recover from injuries or illnesses sustained as the direct result of conditions at work. Coverage for medical care includes:

Travel costs to receive medical care.
Equipment costs for treatment.
Prescriptions written for work-related injuries.
Medical tests.
Other treatment services deemed eligible.

Disability vs. Workers’ Compensation in California

Employees who become injured on the job can file a disability claim. However, they will not usually receive disability benefits and compensation benefits for the same time period. This is because disability insurance pays only for injuries sustained outside of work, whereas compensation pays for heart, neurological, or other injuries which are work-related and includes compensation for disability.

California Workers’ Compensation Requirements

There are things you must ensure that you do after you’ve become injured in order to be eligible to receive benefits. You need to report your illness or injury to your employer as soon as possible after it occurs. You will also need to ensure that you complete and file all of the necessary paperwork within a certain period of time.

Statute of Limitations and Important Points

In order to be eligible for benefits, you must submit a completed DWC-1 form to your employer within 30 days of sustaining or becoming aware of your illness or injury. Not doing so can cause you to miss out on compensation for lost wages and medical care.

When visiting doctors for treatment of a workplace-related injury, it’s vital that you tell them your injuries were sustained at work, as this will help you to establish your case. Doing so will also ensure that your employer is billed for your medical treatments.

Your letter from your employer’s insurance company confirming your claim should arrive within 14 days of your employer having received your DWC-1 form. You will need to contact your employer’s insurance company if you did not receive the letter within this timeframe.

It’s important to remember that fraud on workers’ compensation claims is punishable by law. That said, being honest with all of the information you provide on your claim forms is crucial.

If You Couldn’t File on Time or Your Employer Denies Your Claim

Workers’ compensation laws in California are incredibly complex—even more so when necessary forms are not filed on time. This can also cause several delays in the awarding of compensation for your injuries, making it incredibly important to file in a timely manner. If you are unable to file within 30 days of sustaining an injury, you can get help from an experienced workers’ compensation attorney.

If your employer disputes or denies your claim outright, you still have options. One option is to seek out a qualified medical evaluator. These individuals offer an examination on a completely impartial basis that you can use in court and can also provide you with a second opinion on the nature, severity, and prognosis of recovery from your injury.

Becoming injured at work can leave you feeling completely overwhelmed, and choosing to represent yourself may result in you getting less compensation than you deserve. The Law Office of Jim T. Rademacher understands the complexities of California workers’ compensation laws. Our team is willing to fight for you every step of the way to get you the most compensation possible. Don’t settle for less in your compensation case. Discover how we can help by claiming your free consultation today.

Sources:

Death on the Job: Should Loved Ones Pursue Workers’ Comp Benefits or a Wrongful Death Claim?

- June 21, 2018

Accidents happen in the workplace every day. Some occupations are inherently more dangerous than others—construction work, mining, and logging are a few examples.

Sometimes an accident ends in tragedy when a devoted worker loses his or her life. Thankfully, California’s workers’ compensation system provides death benefits to spouses/domestic partners, children, and other eligible dependents when an employee dies on the job. These benefits are often an essential income lifeline for surviving family members—especially if the deceased employee was the family’s sole income provider.

However, what if an employee dies on the job because of an employer’s negligence? Can surviving family members file a wrongful death claim in this case? What are the differences between workers’ compensation death benefits and a wrongful death lawsuit? We’ll answer these questions ahead.

First, know this: If you lost your spouse or domestic partner to a workplace accident, at a minimum you may be entitled to workers’ compensation death benefits. Depending on the specific circumstances of your loved one’s death, you may be eligible to file a wrongful death lawsuit to recover even more.

A skilled workers’ compensation attorney can help you understand what benefits you’re entitled to and help you get the most favorable settlement possible. No amount of compensation can bring back your loved one, of course—but the payout can help you stay afloat financially. Struggling to pay the bills is that last thing anyone needs after a tragic loss.

Let’s look at workers’ compensation and wrongful death benefits in more detail.

Workers’ Comp Death Benefits vs. Wrongful Death Lawsuit

Workers’ comp is designed to provide financial benefits to a worker/employee who is injured or killed on the job, as well as their dependents.

What many people don’t realize is that workers’ comp is designed to protect employers from being sued for job-related injuries or deaths—even if the employer was negligent or contributed to a dangerous workplace environment.

This means that even if an employer violated safety standards, such as those set by the Occupational Safety and Health Administration (OSHA), they are still protected by workers’ compensation laws.

However, if the workplace death was caused by a third party, such as a general contractor, subcontractor, or negligent equipment manufacturer, the surviving family members may be able to file a wrongful death lawsuit against the third party, not the employer.

To file a wrongful death suit, surviving family members must prove that:

Their loved one died due to someone else’s negligence (such as a negligent equipment manufacturer).
The family has suffered harm because of their loved one’s death, such as lost income or earning capacity, and/or intangible losses, such as lost partnership, reduced quality of life, pain and suffering, etc.

Compensation for intangible losses is part of what sets a wrongful death claim apart—workers’ comp doesn’t provide benefits for these things.

Let’s drill down on the differences between workers’ compensation death benefits and a wrongful death lawsuit.

About Workers’ Compensation Death Benefits

California’s workers’ comp program is a no-fault system. This means surviving family members do not have to prove that the employer caused the death of their loved one due to negligence. Collecting death benefits is often as easy as filing a claim.

Yet, collecting benefits through the no-fault system also means that surviving family members give up their right to sue their loved one’s employer, and workers’ comp death benefits don’t provide compensation for intangible losses, such as reduced quality of life and loss of partnership.

How Death Benefits Are Determined

Death benefits are calculated based on how much the deceased employee earned before his or her death. Typically, death benefits equal two-thirds (66.7%) of the person’s wages, paid on a weekly basis to eligible dependents; the weekly amount for death benefits cannot be less than $224.¹

Additionally, workers’ comp insurance must pay reasonable burial expenses, up to $10,000 for the deceased employee.¹

Who Can File for Death Benefits?

Surviving family members who were totally or partially dependent on the deceased employee for financial support at the time of the accident/injury may be eligible for death benefits. Qualifying relatives include:¹

Spouses/domestic partners
Children (including step-children)
Grandchildren
Parents (including in-laws)
Siblings (including in-laws)
Grandparents
Aunts, uncles, nieces, and nephews

Some family members are automatically considered total dependents. This includes children under the age of 18, children who are unable to earn a living due to mental or physical limitations, and spouses who earned less than $30,000 in the 12-month period before the employee’s death.¹

There is a cap on basic death benefits for total dependents, as follows:¹

$250,000 for one total dependent
$290,000 for two total dependents (split evenly between dependents)
$320,00 for three or more total dependents (split evenly between dependents)

Partial dependents can also receive benefits, but how much they will receive depends on how many total dependents there are and other factors. A workers’ compensation attorney can help you understand whether partial dependents are eligible to receive death benefits.

Surviving family members have one (1) year to file a death benefits claim under the California workers’ comp system. Death benefits are paid to the surviving spouse until he or she remarries.¹ Dependents are typically eligible to receive death benefits until they turn 18.¹

Some employers choose to pay survivors a one-time lump sum rather than paying weekly benefits. It’s important not to rush into a settlement—consult an expert workers comp lawyer who can help ensure you’re adequately compensated by the employer.

Other Expenses

Workers’ comp must also provide surviving dependents with payment for medical expenses, temporary disability, or permanent disability that were still owed to the employee when he or she died.¹

About Wrongful Death Benefits

Surviving family members can often recover much more through a wrongful death lawsuit than through workers’ compensation. Wrongful death benefits can include compensation for:

Medical and other injuries, plus death-related expenses incurred by the deceased person and his or her surviving family members from the moment of the negligent act until his or her death
Funeral and burial expenses
Lost wages that would have been earned by deceased person until his/her retirement
Loss of services, care, assistance, and other benefits provided by the deceased person
Other damages (such as pain and suffering)

In California, the statute of limitations to file a wrongful death suit is two (2) years from the date of the person’s death. (Note that wrongful death claims are not limited to incidents that occurred because of workplace negligence.)

Who Can File a Wrongful Death Claim?

In California, only the following individuals can file a wrongful death lawsuit:

The surviving spouse.
The surviving domestic partner.
The surviving children.
If there is no surviving spouse/partner or children, other heirs, including the deceased person’s parents and siblings, may file suit. The deceased person’s stepchildren may also bring a lawsuit if they can prove they were financial dependents.

Others not mentioned above who are listed in the deceased person’s will cannot file a wrongful death claim, but they may be eligible to file something called a survivorship claim, which distributes benefits to everyone named in a will. An attorney can help you understand what a survivorship claim is and when it’s appropriate to file one.

Advantages & Disadvantages of Death Benefits vs. Wrongful Death Claim

There are pros and cons to filing each type of claim.

Workers’ Comp: One of the main advantages of filing a death benefit is that there is no requirement to prove that your loved one’s negligence contributed to his or her death; collecting benefits is as easy as filing a claim. The main disadvantage is that, by filing a claim, you forfeit your right to sue your loved one’s employer for damages; there are also no benefits for intangible losses (such as reduced quality of life or loss of life partner), and death benefits are capped at $320,000.
Wrongful Death Lawsuit: The main advantage of filing a wrongful death suit is the potential for greater compensation, including benefits for intangible losses; additionally, wrongful death suits that include punitive damage awards can help deter future misconduct, and there are no damage caps. The main disadvantage is that wrongful death suits can take a long time to settle—sometimes months or even years.

Why It Counts to Have an Expert Attorney by Your Side

If you lost a loved due to a workplace accident or injury, the skilled workers’ compensation attorneys at the Law Office of Jim T. Rademacher can help you recover the most from workers’ compensation and help you understand whether a wrongful death lawsuit may be appropriate. If you’re wondering how to find a wrongful death attorney, what the elements of a wrongful death suit are, and about the cost for wrongful death attorney fees, our expert attorneys can help guide you in the right direction.

Employers are responsible for providing proper working equipment, facilities, and training to employees. When they fail to uphold these duties and a worker is fatally injured, they are also responsible for providing adequate workers’ compensation to the victim’s dependents.

Our mission at the Law Office of Jim T. Rademacher is to help surviving family members get adequate compensation and justice.

For a free case evaluation, call us today at 877-922-2889 or use our contact form.

*Fraud on workers’ compensation claims is punishable by law.