How Much Do You Get for Workers’ Compensation in California?
Job injury victims get varying amounts of money from workers’ compensation, based on their lost wages and medical expenses. These life-changing benefits are available even if the victim was entirely at fault for the injury, at least in most cases. So, for the most part, workers’ compensation matters are relatively easy to prove.
However, these claims are procedurally complex. Insurance company interests dominate the workers’ compensation bureaucracy. Furthermore, a bare-bones case usually generates minimal results. To obtain maximum benefits, an Oceanside personal injury lawyer must diligently prepare a job injury case and persevere through a protracted and frustrating legal process.
Medical Bills
Usually, the reasonably necessary rule determines the amount of medical bill compensation in a job injury claim. This rule also applies to job-related illness claims, such as toxic exposure lung disease, a repetitive motion injury, or hearing loss.
Generally, a bill is reasonably necessary if the service is in line with the standard of care for that particular kind of illness or injury and the cost is not excessive, again according to the standard of care.
A broken leg is a good illustration. If Jeff falls and breaks his leg at work, the standard of care usually dictates that the doctor evaluate Jeff’s physical condition, perform diagnostic tests, and repair the damaged bone. More than likely, Jeff also requires some physical therapy and may also need a walker or another medical device.
The standard of care is fixed, but the services performed vary. For example, if Jeff’s broken leg is serious, the doctor must refer him to a specialist who uses metal parts to surgically reconstruct the bone. If Jeff is in poor condition, the doctor may need to split the repair process among several different procedures.
California rules regarding physician choice complicate this matter. In the Golden State, employer claims administrators choose treating physicians for the first thirty days of medical treatment. After that, victims may change providers, if they predesignated a physician or are not satisfied with initial care.
Company doctors often have a much different view of “reasonably necessary” treatment than the independent doctors that an Oceanside personal injury lawyer usually partners with.
Lost Wages
Most job injury and illness victims receive two-thirds of their average weekly wage for the duration of their temporary or permanent disabilities. Once again, the general rule is straightforward, but as they say, the devil is in the details.
The AWW is not the same as average net pay. If Lisa recently changed jobs or got a promotion, her prior wages are not indicative of her current AWW. Furthermore, the AWW must account for noncash compensation, such as matching 401(k) contributions, and future losses, such as missed overtime opportunities.
Additionally, lost wage benefits are usually retroactive to the disability onset date. In occupational disease claims, the disability onset date could be weeks, months, or even years prior to the filing date.
Connect With a Diligent San Diego County Lawyer
Injury victims are entitled to substantial compensation. For a confidential consultation with an experienced personal injury lawyer in Oceanside, contact the Pursley Law Firm. Virtual, home, and hospital visits are available.
Source:
dir.ca.gov/dwc/dwc_home_page.htm
