California Worker's Compensation - Help For Injured California Workers

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  1. #1
    Join Date
    May 2010
    Posts
    2

    Default How Long Until I Recieve WC Benefits

    Hey everyone...i was wondering, generally, how long does it take to start collecting workers compensation once a claim has been accepted?

    Background: i sustained an injury to my lumbar over a period of time. I first visited my family doctor who told me that he felt my injury was work related and wanted me to speak with my employer and handle it through them. Upon visiting the company DR. i was told that i couldnt go back to work. My employer told me to file for SDI while i was visiting the DR's. they wanted me to see. Eventually i grew tired of the treatment i was reciving from the company's claim adjuster (my employer is self insured) and i found an attorney. Until recently i was collecting SDI, now the company, after recieving the QME report, has accepted the claim. Apparently they notified the Disability Office as i recieved a letter from them stating that i would no longer be recieving Disability benifits because my claim is now under Workers Compensation.

    thank you for your help

  2. #2
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,021

    Default Re: How Long Until I Recieve WC Benefits

    As the claim has been accepted and there is appearently no dispute to the wage loss benefits due, TTD, you should receive the difference between your SDI rate and the TTD rate if any is due, and continuing TTD on a bi weekly basis until you have been paid 104 weeks within 5 years of your DOI. The time you have been paid SDI doesn't count.
    Your self insured ER was wrong to tell you to file for SDI once you filed the claim, and they were controlling the medical with having you see their Dr's.

    At any rate, your SDI will be reimbursed by the ER. Once you are paid the 104 weeks of TTD and your PTP still feels you are 'disabled' you would be eligible for an additional 52 weeks of SDI again.

  3. #3
    Join Date
    May 2010
    Posts
    2

    Default Re: How Long Until I Recieve WC Benefits

    Thanks for your help. Ive read some of your other posts and you really seem like you know your stuff, in that case, perhaps you can answer a few more questions for me.

    "As the claim has been accepted and there is appearently no dispute to the wage loss benefits due, TTD, you should receive the difference between your SDI rate and the TTD rate if any is due, and continuing TTD on a bi weekly basis until you have been paid 104 weeks within 5 years of your DOI."

    1. When is my employer supposed to start sending me a check? My QME
    report was accepted roughly two weeks ago.

    2. How did you figure the 104 weeks? What is DOI? And, does that mean
    that my employer can pay anytime they feel like it as long as its paid in
    full within 5 years? If so, then i am really scared. i have a wife and bills
    i need to pay.

    Thank you very much for your help. Your answers are appreciated.

  4. #4
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,021

    Default Re: How Long Until I Recieve WC Benefits

    DOI is Date Of Injury.
    If the QME said you are TTD, then TTD/wage loss is due from the date of the appt/evaluation. Per the date in the report.

    The 104 weeks is a statutory cap. You are eligible for up to 104 weeks paid within 5 years of your DOI. No they don't pay anytime they feel like it. TTD benefits are due bi weekly on the same day each time. ie, if the schedule is check issue on Tuesday, then every other Tuesday they must issue a check. Allow 5 days for mailing, 10 days to notify the CA/Claims Adj if it's still not there so s/he can replace the check.

    If you'll read the fact sheets for injured workers here http://www.dir.ca.gov/dwc/InjuredWorker.htm it will help you understand the WC system and what benefits are/aren't available to you.

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