In California, if you are temporarily or permanently disabled in an accident, and you can’t work, will you be able to receive disability benefits?
It’s a complicated question, but keep reading, because almost anyone could suffer an unexpected injury – so you need to have some answers.
In California, if you are injured at your job, you are probably going to qualify for workers’ compensation benefits to cover your medical expenses and to replace part of your lost wages.
WHAT BENEFITS DOES WORKERS COMPENSATION PROVIDE?
The California Workers’ Compensation Law authorizes workers who are injured on the job to receive benefits that include:
1. Temporary disability benefits – 60 to 70 percent of the injured employee’s average weekly wage – are payable for up to 52 weeks if a doctor confirms that an employee is unable to work. As of 2018, weekly benefits are capped at a maximum of $1,216.
2. Medical treatment for work-related injuries is available through the employer’s medical provider network.
3. Permanent partial disability benefits may be paid if a physician determines that your on-the-job injury has been the cause of a permanent impairment or disability.
4. Workers who cannot return to their previous jobs may qualify for vocational retraining assistance.
HOW DO YOU OBTAIN WORKERS’ COMP BENEFITS?
If you are injured at work, report the injury and seek medical treatment immediately.
Your employer should provide you with a copy of the DWC-1 form, which is your application for workers’ comp benefits. Fill out the top half. Your employer will complete the other half.
You are not required to retain an attorney’s services if you need to file a claim for workers’ compensation benefits, but it’s easy to make a paperwork mistake that could delay your payments or even cause your claim to be denied.
However, an experienced workers’ compensation attorney can help you accurately complete the forms, determine precisely what benefits to claim, and meet the necessary deadlines.
If your claim is disputed or your benefits are denied, a good workers’ comp lawyer will appeal that denial and advocate aggressively for the benefits you need.
WHAT IF YOUR INJURY IS NOT WORK-RELATED?
Workers’ compensation benefits are paid to thousands of employees every year in California, but what if you were injured and temporarily disabled in an accident that was not work-related?
Will you be able to receive any disability benefits?
Here in California, the answer might be yes. California is one of the few states that provide injured employees with disability benefits even if the injury is not work-related.
WHAT IS THE SDI PROGRAM?
Disability insurance in California is part of the State Disability Insurance (SDI) program, established in 1946, to provide partial wage replacement benefits to qualified California workers who cannot work because of a non-work-related injury, illness, or pregnancy.
More than 18 million employees in California are covered through SDI. Contributions are paid by California employees through employee payroll deductions.
WHAT DETERMINES ELIGIBILITY FOR SDI BENEFITS?
If you are legally employed in this state, and if you are temporarily disabled because of a non-work-related injury, whether or not you qualify for SDI temporary disability benefits will hinge on:
1. who has responsibility for the accident and whether negligence was involved
2. the type of accident and type of injury
3. the location and time of the accident
4. the available insurance coverage
5. the benefits being sought
HOW DO YOU OBTAIN SDI BENEFITS?
To qualify for SDI benefits, you must have made at least $300 in SDI contributions during your 12-month base employment period. To apply for temporary SDI disability benefits:
1. File a claim through the California Employment Development Department website.
2. Have your healthcare provider verify that you are temporarily disabled by completing the “Physician/Practitioner Certification.”
3. Complete and submit Part A and Part B of the Claim for Disability Insurance (DI) Benefits (DE 2501) form within 49 days of the date that your disability begins, or you may be denied benefits.
Your employer will be informed that you’ve filed an SDI claim. However, your medical records are confidential and are not shared with your employer.
An independent medical examination to determine your initial or continuing eligibility for SDI benefits may be required.
If you haven’t worked for six or more months due to a disability, whether or not that disability is work-related, you may also be eligible to apply for Social Security disability benefits.
WHAT IF YOUR DISABILITY BENEFITS ARE NOT ADEQUATE?
While Californians consider themselves blessed – very few states provide disability benefits for accidents that are not work-related – the fact is that if you sustain a catastrophic or disabling injury, SDI benefits, and even Social Security disability benefits, are not going to be enough.
Traumatic brain injuries, severe spinal cord injuries, conditions requiring amputation, and any other catastrophic or disabling injury will require substantial compensation to cover long-term care, surgeries, therapy, and rehabilitation.
If another person’s negligence is the reason you’ve been injured – in a traffic accident, in an incident of medical malpractice, or even if you’re bitten by your neighbor’s dog – you may have legal standing to file a personal injury lawsuit.
In this state, the injured victims of negligence are entitled by law to complete compensation for all injury-related medical costs, lost wages, pain, suffering, and more. “Entitled,” however, makes obtaining personal injury compensation sound easy. It isn’t.
CAN A PERSONAL INJURY LAWYER HELP?
You’ll need to prove that you’re entitled to damages – that you’ve been injured by negligence – and in central California, you’ll need the help of a skilled personal injury attorney.
And although you cannot file a personal injury lawsuit against an employer – that’s what workers’ compensation is for – if you are injured in the course and scope of your employment, you may still have a legal option.
If any party other than your employer was even partially responsible for the accident and your injury, you may be able to bring a “third-party” personal injury lawsuit seeking damages.
IF YOU ARE INJURED, WHAT ARE YOUR TOP TWO PRIORITIES?
If you are injured in California – at the job or away from the job – seek medical treatment immediately. That’s the number one priority.
But after you’ve seen a healthcare professional, the next priority is discussing your rights and options with an experienced Fresno personal injury attorney. You may be eligible for benefits – or have grounds for legal action – that you don’t know about.
Nothing is more important than your health and your future. If you’ve been seriously injured in California, get an accident attorney’s advice – immediately.