Workers' Compensation in California: Temporary Disability

When someone is unable to work as a result of an industrial injury they may be entitled to specific disability benefits. In order to qualify for benefits an injury must be accepted as industrial by the employer or their insurance carrier/administrator. A medical finding of a disability by a physician is also required.

When a physician finds an employee is temporarily disabled and unable to perform his or her job duties as a result of a workplace accident, the employee is entitled to temporary disability benefits. There are two types of temporary disability benefits a person may receive.

Temporary Total Disability (TTD) benefits are payable when an employee cannot return to any type of work for more than three (3) days. TTD compensation is paid at two-thirds of the injured employee's weekly wages with a maximum set by the State.

The first 3 days of disability are referred to as the "waiting period." An injured worker is not entitled to receive compensation for the waiting period unless they have been temporarily disabled for more than fourteen (14) days or if they required overnight hospitalization as a result of the industrial accident.

TTD benefits are paid to the injured employee until one of the following occurs: (1) the employee returns to work; (2) he or she is medically released to return to normal work activities; (3) he or she is medically released to return to a modified work position and the employer is able to offer such a position; (4) the injured worker's condition is medically deemed P&S (permanent and stationary) or MMI (maximum medical improvement).

Temporary partial disability (TPD) benefits are paid to an injured worker disabled because of an industrial injury who cannot return to his or her usual occupation, however, is able to return to work in some type of modified capacity. The modification can be a restriction on the number of hours or the type of work to be performed.

The amount of TPD is calculated by deducting the amount an injured worker earns per week from the amount they would normally earn. If an employee earns over the maximum rate of pay set forth by the State, the maximum is used instead of the normal wages and the modified work earnings are then deducted. The next step in the calculation is to multiply the results by two-thirds for the TPD compensation due. If an employee earns over the maximum rate while working at a modified position, he or she will not be eligible for TPD benefits.

An employer may elect to offer a Workers' Compensation plan to compensate an injured worker with 100% of his or her pay for a specific number of weeks through a structured plan. These types of plans usually decrease the percentage of pay the longer someone is disabled. This is referred to as a "Salary Continuation Plan" and several public agencies provide such benefits for their employees.

Another type of salary continuation an employer may utilize is to offer the employee an opportunity to supplement temporary disability compensation with vacation or sick-leave payments. This allows an injured worker to receive his or her full wages while on disability leave.

Salary continuation benefits vary by company and many companies don't offer this additional benefit. To find out if your employer has a salary continuation plan, check with your supervisor or the Human Recourses department.

An employee injured between the dates of April 19, 2004 through and including December 31, 2007 is not entitled to more than 104 weeks (from the date of the first payment) of temporary disability. Employees injured on or after January 1, 2008 may receive up to 104 weeks of temporary disability payments within a five-year period from the date of injury.

Temporary disability payments for some long-term injuries, such as chronic lung disease or severe burns may proceed beyond the 104 weeks and may continue for up to 240 weeks, within a five-year period.

An injured worker may file a claim for State Disability Insurance (SDI) with the Employment Development Department regardless of whether a Workers' Compensation claim is accepted or not, however, the employee must advise EDD regarding the status of the industrial injury claim and whether any payments have been made. The SDI claim may provide for payments in the event someone is temporarily disabled beyond the 104 week limitation.

The first step in filing a Workers' Compensation claim is to report the injury and submit a DWC1 – Claim Form. To learn more on filing a claim see "Workers' Compensation in California: How to File a Claim for Benefits."

For questions regarding a claim, the injured worker should contact the insurer or administrator handling the case. If problems continue and the worker is not satisfied with the answers or lack of answers by the insurance company, the worker may contact their local State Division of Workers' Compensation and ask to speak to an Information and Assistance (I&A) officer.

An injured worker may also contact an attorney for legal advice or for more information about their rights. For the best advice, speak to an Attorney who is a Certified Specialist in Workers' Compensation.

*Disclaimer: The information in this article is general and not intended as a substitute for legal advice. Changes in the law or specific facts of a case may result in legal interpretations different from those presented here. For legal advice seek the services of a qualified attorney in the field of Workers' Compensation.