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How Are Workers’ Comp Benefits Calculated in California?

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Posted By DAM Firm | February 6 2023 | Workers' Compensation

Individuals who sustain injuries on the job should be able to recover various types of compensation for their losses. First and foremost, this includes coverage of their medical expenses. If an injury prevents an individual from working for a short or longer period of time, they may also be able to recover a significant portion of their wages as part of the compensation. The total amount of compensation available in these circumstances is set by state law and has a maximum allowable amount.

How is Workers' Comp Calculated

Covering the Medical Bills

Calculating medical bills paid by workers’ compensation is not as challenging as calculating lost wages. The reality is that workers’ compensation benefits are designed to completely cover medical expenses arising as a result of an on-the-job injury.

So long as a doctor associated with the treatment agrees that treatment is needed, medical expenses will be covered. In the event a doctor determines that medical care should be terminated, but the injury victim does not agree with this, there is an appeals process.

Workers’ compensation benefits for those in California will pay for doctor visits, hospital expenses, emergency medical bills, physical therapy and rehabilitation, prescription medications, and more.

How Lost Wages are Calculated

In California, if individuals are unable to work due to their work-related injuries, they will typically receive two-thirds of their pretax weekly wages. The amount available is set by law, and there is also a maximum allowable amount. The minimum temporary total disability rate for California work injury victims is $242.86 in 2023. The maximum compensation available per week in 2023 is $1,619.15. 

In order to calculate the average weekly wage so that the two-thirds competition can be properly calculated, individuals can take their total annual salary and divide that by 52. To make it simple, we can imagine a person that makes $52,000 a year. This means their average weekly wage would be $1,000, and the benefit awarded to them through workers comp would be $666.66.

In some cases, companies in this state will have a program that allows for disability with paid leave that makes up the difference between the lessened salary and the real salary a person typically earns. Following the example above, if a company had this type of program, they would receive $333.34, so they could reach their original $1,000 in salary.

Individuals can typically receive benefits for up to 104 weeks from the date their injury occurs. However, for severe injuries, benefits could be extended for up to 240 weeks.

Call an Attorney if You Receive Pushback

If you have any questions about how your workers’ compensation benefits will be calculated or if you have any concerns that you are not receiving enough compensation for your claim, we encourage you to reach out to a skilled work injury lawyer in San Bernardino. An attorney can use their resources to look into your claim and help ensure that you are being treated fairly by the insurance carriers and your employer. These cases are challenging, but an attorney may be necessary to make sure that you and your family receive the compensation necessary to get through this difficult time in your life.

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