In California, temporary disability benefits are paid out to cover lost wages. An injured worker can only be eligible for temporary disability benefits if their employer’s workers’ compensation company agrees that the injury is work-related. If the claim is denied, then the injured worker will not receive any benefits.
Eligibility Requirements for Temporary Disability Benefits
To obtain temporary disability benefits in California, the employee’s doctor must say that they are unable to work or are limited in the type and amount of work they can perform. The employer must then decide if they can modify any work according to the injured employee’s physical capabilities. The injured employee will receive a physical evaluation every 45 days and the physician will make recommendations about their ability to perform certain tasks in the workplace.
How Temporary Disability Benefits Are Calculated
Injured employees unable to work at all will receive temporary total disability benefits. This amount is equal to two-thirds of the employee’s average weekly wage (AWW). Employees who can work part-time will receive benefits equal to the wages they are losing from the hours they are not working.
Payment Schedule
Temporary disability payments are made every two weeks by the employer’s insurance company. The first payment should be sent out within 14 days of receipt of the medical report stating the injured employee cannot resume previous work responsibilities. If a payment is late, a 10% late fee is automatically applied.
Temporary disability will end once an employee returns to work, the employee’s doctor recommends returning to work, or once the employee’s condition stabilizes and they become eligible for permanent disability benefits.
Maximum Temporary Disability Benefit Amount
In California, injured employees may receive temporary disability benefits for up to 104 weeks within a five-year period from the date of injury.
However, employees may qualify for up to 240 weeks of temporary disability if they have the following conditions:
- Acute and chronic hepatitis B
- Acute and chronic hepatitis C
- Severe burns
- Amputations
- Human immunodeficiency virus (HIV)
- Chemical burns to the eyes
- Pulmonary fibrosis
- High-velocity eye injuries
- Chronic lung disease
When to Hire a Workers’ Compensation Attorney
If medical reports offer differing opinions regarding an employee’s injury or even if a medical report says that an employee is temporarily disabled, an insurance company may deny the claim and refuse to pay temporary disability benefits. In these cases, it’s important to hire an experienced workers’ compensation attorney who will review the employee’s unique situation and determine how best to proceed.
A workers’ compensation lawyer may request a judge to decide whether an employee is entitled to those benefits. The lawyer will file the necessary paperwork and await the notice of a hearing date. During the hearing, the injured employee will need to testify and submit medical reports showing that they should be receiving temporary disability benefits. A workers’ compensation attorney will help ensure the employee is well-prepared for the hearing and qualifies for temporary disability benefits.
Trust The Best Workers’ Compensation Attorney in Orange County, CA
When you are struggling financially due to a work injury or condition, Workers’ Compensation Lawyer Thomas F. Martin can help you make sure the employers’ claims administrator is paying you what is owed under California law.
If you believe you are entitled to temporary disability benefits, or question the weekly rate you are being paid, but are not receiving the wage, don’t wait to discover your rights. Give us a call.