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What is Workers’ Compensation?

If you get hurt on the job, it is required by law that your employer pay for your workers' compensation benefits. Make the right choice and call the experienced Law Office of Harley Merritt for your Workers' Compensation Claim.

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What benefits should I be receiving as an injured worker?

Injured workers are entitled to compensation and work comp benefits, some which they may be unaware of. Depending on the specifics of your claim, Workers’ Compensation benefits typically include:

Medical Treatment and Care: Workers' Compensation is responsible for paying for all the medical expenses associated with your injury or illness. The insurance company has the right to review the necessity of treatment and medications requested by your doctor, through Utilization Review (UR). Any treatment or medication that is denied through UR, can be appealed through the Independent Medical Review (IMR) process. Our office will make sure that UR determinations are properly reviewed and served. Our office also automatically appeals all UR denials and/or modifications and will promptly notify you of their decision.

Lost Wages: Disability benefits depend on whether your work injury has caused you to be temporarily or permanently disabled. These decisions are determined during the regular visits with your doctor.

Temporary Disability
- Temporary Total Disability (TTD) is when your doctor believes you will recover from your work related injury, but you are currently unable to work at all. You are compensated for your lost wages in the form of TTD, which is ⅔ of your gross average weekly earnings and is typically limited to 2 years (104 weeks) of payments.
- Temporary Partial Disability (TPD) is when your your doctor has released you work but you have work restrictions (examples: "light duty", no overhead lifting, no driving for longer than 30 minutes at a time, work half shifts instead of full, etc.) as your regular job would interfere with treatment or agitate your injury. If the wages earned from the modified work duties are less than the wages of your regular job, you are entitled to compensation of a portion of your lost earnings (again, typically ⅔ of your average gross weekly earnings). Our office frequently verifies that the employe's insurance company is correctly calculating our clients disability payments.

Temporary Disability Benefits end when your doctor has declared you are Permanent and Stationary (P&S). P&S means that the doctor does not expect you to get any better or worse, with or without treatment, in the near future.

Permanent Disability
- Permanent Disability: Once your doctor has determined that you are Permanent and Stationary, Permanent Disability (PD) is addressed by through an Agreed Medical Evaluation and/or Qualified Medical Evaluation (AME/QME). Through the evaluation, your injury is rated as a percentage ranging from 0-100%. Each percentage of disability has a different dollar value attached. The higher the percentage of your disability, the higher the dollar value of your Permanent Disability benefits.

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Work Voucher (also known as supplemental job displacement benefits or SJDB) and Return-to-Work Supplement Program (RTWSP):

SJDB - Supplemental Job Displacement Benefits / Work Voucher: Once you have been deemed Permanent and Stationary and permanently partially disabled , you may be entitled to a voucher if your injury has prevented you from returning to work for the employer. If you were injured between January 1, 2004 and December 31, 2012, you may be entitled to $4,000-$10,000, depending on the percentage of your permanent disability. If your injury occurred after December 31, 2012, you may be entitled to $6,000 (which allows you to spend up to $1,000 on computer equipment and up to $500 on miscellaneous expenses).

For more information on voucher eligibility and requirements, visit the State of California's Department of Industrial Relations website.

RTWSP - Return-to-Work Supplement Program: If your injury occurred on or after January 1, 2013 and you have received a Supplemental Job displacement Benefit (SJDB) voucher, you may be entitled to an additional $5,000 from the State of California.

For more information regarding the eligibility of the RTWSP, visit the State of California's Department of Industrial Relations website.

How will my claim settle?

Once it comes time to settle your case, you should be aware of your two options. Settlement is a huge decision that shouldn't be made lightly and as your attorney, Harley will offer you his sound legal advice

  1. Settlement by Stipulation or Stipulated Award: Your case settles for the dollar value attached to your percentage of disability but in this instances, you are keeping your rights to lifetime medical treatment for your work related injury (all treatment and medications are still subject to review by the insurance carrier). Your settlement is received in bi-weekly payments, until paid in full.
  2. Compromise and Release (also known as C&R): Your case settles for the dollar value assigned to your percentage of disability, plus extra money because you’ve given up your right to future lifetime medical. Settlement is received in a lump sum.

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