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  1. #1
    Join Date
    Jan 2007
    Posts
    30

    Default Length Of A W.C. Claim

    Time Line:
    Injured on the Job-Feb 1st, 06
    Filed W.C. Claim-Feb 06
    W.C. Denied Claim-May 06
    Hired Attorney-June 06
    W.C. Accepted Claim-December 06
    First Disability payment from W.C. December 06

    With that being said, I know that a California W.C. Claim (payments) are good for 2 years.

    MY assumption was that 2 years starts on the 1st Check received from W.C. (which was December 06).
    So I would think that payments should be received through December of 08.
    Am I mistaken here?

    I asked my Attorney and "originally" he said February of 08, but then cited a Case Law where it WAS 2 years from the 1st payment.

    He told me to "cover my bases" I should call California State Employment and get Registered for California State Disability.

    Originally I when W.C. denied my Claim, I filed with SDI (California State Disability) and they paid me until W.C. took over my case. W.C. paid BACK the money that SDI had paid to me.

    Hope I haven't confused anyone.
    I'm looking for clarification.

    Roger

  2. #2
    Join Date
    Dec 2006
    Posts
    2,169

    Default Re: Length Of A W.c. Claim???

    The two year cap starts on the date your FIRST TTD check was PAID, so you have until December 08 for TTD benefits. So, if treatment/surgery has been recommended, you can basically count on the IC to DELAY/DENY until your two year cap has run...thereby placing you in the very untenable position of either forgoing treatment/surgery and trying to go back to work prematurely, or having the treatment/surgery, but NO INCOME from TTD.

    Do NOT let the IC of the hook if/when they start unreasonably delaying/denying treatment requests. A new WC panel decision was recently rendered that says Delay caused by the IC does NOT extend the two year cap under the theory of "estoppal", Your attorney should be aware of this, and hopefully will be aggressive...

    Listen to your attorney, and CYA FINANCIALLY. If you are unable to work, then apply for SSDI ASAP.
    Last edited by Charles Stevens; 01-09-2008 at 01:29 PM.

  3. #3
    Join Date
    Oct 2006
    Posts
    9,109

    Default Re: Length Of A W.c. Claim???

    not their first check to "you".
    2 yr clock starts with first check to anyone including SDI.
    You had better verify dates before you are surprised by an "early" count.

  4. #4
    Join Date
    Dec 2006
    Posts
    2,169

    Default Re: Length Of A W.c. Claim???

    WRONG, .SH. THe Hawkins decision is directly ON POINT: TTD cap begins when TTD is first paid to APPLICANT, irrespective of WHEN retro-payments were first made to EED/SDI by the IC.

    http://www.dir.ca.gov/WCAB/EnBancdec.../2007-EB-6.pdf
    Last edited by Charles Stevens; 01-09-2008 at 02:30 PM.

  5. #5
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,045

    Default Re: Length Of A W.c. Claim???

    ''State: California
    Gov. Signs Bills on TD and 24-Visit Cap; Vetoes Others: Top [10/15/07]
    Gov. Arnold Schwarzenegger over the weekend signed bills that extend the two-year cap on temporary disability benefits, lift the hard 24-visit cap on chiropractic treatment and physical therapy and make other mid-course corrections to a workers' compensation system that was sharply redirected by reforms in 2003 and 2004.

    The governor's signature on AB 338 by Assemblyman Joe Coto, D-San Jose, puts into law a hard-fought compromise between business and labor. The bill, while still limiting collection of temporary disability benefits to 104 weeks in total, allows injured workers within five years after injury to return to work and cease benefits but take time off later and resume benefits''. (source WCC)http://www.workcompforums.com/ca/iw/...&threadid=2429

    That is what I was looking for Charles...thankx!
    The above is new 'news'...on TTD.

  6. #6
    Join Date
    Dec 2006
    Posts
    2,169

    Default Re: Length Of A W.c. Claim???

    Thanks BiVA, I checked the link you provided. Looks like it won't take effect until some time in '08, and will only apply to DOIs on or after 1/1/08.

    Hawkins is still good case law: Two year TTD cap starts to run date TTD FIRST PAID TO APPLICANT.

  7. #7
    Join Date
    Jan 2007
    Posts
    30

    Default Re: Length Of A W.c. Claim???

    Just to let you all know, I've had 3 operations in 2007.
    2 on the Right Shoulder and one on the Left.
    Currently in Therapy now.
    My former employer fired me for "supposed;y" an unrelated issue, but my Attorney doesn't want to "go after them" and I'm fine with that, as I didn't want to work for that company any longer.
    I was just trying to find out about retraining/School Vouchers and Settlements from my Attorney.
    When he called and left the message that my W.C. checks would run out next month...I FREAKED!
    I was under the assumption that wouldn't be until December of 2008,
    (2 years from receiving my 1st check from them).
    So why is my Attorney telling me to contact EDD about State Disability, when I'm STILL receiving Checks from W.c>?

    Roger

  8. #8
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,045

    Default Re: Length Of A W.c. Claim???

    It's not suprising...lots of AA's are slow to the punch at times...
    Print out the case Charles provided and take it to your AA if necessary...that'll wake him up..

    Attorney doesn't want to "go after them"

    It can be difficult to bring up proof in a 132a filing...but ask your AA 'why' he doesn't want to pursue this issue... could it possible be that he only gets a $250.00 fee for his efforts...?

    It is a good thing you have already made application for SDI/EDD because you have protected your dates of entitlement in the event you do need the benefits at a later date...but you attorney is wrong about how the TTD benefits are calculated and for what periods of time in your case. You should, based on your information provided/DOI be receiving TTD until Dec/08
    if that is the FIRST PAYMENT of TTD you received...even though it included retroactive benefits from the DOI you were due.
    Make sure the differences in your TTD rate and the SDI rate have been calculated properly...they are different amounts.

    Currently in Therapy now.

    WATCH carefully how you use the PT visits..you are capped at 24 PT/OT/Chiro for the LIFE OF YOUR CLAIM>>>
    See if the PT'ist can give you at home exercises to do so you don't use up your allowed visits.

  9. #9
    Join Date
    Oct 2006
    Posts
    9,109

    Default Re: Length Of A W.c. Claim???

    sorry charles, you can't even read caselaw correctly.
    Please talk to somebody who knows something about the law before you come here.
    the point of contention in the hawkins case revolves around the issue of TD start date (owed) vs pay date (check sent).

    It has nothing to do with the payee (apparantly the first check paid both SDI and the applicant but that was not the issue).
    Last edited by .SH; 01-09-2008 at 06:27 PM.

  10. #10
    Join Date
    Dec 2006
    Posts
    2,169

    Default Re: Length Of A W.c. Claim???

    http://www.dir.ca.gov/wcab/wcab_enbanc.htm

    "Valeri Hawkins,
    v.
    Amberwood Products; and State Compensation Insurance fund
    June 13, 2007 2007-EB-6
    version
    2007-EB-6
    version
    (WCAB No. SAL 0107814)
    72 Cal. Comp. Cases 807
    The Board held that "the date of commencement of temporary disability payment" as used in section 4656(c)(1) means the date on which temporary disability indemnity is first paid, and not the date for which temporary disability indemnity is first owed.

    In this case, applicant was injured on July 16, 2004. Defendant's first payment of temporary disability indemnity was made on May 3, 2005, which covered the period of TD from July 17, 2004 through May 3, 2005 and defendant then made periodic temporary disability indemnity payments through July 14, 2006. The WCJ's decision concluded that the "period of two years from the date of commencement of temporary disability payment" as provided in section 4656(c)(1) began on May 3, 2005, the date on which temporary disability indemnity was first paid, and not from July 17, 2004, the date for which temporary disability indemnity was first owed. The WCJ's decision was accordingly, affirmed.
    This holding involved an interpretation of an addition to Labor Code ?4656 under SB 899."

    And the retro-period when Hawkins was paid SSDI WAS in contention...although she was DUE TTD benefits for that period, it was paid by SSDI, NOT the IC...the Court held that TTD benefits commenced the date TTD benefits were FIRST PAID TO APPLICANT, even though they included RETROACTIVE AMOUNTS.

    Simply put. If you don't like the en banc decison, then argue with the Commissioners.
    Last edited by Charles Stevens; 01-09-2008 at 06:44 PM.

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