When do Do Workers’ Compensation Payments stop?
When do Do Workers’ Compensation Payments stop? Worker’s compensation benefits will cease once certain milestones have been reached. Here’s what you need to know about the end of temporary disability and permanent disability payments in California.
Temporary disability benefits will begin when you are hospitalized overnight or when your doctor tells you that your injury will prevent you from working for three or more days. Temporary disability benefits are paid every two weeks for a total of 104 weeks. These benefits will end when you return to work or when your doctor tells you that further recovery is unlikely. If you were injured after January 1, 2008, you can receive up to 104 weeks of temporary disability benefits within five years.
If you suffer from chronic lung disease or severe burns, your temporary disability benefits may be extended. For this condition, you may be eligible to receive temporary disability benefits for up to 240 weeks in five years.
If your doctor determines that you have a permanent disability, the insurance company’s claims administrator will calculate what you should receive and begin making payments. These benefits will be payable to you, in addition to any temporary disability benefits you are receiving, until your final disability rating is determined. When the amount is determined, any amount that exceeds the estimate you receive must be paid by you.
If your permanent disability is qualifying, meaning it can be assessed or adjusted using a formula or percentage, you will not receive permanent disability payments if you return to a regular, alternative, or modified work schedule, as long as you receive 85% of your previous wages. When your permanent disability award is paid, you will begin receiving payments after your temporary disability benefits end.
Once the amount of your permanent disability has been determined, you will likely receive compensation and an award of your benefits. This can be paid as a lump sum payment or in a stipulation and award request. A stipulation agreement will usually include a monetary payment and a promise to pay future medical expenses. Payments will be made over time.
California Workers’ Compensation Laws
Several important statutes apply to most workers’ compensation claims. California Labor Code section 3600 sets forth the rules governing injuries that must be covered by workers’ compensation. In general, injuries sustained during the course and scope of employment are covered.
California Labor Code sections 5400 to 5405 contain the timelines and procedures you must follow in the event of an injury and how to report your injury. If you miss these deadlines, you could lose your right to workers’ compensation benefits.
California Labor Code section 4600 includes your right to receive payment for your medical expenses. At the same time, it analyzes when you can and cannot choose your own doctor.
California Labor Code sections 5500 to 5507 cover the requirements for filing an application to appeal a denial by the insurance company. These statutes also describe the procedures for a hearing. California Labor Code sections 4060 to 4062 and section 4616.3 include rules for medical evaluations in the event of different types of disputes with the insurance company. Finally, the rules for calculating temporary and permanent disability benefits are found in California Labor Code sections 4650 through 4654.
There are several exemptions to worker’s compensation that you should be aware of. Employers are not required to provide workers’ compensation coverage for the following types of workers:
- independent contractors
- Casual workers (employees hired occasionally or sporadically)
- domestic workers
- Certain farm workers
- Real estate agents who only receive a commission payment
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