Four Types of Workers' Compensation Benefits

Workers’ compensation is a collection of benefits provided to people who are injured at work or “in the course” of work. All employers in California are required to carry workers' compensation insurance, and they are required to pay benefits to injured employees.

There are four distinct types of Workers’ compensation benefits:

• Medical treatment benefits

• Disability benefits

• Supplemental job displacement benefits

• Death benefits

Let’s take a look at each of these to understand who is eligible and what benefits are provided.

1. Medical Benefits

Workers’ compensation provides medical care that is “reasonable and necessary” to cure or relieve from the effects of an on-the-job injury. This can include doctor’s visits, medication, therapy (including chiropractic care), medical mileage expenses and surgery.

Unfortunately, medical care under workers’ compensation is highly regulated, through Utilization Review and Independent Medical Review.

When an insurance carrier receives a Request for Authorization for medical care, the insurance carrier can (and usually will) have a doctor they have chosen review your doctor’s requested care. If the insurance carrier approves or certifies the recommended care, then the care is usually authorized and provided. However, if any or all of the care recommended by your doctor is denied or “not certified,” then an appeal must be filed within 30 days of the date of the denial.

2. Disability Benefits

If your work injury affects your ability to work, you may be eligible for disability benefits through workers’ compensation. These benefits typically fall into temporary or permanent categories.

Temporary Disability

Temporary Disability (TD) pays an injured worker during a period of time that they are Totally Temporarily Disabled. This is, most often, a period of weeks or months immediately following an injury or a surgery. 

How are temporary disability benefits determined?

The weekly benefit rate is two-thirds of your average weekly wages. If you were paid a regular weekly salary, your benefit rate is two-thirds of that weekly salary. If your wage changes from week to week, then we calculate your average weekly wages made during the past year and you are paid two-thirds of that amount. The benefit, in most cases, is limited to 104 weeks.

Permanent Disability

Permanent Disability benefits (PD) can be paid to injured workers who have not fully recovered from their injury and have suffered “impairment” to the body that is not expected to go away.

How are permanent disability benefits determined?

Calculating an injured worker's PD rating is done by considering various factors, including the medical information available, the earnings at the time of injury, and the worker’s age and occupation. The law requires that a doctor evaluate an injured worker to determine their level of PD by applying rules established known as the American Medical Association Guides. PD benefits are weekly benefits. The higher the percentage of disability, the more weeks of benefits are payable.

3. Supplemental Job Displacement Benefits

A supplemental job displacement benefit is a voucher that promises to help pay for educational retraining or skill enhancement at eligible schools. You can use the voucher to pay for tuition, fees, books, tools, or other expenses required by the school for retraining or skill enhancement, and for licensing or professional certification fees, related examination fees, and examination preparation course fees.

You will be offered a supplemental job displacement benefit if the following are true:

• Your injury causes permanent partial disability.

• Your employer does not offer you regular, modified, or alternative work within 60 days of the termination of temporary disability.

4. Death Benefits for Dependents

While no one wants to think about being killed on the job, it’s good to know that dependents will be taken care of if it happens. Death benefits are provided to the deceased worker’s minor children, spouse, and other dependents they may have. These are provided at two-thirds of the worker’s average weekly wage before their accident. These benefits also cover funeral and burial costs.

Workers’ compensation benefits provide workers with the peace of mind that if they are injured on the job, they will still be able to support themselves and their families. That being said, the workers’ comp system is complicated and you may run into issues with your employer or the insurance company.

A workers’ compensation lawyer can help you seek the benefits you need - and deserve - after a work injury.

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Cole, Fisher, Cole, O’Keefe + Mahoney is Central California’s leading workers’ compensation and social security disability law firm. With over 30 years of successful experience, we are committed to securing maximum benefits for our clients in the Fresno, California area. Schedule a free consultation today.