How to Calculate Workers’ Compensation in California

California’s workers’ compensation law applies to any workers who suffer workplace injuries or illnesses. The law provides no exemptions for small businesses, so even if you work for a company with a single employee, your employer must carry a worker’s compensation policy. In addition to paying your medical bills, California’s workers’ compensation laws provide for payments for your support should you be temporarily or fully disabled. 

What is Workers’ Compensation?

California’s workers’ compensation insurance law helps protect employees and businesses from the financial losses resulting from job-related injuries and illnesses. All California businesses are required to purchase no-fault policies if they have one or more employees. Workers’ compensation is sometimes referred to as “workers’ comp,” “workman’s compensation,” or “workman’s comp.”

Workers’ compensation insurance protects workers from being financially devastated by the medical bills and lost earnings that can result from on-the-job injuries that occurred during the course of their employment. It also shields employers from needing to make direct payouts to injured workers and their families for workers’ compensation claims or civil lawsuits.

Because California’s workers’ compensation law provides for no-fault insurance, employees need not show that their employers were at fault for their injuries or negligent. 

Common Work-Related Injuries

The most common types of injuries for which workers receive benefits are cuts, sprains, and muscle strains. While these may seem like minor workplace injuries, treatment may involve several visits to a medical professional and the worker is likely to lose income if the injury keeps them from performing their job.

Some of the most common accidents, events, and conditions that result in workplace injuries include:

  • Accidents involving tools or machinery
  • Exposure to dangerous substances like asbestos, chemicals, or lead
  • Slipping, tripping, or falling on wet floors, icy walkways, or uneven surfaces
  • Vehicle accidents where an employee is driving, riding in, or struck by one while performing their job
  • Being struck by something that fell from a shelf or was dropped by another worker
  • Fires or explosions
  • Overexertion that results in physical injury
  • Workplace violence
  • Electrocution that causes burns or other physical damage

Benefits of Workers’ Compensation

All California employers must provide medical care to their injured workers to both treat them and help with their recovery. You must file a claim with your employer as soon as possible and while your employer is considering your claim for workers’ compensation, you can receive up to $10,000 in treatment.

Other benefits include:

  • Paying the costs of ongoing treatment, including prescription drugs, necessary medical devices, and transportation
  • Temporary and permanent disability benefits
  • Vocational training when you can no longer perform your job functions and your employer can’t accommodate you with another job.

If you are temporarily or permanently disabled, you will receive disability payments of two-thirds of your weekly income up to $1,356 per week for injuries sustained after January 1, 2021. Disability payments are not taxed.

Unfortunately, in most cases, injured workers are limited to making workers’ compensation claims against their employers because they are usually not allowed to bring civil lawsuits. Additionally, injured workers in California are not entitled to payments for their pain and suffering. 

Death Benefits

Workers’ compensation insurance also provides generous death benefits for the dependents of those who die while on the job, including $10,000 in burial expenses. The benefit amounts for surviving dependents are:

  • $250,000 for one dependent
  • $290,000 for two dependents
  • $320,000 for three or more dependents

Death benefits are usually paid in installments that are calculated in the same manner as they would be for disability benefits, but not less than $224 per week. Dependent minors will continue receiving benefits payments until their 18th birthday, even if they exceed the above-listed amounts.

Who Qualifies for Workers’ Compensation?

California workers must receive workers’ compensation benefits if they are injured on the job, regardless of who is at fault. That means that many part-time workers, temporary workers, and independent contractors are eligible. Additionally, there is no requirement that the injured worker be a legal U.S. resident.

However, the law does not provide universal coverage for all workers, and those who fall into the following categories are not covered:

  • Business owners who have no employees (except roofers)
  • Some types of volunteers
  • Students and officials participating in amateur sporting events
  • Domestic workers who are related to their employer
  • Individuals who are working for food or housing instead of pay
  • Deputy sheriffs and clerks

What to Do If Your Claim is Denied

Many workers’ compensation claims are quickly resolved without any difficulty, but sometimes an insurance company will choose to deny a claim. The most common reasons that claims are denied include:

  • The injury did not require medical treatment
  • There was no proof that the injury occurred
  • The injury was not related to the job or occurred while working another job
  • The injury is not stopping you from returning to work

If your employer or its insurer denies your claim, you can still file an appeal with the Workers’ Compensation Appeals Board asking it to review the determination. When you file an appeal it is usually a good idea to speak to a workers’ compensation attorney to ensure that your rights are protected and that you put the best possible case before the board.

While it may sound expensive to hire a lawyer to represent you, the attorneys at the California Workers Injury Law Center will only charge a fee when you receive the settlement or benefits you deserve. In other words, we don’t get paid until you receive results.

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