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California Worker's Compensation Benefits

Important Notice: The following overview of California's worker's compensation (workmans comp) benefits is presented on an as-is basis. This information is believed accurate as of the date of authorship, but is not intended to provide a complete analysis of available benefits and may not reflect subsequent changes in the law. For a full review of California's worker's compensation law, or for a determination of how the law applies to a specific worker, please consult a worker's compensation attorney licensed to practice in the state of California.

Contents

Introduction

California's system of worker's compensation (workman's comp) is compulsory, meaning that employers are required to provide worker's compensation insurance for their employees. Worker's compensation insurance may be provided through a competitive state fund, a private insurance carrier, or employers may self-insure. Waivers are not permitted.

Special Employment Situations

The state worker's compensation act applies to agricultural workers. Domestic workers, including child care help, who are employed 52 or more hours, or who earned $100 or more, during 90 calendar days immediately preceding the date of injury or last employment exposing the worker to the hazards of an occupational disease, are covered by the state worker's compensation act, with the exception of workers employed by a parent, spouse, or child.

Medical Benefits & Choice of Physician

Full medical benefits are provided to employees entitled to worker's compensation benefits, with no time or monetary limits. Unless a personal physician has been pre-designated by the employee from an employer-sponsored health plan for medical conditions unrelated to work, the employer selects the initial physician who will provide care, with the employee obtaining free choice of provider usually after thirty days. However, if the employer has established a PPO-style network, the employee must choose a physician from within the network.

Disability Benefits Provided

Payments are made for temporary total disability (TTD) and temporary partial disability (TPD) in an amount determined by a percentage of the worker's wage, subject to weekly maximum and minimum payment amounts. For most workers, payments may continue for up to two years.

Payments are made for permanent total disability (PTD) based upon a percentage of the worker's wage, subject to weekly minimum and maximum payment amounts. Payments for PTD continue for life.

Payments for permanent partial disability (PPD) are made based upon a percentage of the worker's wage, subject to weekly minimum and maximum payment amounts. Depending upon the extent of the disability, payments for PPD may continue for up to 619.25 weeks.

Scheduled awards are paid in addition to total temporary disability benefits starting upon termination of the termination of the TTD benefits. Scheduled awards are not reduced because of receipt of TTD benefits.

Disfigurement may be considered when determining the percentages of total disability.

Physical rehabilitation benefits are available, and limited vocational rehabilitation benefits may also be available to some injured workers.

Within certain constraints and filing deadlines, occupational hearing losses may be compensable.

Death Benefits Provided

Death benefits are payable to an employee's surviving spouse, or spouse and children, based upon a percentage of the employee's wages, subject to a cap. A minimum benefit is provided regardless of the employee's earnings. A burial allowance is available.

Limits on Attorney Fees

Attorney fees for claimants are approved by the agency on a case-by-case basis. In certain cases, the attorney fee may be added to the award.