So now that you have determined that you have suffered a Workers’ Compensation injury, you may wonder what benefits you are entitled to. The two main and basic benefits an injured employee is entitled to are Indemnity and Medical Care.
Indemnity consists of monetary benefits, and there are two types in Workers’ Compensation you may be entitled to. The first type of benefit is called Temporary Total Disability (TTD). This type of benefit is to compensate your loss of income/ability to work. You are entitled to TTD if your treating physician determines that you are unable to return to work while you recover from you injury. TTD is calculated by multiplying your average weekly wage by two-thirds. TTD is limited to a maximum period of 104 weeks.
The second type of indemnity is called Permanent Disability (PD). Most people think this means that a doctor has to determine that have a Permanent Injury to get Permanent Disability . That is an understandable, but incorrect assumption. PD value is based on a percentage value that a physician issues to you once the physician determines when he/she completes treating your injuries. This percentage value is then given by the State of California a monetary value.
Other than indemnity, if you are deemed to have suffered a Work Injury, you are also entitled to Medical Care. Medical Care i determined first by your treating physician, but he/she may require authorization by the Worker’s Compensation insurance company. And, as one would imagine, the WC insurance company is conservative in authorizing treatment, since they have to pay for your Medicare Care. Thus, most Injured Workers tend to settle their Medical Care for a lump sum of money (i.e. the WC Insurance Company “buys out” your Future Medical Care for a lump sum of money, which I as your attorney will negotiate the value/amount of the lump sum settlement).
REAL CASE SCENARIO: A nurse injures her low back while lifting a patient out of bed. She is deemed to be TTD for 8 months by her Primary Treating Physician. Since her AWW was $1,250, her TTD value came out to $833.33. Thus, during the 8 months that she was unable to return to work due to her injuries, she received $833.33 of TTD per week. After the 8 months, her Primary Treating Physician determined that this nurse is done with her treatment, and issues a “final report” that gives the nurse 21% PD, which the State of California gave a value of $23,345. Her Primary Treating Physician in the same report determined that she will likely require physical therapy, pain/anti-inflammatory medications, and cortisol injections. The nurse decided that she didn’t want to deal with obtaining treatment through the Workers’ Compensation insurance, and so I negotiated the value of her Future Medical Care.
(NOTE: The above scenario was specific to this nurse, and in no means represents any promise or guarantee of obtaining similar benefit amounts for you the reader. All cases are unique and thus will yield unique results)