If you are injured at your job, workers’ compensation pays for your medical treatment and partially replaces your lost wages. If you become ill or injured at work anywhere in the San Francisco Bay Area, arrange at once to speak with a San Rafael workers’ compensation attorney.
Employers in California must have workers’ compensation insurance. When an employee suffers a job-related injury or illness, workers’ compensation covers that employee’s medical bills and a percentage of the lost wages. The most seriously injured workers may qualify for permanent disability benefits.
Although most workers recover quickly from job-related injuries, some workers continue to have serious health problems. If the doctor who is treating you says that you will never completely recover or that the work you can do will always be limited, you may have a permanent disability.
This means that you may be eligible for permanent disability benefits through the workers’ compensation system in California. Permanent disability benefits compensate you for the loss of your earning capacity.
What is a P&S Report?
When you recover from an injury to the point where your condition is neither improving nor getting worse, that condition is considered “permanent and stationary” (or “P&S”). At this time, the doctor who is treating you will produce a “P&S Report” that should describe:
1. Specifics such as the intensity of your pain or your ability to move injured body parts
2. Work restrictions, the limitations on the work you are able to do
3. The medical care you may require in upcoming weeks and months
4. Whether or not you can return to your job
5. How much of your disability was actually caused by your work
The doctor who is treating you sends the P&S report to the insurance company. You have the right to a copy of that report. Request it in writing from the doctor or the insurance company’s claim administrator.
Scrutinize your P&S report thoroughly, and make sure that it’s accurate and complete and that you agree with the physician’s conclusions. Omitted or inaccurate information might cause you to lose some of the benefits that are rightfully yours.
How Are Permanent Disability Benefit Amounts Determined?
Permanent partial disability or total disability benefits may be approved after a P&S report confirms that you have reached “maximum medical improvement,” and the physician who is treating you concludes that the injury has caused permanent disability or permanent impairment.
Then, under the workers’ compensation guidelines, your permanent disability is “rated” from one percent to one-hundred percent. If you receive a one-hundred percent disability rating, it means that you are entirely unable to work in any capacity whatsoever. This is called a permanent total disability.
If your work-related illness or injury causes a permanent disability, you are entitled to workers’ compensation permanent disability benefits, even if you’re partially disabled and you can work with some limitations. Once you have the rating, it must be converted into a dollar amount.
The weekly payment rate for permanent disability benefits is based on the state’s average weekly wage. Since 2014, the maximum permanent disability rate in California is $290 per week.
Why is an Attorney’s Help So Important?
Pursuing a workers’ comp permanent disability claim is complicated and takes time. You will need a workers’ compensation attorney’s help. A mistake or a misunderstanding at the beginning could delay the process or even cause your workers’ comp claim to be denied.
But when you work with the right California workers’ compensation attorney, your claim will be accurate and filed on-time, and your rights will be protected. Your attorney will help you meet the deadlines and ensure that all of your paperwork is properly and thoroughly completed.
Can Your Own Doctor Treat You?
Many employers and workers’ comp insurance companies in California use medical provider networks (MPNs) to handle work-related injuries. If your employer uses a medical provider network, your injury – in most cases – must be handled by that network of healthcare providers.
To receive treatment by your own doctor or any physician outside of the network, you must “pre-designate” that doctor before you sustain a job-related injury, but you may pre-designate a specific doctor only if:
1. That doctor has seen you previously and has your medical records.
2. Group health coverage is provided by your employer.
3. The doctor agrees to treat you for job-related injuries prior to any job-related injury.
It is important to understand that if you want your own doctor to treat you, that doctor must be pre-designated. Before any injury or illness actually happens, you must complete the necessary workers’ comp forms and tell your employer that you are pre-designating a specific doctor.
What Are Your Rights With a Medical Provider Network?
If you have not pre-designated a physician, you will be seen for a job-related injury by a doctor in the insurance company’s medical provider network. However, you may change doctors within that network after the first visit.
MPNs follow guidelines set forth by the state’s Division of Workers’ Compensation. An MPN must offer you an opportunity for a second and even third opinion if you disagree with your first diagnosis. If you disagree after a third opinion, you have a right to an independent medical exam.
In cases where workers and insurance companies simply cannot agree on the value of a permanent disability, a judge can hear the case. You can testify about your injury, and the judge will review the medical records and reports to decide your disability level.
How Will a Workers’ Compensation Lawyer Help You?
Determining what benefits an injured worker is entitled to is rarely easy. After an injury at the workplace, you may not know if you are eligible for workers’ comp benefits, or you may not know how to apply for the benefits.
There are precise legal steps that you can take if your workers’ compensation permanent disability benefits are unfairly delayed, restricted, or denied, but you’ll need an attorney’s help.
In the San Francisco Bay Area, an injured worker will need to seek the advice and services of a San Rafael workers’ compensation attorney who deals routinely with complicated workers’ compensation claims and who understands what it will take to acquire the benefits you need.
The workers’ comp application process in this state is complicated and sometimes baffling, so if you are injured on-the-job, you must have the right workers’ comp lawyer working on your behalf. Your health and your future are too important to settle for any other option.