Unfortunately, employees do not always fully recover from workplace injuries. As a result, you may face a lifetime of diminished employment opportunities or find yourself unable to work at all. Under these circumstances, you will be entitled to significantly more compensation than a temporarily disabled worker – perhaps even a lifetime stipend! It is important you discuss your case with a skilled and proven Thousand Oaks Permanent Disability Attorney.
HOW IT WORKS
If an injury leaves the employee with a disability that affects their ability to earn a living, they are entitled to permanent disability benefits. This benefit becomes payable once the injured worker’s condition has become permanent and stationary (has improved as much as they are going to) and is calculated using many factors including age, occupation, date of injury, income level, and disability as determined by the treating physician or Panel Qualified Medical Examiner (PQME).
There are two types of permanent disability: permanent partial disability (PPD) and permanent total disability (PTD). A total disability is considered 100% disabled and represents a level of disability at which an employee has sustained a total loss of earning capacity. This category is reserved for the most serious of injuries and, in certain circumstances, is conclusively presumed. This includes loss of sight, loss of both hands or use thereof, total paralysis, or a brain injury resulting in mental incapacity or insanity. A partial disability represents all other permanent disabilities, whether 1% disabled or 99% disabled.
The first payment of permanent disability becomes due once the injured worker has been found permanent and stationary by the treating physician. This remains true unless the employer has offered the employee a job that pays at least 85% of pre-injury wages or if the employee is employed with another employer that pays at least 100% of the pre-injury wages. These payments are known as permanent disability advances (PDAs) and will be deducted (as a credit to the carrier) from any settlement or Award at the end of the case. The claims administrator must keep the employee up to date regarding this benefit by sending letters that explain how the payments were calculated when they will begin, reasons for changes in permanent disability amounts, and reasons for delay or nonpayment. If the permanent disability advancement has been unreasonably delayed or refused, the insurance company may be liable for a penalty of up to 25% for each late payment.
If you have questions about how this will affect your case, please call me, an experienced Westlake Village permanent disability lawyer at (805) 430-3300.
There are two important permanent disability percentages which can trigger special benefits in California, 70%, and 100%. A 70% disability and above provides for a life pension which gets paid after the permanent disability has been fully paid. For a rating of 70-99%, the base weekly payment for the life pension is determined using a formula based on the value of the rating and the date of the injury. For a rating of 100%, i.e. totally disabled, the base weekly payment is the same as the temporary disability payments. As the temporary disability rate is usually higher than the rate for weekly payments under a 70-99% award, insurance companies will fight hard to keep the claim to below 100%. Therefore, if you have had a significant injury it is important to contact a knowledgeable Thousand Oaks permanent disability lawyer attorney to ensure you are getting the proper benefits.
If you have questions about how this will affect your case, please call us at (805) 430-3300. As professional and proven Westlake Village permanent disability attorney, I can help you navigate these issues and represent you fully.
Frequently Asked Questions (FAQs)
What does “permanent and stationary” mean?
“Permanent and stationary” (or “maximum medical improvement”) is a term used by your doctor to assert that your condition has improved as much as it is ever going to. You must reach a permanent and stationary condition before you can receive a Permanent Disability determination.
Is there an appeal procedure for adverse determinations?
You may appeal any adverse determination to the California Workers’ Compensation Appeals Board. You are entitled to a hearing on the matter, and you may be represented by a permanent disability attorney. The Board has seven members and is vested with full judicial powers.
Does the claims administrator have to pay a penalty for late payments?
Yes! For each payment that was unreasonably delayed (late) or refused, the insurance company must pay you an additional penalty of up to 25%, or $10,000.00, whichever is less. To ensure you get all the benefits you deserve, it’s important to keep copies of your records and other correspondence relating to your claim.
Who is required to offer workers’ comp insurance?
All California employers must provide workers’ comp benefits to their employees, even if they only employ one person. However, it is important to be aware of the legal distinction between an employee and an independent contractor (most commercial truckers are independent contractors, for example).
How do I become classified as permanently disabled?
The process works like this:
- The doctor waits until your condition has stabilized and you have likely recovered as fully as you are ever going to (“permanent and stationary” or “maximum medical improvement”).
- The doctor determines whether or not you are permanently disabled, and to what extent your disability is work-related.
- The doctor completes a report and sends it to the claims administrator.
What can I do if I disagree with the doctor’s assessment of my disability?
You can request to be examined by a Qualified Medical Evaluator (QME) by filling out forms sent to you by the claims administrator and sending them to the DWC Medical Unit within 10 days after the claims administrator authorizes you to begin the process. Your employer will pay for the examination.
What is a PD rating and how is it calculated?
The PD rating is a measure of your disability. It is calculated as follows:
- The doctor determines how your injury affects your ability to perform daily life activities and to what extent your injury is work-related. This determination is called the impairment number.
- A formula is applied to your impairment number to calculate your percentage of disability.
- Your percentage of disability is discounted by the extent to which it is not work-related.
How are permanent disability benefits paid?
Permanent Disability payments must begin within 14 days after your Temporary Disability ends, as long as your doctor confirms that you are permanently disabled. Payments are made every two weeks until your disability amount has been paid in full.
How will my claim be finally resolved?
Most Permanent Disability payments are resolved by a settlement that must be approved by an administrative law judge. The settlement may be in lump sum or paid out periodically, and it can include an amount for future medical expenses if your condition warrants it.
How will my family be taken care of if I eventually die from my injury?
California offers workers’ compensation death benefits to the deceased workers’ dependents, including:
- Children under 18
- Children over 18 who are disabled (they cannot support themselves)
- The workers’ spouse (who may be classified as only “partially dependent” if his/her annual income exceeds $30,000)
Other household members may qualify if they are genuine dependents.
Believe It or Not, You Don’t Need Any Money to Retain Me
At my office legal fees are calculated as a percentage of your actual recovery. That means that if I am unsuccessful, you won’t owe me a dime because any percentage of zero is still zero. I wouldn’t be able to afford to offer this arrangement if I wasn’t confident, based on experience, in my ability to win. It is the quality of your claim, not your finances, that matters most to me.
Let’s Make It Happen Together; Contact Kenton at the Law Office of Kenton D. Trigger Today
For a variety of reasons, it is critical that you begin vigorously pursuing your claim as soon as possible after you are injured. As a very experienced Thousand Oaks Permanent Disability Lawyer, I know how to handle your claim – and take the stress off of you while you heal. Call me at (805) 430-3300 or contact me online, and I will schedule you a free initial case consultation. I can meet you at home or in the hospital if you cannot come to my office.