Maison Law guides workers in California through the workers’ compensation claims process. Of the many questions you probably have, one of the most universal is simple: how much do you get in terms of benefits? The answer, like most things, is that it depends. Our team can set you up for success and make sure you get the benefits you need to get better. Contact us today for a free consultation to learn more.
How Much Do You Get in Workers’ Comp Benefits?
The main purpose of workers’ compensation insurance is to provide benefits to workers when they get hurt or sick on the job. There’s a lot of good things that come with workers’ comp, but it’s the financial support that you get when you file that is really helpful.
Better yet, you don’t have to prove fault or negligence to get benefits–you simply fill out the claim form, submit it, and your employer’s workers’ compensation insurance evaluates the claim and provides benefits.
The question, then, isn’t can you file. It’s what you can get in terms of benefits. Generally, once you file your claim, you can get the following things:
- Medical expenses – This benefit helps cover all your medical expenses, including doctor visits, treatments, and medications related to your injury or illness, reducing the financial impact on your health.
- Temporary disability (TD) benefits – If you’re temporarily unable to work due to your condition, this provides a portion of your lost wages, giving you financial stability while you’re unable to earn.
- Permanent disability (PD) benefits – If your condition results in long-term or permanent problems, this benefit covers you based on how it affects your ability to work, offering ongoing financial support.
- Job retraining assistance – If you’re unable to return to your previous job, this benefit helps fund training for a new career, ensuring that you can continue working in a different role if needed.
Workers’ compensation ensures that you receive these benefits without needing to prove employer fault. However, there’s also the chance that these benefits won’t cover all your needs–especially if you’re more seriously injured or sick. Workers’ comp benefits generally last for a maximum of 104 weeks, so it’s important to understand what actually influences the benefits you get when you file your claim.
What Influences the Workers’ Comp Benefits You Get?
Even though you have the right to access workers comp benefits when you’re hurt or sick on the job, it’s important to remember that it’s effectively still an insurance claim–which means an insurance company is going to be the decider on what you get.
While your employer’s workers’ comp insurance company has a lot of control, there’s still objective factors that are going to influence how your claim plays out and what you get in terms of benefits:
- How bad your injury is – The worse your injury or illness, the more benefits you may get. If it’s a serious or permanent injury, your benefits will be higher.
- Medical care – Workers’ compensation covers the medical treatment you need for a work-related injury or illness. The type and cost of your treatment will affect how much you get.
- State limits on benefits – California has limits on how much you can get in temporary and permanent disability payments. These limits are updated each year, based on the state’s average wages, so if you make a lot more than the state average, your benefits may be lower than what you earned before the injury.
- Salary and work history – Your benefits are based on what you were earning when you got hurt. If you earned more, you may get more in benefits, but only up to a certain limit set by the state.
- Filing on time – You need to report your injury to your employer quickly, ideally within 30 days. If you don’t, it could affect your ability to get benefits.
- Employer’s insurance – Employers in California are legally required to have workers’ compensation insurance. But, the quality of the insurance can affect how fast you get paid, but if there are delays, you may need to work with the insurance company to get the benefits you need.
- Pre-existing conditions – If you had an injury or health problem before but it got worse because of work, you can still get benefits. The doctor will look at how much of the problem is related to your work injury.
Obviously, you can easily find yourself in a situation where you need to file a workers’ comp claim. Your recovery is going to be heavily influenced by these factors and the benefits you get. That’s why you might need a lawyer.
Why Would You Need a Workers’ Compensation Lawyer?
In California, workers’ compensation typically comes into play in two main situations. First, if you’re injured on the job, your employer is required by law to have workers’ compensation insurance. However, issues can arise if your employer doesn’t have the right coverage or, more commonly, if they retaliate against you for filing a claim. Additionally, if someone else’s negligence caused your injury, the situation can get more complicated.
In such cases, it’s important to consider your legal options. Our team can assist by:
- Explaining your rights and options
- Identifying the cause of the accident and who is responsible
- Helping you gather evidence and file your claim
- Negotiating with your employer and insurance companies to secure a fair settlement
Getting injured can make life harder, even with health insurance or workers’ compensation. Our goal is to simplify the process for you, so you can focus on recovering and getting back to work. Contact us today for a free consultation to get the process started.
