Victorville
Workers' Compensation Benefits
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Work-related injuries affect millions of Americans every year, but thankfully the workers’ compensation system provides a process for recovering expenses incurred as a result of their injuries. In 2018, injured workers throughout the U.S. receivedU.S..8 billion in workers’ compensation benefits, with each claim generating an average compensation amount of $41,003. A valid workers’ compensation claim can allow injured workers to obtain a reasonable settlement to cover their damages, meaning they can focus on healing during this challenging time rather than struggling to maintain financial security for their families.

The only way to successfully navigate this difficult process is to hire the services of an experienced Victorville workers’ compensation attorney. At Kampf, Schiavone & Associates, our expert team approaches every claim with compassion, care, and dedication. Employing comprehensive legal knowledge and decades of litigation experience, we provide clients with first-rate legal representation throughout the claims process and work diligently to deliver you the best possible results in your workers’ compensation benefits package.

Eligibility for Workers’ Compensation

In California, workers’ compensation operates according to a no-fault system if the injured worker demonstrates they suffered injuries and incurred expenses as a direct result of their employment. An injured worker does not need to hire a lawyer to make a workers’ compensation claim. However, experienced legal representation can make a significant difference in the outcome of your claim. They can guide you through the process, ensure you complete all necessary steps within the proper statute of limitations, and coordinate an aggressive defense against your employer’s insurance company. If a claim is denied or becomes excessively complicated, a lawyer knows how to handle these issues, so they do not prevent you from receiving benefits.

Requirements to Apply for Workers’ Compensation

Workers’ compensation in California includes specific requirements for submitting a valid claim, such as time limits for reporting your injury. However, eligibility for workers’ compensation benefits does not require the victim to suffer from specific injuries, diseases, illnesses, or debilitating conditions. An injured worker may also recover lost wages equaling up to two-thirds of their regular income. In cases where the injury resulted in the victim’s death, the surviving family members may seek death benefits as well.

Types of Workers’ Compensation Insurance Benefits

Benefits available to claimants of workers’ compensation consist of medical benefits, temporary or permanent disability benefits, occupational rehabilitation or retraining benefits, right-to-work funding, and compensable consequences benefits.

• • Medical Benefits

    When an employee suffers an occupational injury, they likely require a variety of medical expenses for current treatment and continuing care into the future. Medical benefits are defined as any medical or hospital costs deemed reasonably necessary to either fix the injury or provide relief from its effects. This includes reimbursement for medical treatment, procedures, surgeries, medication, travel to and from doctor appointments, and any additional out-of-pocket medical costs required to ensure the worker recovers fully and may reenter the workforce. By submitting a valid claim within the specified statute of limitations, injured workers can recover 100% of their medical expenses. Nearly two-thirds of workers’ compensation claims are filed to exclusively cover medical benefits.

    The employer typically reserves the right to enforce limitations on the doctor or healthcare facility the employee visits during the 30-day period following the injury. The patient may receive as much care as necessary to encourage total recovery, but such care involves completion of a Utilization Review. During this review, another doctor who has not examined you is hired to assess the attending physician’s recommendations. They will employ their own medical knowledge and experience to decide whether the treatment process falls within predetermined guidelines and is needed to facilitate full recovery after the injury. If the employer delays this process, they are considered responsible for reimbursing up to $10,000 of medical treatment once the decision has been made.

• • Temporary Disability Benefits

    California’s workers’ compensation program defines temporary disability as any injury or condition resulting from occupational duties that cause the injured employee to miss at least three days of work while seeking treatment or any injury or condition that requires hospitalization. Temporary disability benefits provide up to two-thirds of the amount they would have earned in a typical week if they were not restricted from working due to their injury, referred to as average weekly earnings (AWE). As the AWE increases, so does the temporary disability rate.

    Medical documentation is needed to support the assertion that the employee cannot physically return to work, and temporary benefits are available for a maximum of two years or at which time the employee has recovered enough to resume the essential duties of their job, whichever occurs first. The injured worker will receive bi-weekly payments, determined using AWE and minimum disability rates. Even if the worker still cannot reenter the job force after this period has concluded, temporary disability cannot extend beyond two years.

    Temporary disabilities may be partial or total. A partial temporary disability prevents an injured worker from performing certain occupational tasks and is based on the presumption that they will eventually recover fully and return to their previous work capacity. In these cases, the worker may return to their workplace before achieving total recovery, often with limited responsibilities and a reduced salary. If an injured worker suffers from a total temporary disability, they are temporarily prohibited from continuing the job they performed before sustaining their injury or any other job they were capable of performing before the injury. However, they are expected to heal, and the majority of workers receiving these benefits end up recovering fully and returning to their job, leading to termination of benefits.

• • Permanent Disability Benefits

    An injured worker may recover permanent disability benefits if the initial injury they sustain results in a long-term or significantly life-altering impairment even after recovery. These benefits are calculated into a percentage based on the health and disability of the worker, then adjusted higher or lower depending on age and occupation. Permanent disability benefits vary due to the extent of harm suffered and range from under $1,000 for one percent disability to more than $260,000 for 99 percent disability.

    An individual with a 100% disability is considered totally permanently disabled and may no longer complete the work tasks they performed before sustaining the injury. They will receive disability benefits throughout their lifetime. Very few workers’ compensation claims involve permanent total disabilities. An injured worker deemed over 70% disabled may receive a life pension that pays a variable rate comparable with disability benefits. Permanent partial disabilities are typically limited to a certain duration of time or a total dollar amount.

    Similar to temporary disability, benefits are paid biweekly until the injured worker receives the total compensation amount. Even workers affected by permanent disabilities may ultimately return to the company they worked for previously and perform a modified version of their job with a limited number of occupational tasks. A workers’ compensation physician must inform the employer of accommodation requirements that must be made at the workplace to allow disabled employees to continue working.

• • Vocational Rehabilitation Benefits

    When temporary and permanent disabilities prevent an injured worker from returning to the same industry or job they performed before becoming injured, vocational rehabilitation benefits may be awarded. In California, the Supplemental Job Displacement Benefits provides up to $10,000 for job rehabilitation and retraining, ten percent of which may be used to hire a counselor to assist in your job search. Some benefits are offered in the form of cash rather than training. If the previous employer does not offer employment within a 60-day period after the worker has reached maximum medical improvement, vouchers may be provided. These vouchers assist the worker in seeking employment at a different workplace.

• • Right-to-Work Fund

    If an injured worker is eligible for Supplemental Job Displacement Benefits, they are also eligible for the right-to-work fund. This offers extra assistance to injured workers unable to return to their previous jobs. The maximum available right-to-work fund benefit equals $6,000 per injury. The state of California covers this benefit, not your employer or workers’ compensation insurance.

• Compensable Consequences Benefits

  An injured worker suffering occupational injuries that cause additional health problems may be able to pursue compensable consequences benefits as well. Examples of compensable consequences include wrists broken during a fall caused by a work-related knee injury, back injuries developing from a limp caused by occupational knee or ankle injuries, injuries sustained in an automobile accident while traveling to the doctor for treatment of your occupational injury, or injuries caused by medical malpractice during treatment.

Schedule Your Free Consultation Today

If you or a loved one sustained an injury in a work-related accident, you may be entitled to receive benefits through the workers’ compensation system in California. For over three decades, the team of workers’ compensation specialists from Kampf, Schiavone & Associates has assisted thousands of California families in navigating this process with confidence and convenience. We are proud to be recognized as the largest workers’ compensation law firm in the San Bernardino area and have recovered more than $250 million for our clients.

We offer free consultations for prospective clients and never charge until we win your case. To discuss your legal options with our team, call (866) 583-8796 or contact us online.