Worker's Compensation* Attorneys in California
CHAIN | COHN | STILES has a very active Worker's Compensation Department. We have successfully represented thousands of clients who have been injured on-the-job.
For information on Worker's Compensation, please visit the topics below. In addition, our Frequently Asked Questions on Worker's Compensation has further information that may be helpful to you.
Specific Injury An on-the-job injury includes any injury or disease that arises out of employment. The injury can occur as a result of one incident or exposure. A work injury may be the result of falling from a platform, dropping an object on your foot, or cutting your finger on a machine.
Cumulative Trauma 
An injury may also be a result of work activities over a period of time. For example, a person whose job requires the lifting of heavy objects over a period of time may develop back or neck pain due to repetitive trauma on the job. Another example would be a person whose job requires repetitive motion of the hands or wrists such as assembly work or typing at a computer. This worker might develop carpal tunnel syndrome or repetitive use syndrome of the hands or wrists, and this would also be a work injury entitling a person to the same benefits as if it had been a specific injury.
A work injury may also be the result of an occupational disease or illness that the work place has produced. An example would be a worker who develops asbestosis due to exposure to asbestos products on the job.
An incident or activity on the job, which aggravates a previous injury or condition, is also considered a work injury. An example of this would be an employee who has had prior back problems and then re-injures the back while lifting on the job. That person is entitled to work injury benefits for the aggravation of the pre-existing condition and re-injury.
In some instances, a person may be entitled to workers' compensation benefits even if the injury did not occur while at the work site. For example, if the injury occurred in the company parking lot on the way to or from work, it may be considered a work injury. A heart attack or stroke, which is due to work stress, may be a work injury, even if the heart attack or stroke occurs at home.
Benefits
Medical Treatment
An injured worker is entitled to all medical, surgical, chiropractic, and hospital care reasonably required to cure and relieve the injured worker from the effects of the industrial injury. This includes all medicine and medical supplies as well as transportation expense which is currently .50 cents per mile for all trips to doctors or medical facilities.
The employer, or their insurance company, is required to provide the medical care. The employer has the right to select the treating doctor during the first 30 days following reporting of the injury. However, an employee can treat from day one with their own personal physician if the employee has notified the employer in writing before the injury that the worker has a personal physician and notifies the employer of the doctor's name, address, and telephone. For more information, see How to Choose Your Own Doctor
After 30 days, the employee can change physician by notifying the employer or insurance company of the new doctor's name, address, and phone number and that this is the new treating doctor. However, the doctor must be chosen from a Medical Provider Network (MPN) list provided by the insurance carrier. If the insurance carrier does not have an MPN, the injured worker can then choose any doctor who is willing to provide treatment under the Workers’ Compensation system. An injured worker is entitled to an unlimited number of changes of doctors, limited only by reasonableness.
Temporary Disability
When an injured employee is unable to work because of an injury or illness, which was caused by the employment, the employee is entitled to receive temporary disability compensation. This benefit is payable at the rate of two-thirds of their weekly earnings with certain maximums and minimums. For injuries which occur after January 1, 2005 and commencing January 1, 2007 the limits are increased annually by percentage increase of State Average Weekly Wage (SAWW), the maximum weekly payment is currently at $986.69/week. No temporary disability compensation benefits are payable during the first three days off work, unless the injury required hospitalization or the disability lasts for more than l4 days.
Temporary disability compensation benefits will terminate when the injured worker returns to work, has been released by the treating physician to return to his or her regular work, or when the injured employee's condition reaches maximum medical improvement and becomes permanent and stationary, meaning that the injury has healed as much as possible, and no further improvement is expected. Temporary disability benefits are only available for 104 weeks from the date the insurance carrier first starts payment of this benefit with some exceptions.
If the treating physician releases a worker to light duty work (such as no lifting over 10 pounds), before the worker is Permanent and Stationary and the employer does not make work available within those restrictions, the injured worker is entitled to receive temporary disability payments.
Permanent Disability
Permanent disability is that degree of disability or impairment that remains after the employee has reached the point of maximum healing. A permanent disability may be partial or total. If a person suffers a permanent partial disability, the person is entitled to a permanent disability rating and award even though he or she may be able to return to work.
Permanent disability ratings are provided under the law in the form of money payments, the amount of which depends on a number of things, including the injured's age, occupation, the part of the body injured, and the extent of the disability. The rating can range from l% to l00% depending on how the permanent disability affects the injured Workers' future earning capacity. A total disability for any type of work carries a l00% rating. Some examples of potential total disability would be the loss of both arms, both legs, or the loss of sight in both eyes.
The weekly rate at which permanent disability payments are made varies, depending on the date of the injury, and the extent of the permanent disability. A person who is permanently totally disabled with a rating of l00% is entitled to receive their temporary disability rate for life.
For permanent partial disabilities that occur after July l, l996, the injured worker is entitled to receive payments at either $l40.00, $l60.00, $l70.00, $230.00 or $270.00 depending upon the percentage of disability. The number of weeks of payment is determined by the percentage loss of the injured worker's working capacity. The greater the disability, the longer the payments are made. For permanent disability of 70% or more, in addition to the normal payments, the person is entitled to a small life pension.
Payments for permanent disability are payable in addition to any payments that the injured worker may receive for temporary disability, and are over and above the cost of medical care. These payments are made after the injury becomes permanent and stationary, or the last date of payment for temporary disability.
Substantial problems may occur in determining the amount of permanent partial disability payable to the injured worker where there is a pre-existing disease or impairment to the same part of the body that has been injured. Disputes often arise regarding how much of the disability is due to the injury, and how much is due to the pre-existing condition.
Vocational Rehabilitation Supplemental Job Displacement Voucher
If an injured employee does not return to work within 60 days of termination of temporary disability benefits, the injured employee shall be eligible for a job displacement voucher that varies according to the percentage of permanent disability associated with the injury. The amount of the voucher varies from $4000-$10,000. If the insurance carrier is willing, the injured employee may settle this benefit by payment of an alternative monetary amount paid directly to the injured worker.
Death Benefits When an injury or illness causes or contributes to the death of an employee, the surviving dependents are entitled to recover death benefits. The amount of the death benefit is affected by the date of the injury and the number of persons dependent upon the deceased employee for financial support. There are numerous and complex rules regarding who is a dependent, and whether they are total or partial dependents of the deceased employee. For example, for a worker whose injury occurred after July l, l996 and before January 1, 2006, which resulted in death, one total dependent would be entitled to receive $l25, 000.00; two or more total dependents are entitled to receive $l45, 000.00; three or more total dependents are entitled to receive $l60, 000.00. For an injury that results in death that occurs after January 1, 2006, one total dependent would be entitled to $250,000 to total dependents would be entitled to $290,000 and three or more total dependents would be entitled to $320,000. These payments are not made in a lump sum, but are payable weekly at the temporary disability rate, but not less than $224.00 per week.
Additional benefits may be payable to a very young child of a deceased parent in certain situations. If there are one or more total minor dependents, the death benefit is the temporary disability rate (not less than $224.00 per week) until the youngest child reaches the age of l8.
If there is one or no surviving total dependent, partial dependents may be entitled to some benefits.
In addition, burial expenses are payable up to $5,000.00 for injuries occurring on or after January l, l99l.
Time Limitations As soon as the worker knows or suspects that he or she has a work related injury or illness, he or she should immediately report it to his or her employer. Within one day after reporting the injury, the employer must give the worker a claim form. Waiting to report an injury or illness can cause a delay or denial of workers' compensation benefits.
A claim which is not filed until the worker has been notified that they are being terminated is not valid under California law unless it can be shown that, before the notice of termination, the injury had already been reported to the employer, or that there is evidence of the injury in the employee's prior medical records.
After filing the initial claim form, the injured worker has one year from the date of injury to file an application for adjudication with the Workers' Compensation Appeals Board. In the case of a specific injury, the date of the injury is the date the one-year time begins. However, in a case of an occupational disease or repetitive trauma claim, the date of the injury is considered to be the date in which the injured worker is actually disabled and has knowledge that it is work related.
When benefits such as medical treatment or temporary disability have been provided by the employer or workers' compensation insurance carrier, the injured worker has up to five years from the date of the injury to file a claim for new and further disability.
In other circumstances, time limitations may not be a factor, such as mental incompetence, minority, and other issues. You have the right to consult with an attorney to assist you in executing all claims in a timely manner.
Workers Compensation Claims The injury was caused by someone else's negligence. Can I file an additional lawsuit against them?
In order for an injured employee to recover civil damages, in addition to his or her workers' compensation benefits, it is necessary that proof be offered that the injury was the fault of a "third party." A third party is considered to be a person or party separate and distinct from the injured employee's employer.
One example of a potential third party would be when a delivery driver suffers an injury in a rear end auto accident. In this example, the third party would be the driver who rear-ended the car of the delivery driver. Therefore, the delivery driver would be able to pursue a Workers Compensation action against the other driver, as well as a workers' compensation claim with their employer.
The law in this area is constantly changing and the circumstances under which third parties are legally responsible for civil damages are often difficult to identify. Therefore, it is important for the injured worker to talk with an attorney knowledgeable in this field to determine whether a third party civil damage action is appropriate. Any job accident should be closely examined to determine whether some element of third party fault would permit the injured employee to recover civil damages in addition to workers' compensation benefits.
Recent Developments
As you may know, major changes were enacted in 2004 in the workers' compensation system. We are taking this opportunity to provide a brief summary of these changes, which will apply to injuries occurring at various dates beginning on January 1, 2003.
Temporary Disability Benefits In the past, when injured workers became temporarily disabled, they were entitled to receive two thirds of their earnings up to a maximum of $490 per week. Unfortunately, there had been no increases in the maximum rate since July 1, 1996. The new legislation increases benefits to a maximum of $602 in 2003, $728 in 2004, and $840 in 2005. Currently, the maximum rate is $986.69. Beginning in 2006, the new law also allows the maximum rate to automatically increase based upon increases in the state average weekly wage.
Permament Disability Benefits Permanent disability benefits have been drastically reduced due to the way such benefits are to be evaluated and calculated. Permanent impairment is now to be rated using the AMA Guide to the Evaluation of Permanent Impairment,
fifth edition. There is considerable litigation currently ongoing as a result of the application of this new impairment rating formula. Therefore, permanent disability ratings are in a state of flux depending on the outcome of this ongoing litigation.
Pensions If a worker has a permanent disability of 70% or greater, they are entitled to receive a life pension. If their disability is 100%, they are entitled to receive weekly payments at their temporary disability benefit rate for the rest of their life. Previously, these life pensions were paid at a fixed rate, ignoring any changes in the cost of living. The new legislation provides that if there has been an increase in the state average weekly wage, the pension or total permanent disability award will also be increased annually. This increase will apply to injuries occurring after January 1, 2003, and will allow the most disabled workers to receive reasonable yearly adjustments of their benefits.
Medical Treatment Any pharmacy providing medicines will be required to use generic drugs, if available, unless the prescribing physician specifically provides otherwise in writing.
Vocational Rehabilitation SJDV Prior to the new legislation, vocational rehabilitation was a "use it or lose it" benefit. The injured worker could not give up the vocational benefit in exchange for a larger settlement. However, some workers do not require a formal vocational program to return to suitable gainful employment. Therefore, the new legislation provides that a worker may be able to settle their rights to vocational rehabilitation benefits by payment of up to a maximum of $10,000.
Death Benefits Death benefits are based upon the number of dependants, which the worker has at the time of injury. The present death benefit ranges from $125,000 to $160,000. For injuries after January 1, 2006, these benefits will double. In addition, if the deceased employee leaves a child who is mentally or physically incapacitated from earning, the child will be entitled to receive the temporary rate of the deceased employee during their incapacity until their death.
Practice Areas 
California Personal Injury Attorneys