After suffering an injury at work, you may be wondering what types of benefits you may be eligible for. Although many people are familiar with workers’ compensation benefits, there are also other options to look into. It is always a good idea to look into all available options for benefits so that you can ensure that you are taking advantage of any programs designed to help people in your position.

California Workers’ Compensation Lawyers

Attorney Matthew A. Schondel and his team of legal staff have twenty nine years of experience handling workers’ compensation cases. We understand that the aftermath of a work injury can be a challenging time for many reasons. 

Our team is dedicated to helping our clients navigate the legal issues that often arise throughout a workers’ compensation claim while also ensuring open lines of communication with a personal touch. If you have recently been injured at work, contact us today to learn more about how we can help you obtain the workers’ compensation benefits that you deserve.

What Is State Disability Insurance?

The state of California has a program called California State Disability Insurance (SDI). This program gives eligible workers benefits such as short-term disability insurance, as well as paid family leave. 

The California State Disability Insurance (SDI) program covers over 18 million workers in the state. The program acts as a partial wage-replacement insurance plan for those who are eligible for its benefits.

man on workers comp and dealing with lost wages in california

How Do I Apply for State Disability Insurance?

You can find out more about the process of filing for state disability insurance, along with other crucial information about the program, by visiting the State of California Employment Development Department website. Additionally, you can hire an experienced workers’ compensation attorney to represent you in your workers’ compensation claim. Your lawyer will be able to advise you as to the various benefits that you may be eligible for to maximize the benefits available due to a work injury or illness.

What Is the Difference Between State Disability Insurance and Workers’ Compensation Insurance Benefits?

Before moving forward with making a claim for benefits, it is helpful to understand the difference between state disability insurance and workers’ compensation insurance. In California, nearly every employer is required to get and maintain workers’ compensation insurance.

Workers’ compensation insurance is meant to cover medical expenses and provide benefits to employees who suffer a work-related injury or illness. State disability insurance, on the other hand, is used in a broader range of circumstances. Some of these circumstances include injuries, pregnancy, and taking care of ill family members.

What Workers’ Compensation Benefits Am I Eligible For?

Your workers’ compensation attorney can give you information regarding benefit eligibility that is specific to your individual circumstances. However, some of the common workers’ compensation benefits that California employees are eligible for include the following:

  • Payment of medical bills that are reasonable and related to the work injury or illness;
  • Temporary disability benefits (payment for lost wages);
  • Permanent disability benefits (compensation for permanent loss of use or function); and
  • Job displacement benefits (payment or assistance with job retraining or acquiring new skills).

What Should I Do If I Cannot Return to Work Yet Due to My Work Injury?

Injured workers in California are often eligible for temporary disability benefit payments. If you are unable to go back to work after your work injury based on your doctor’s recommendation, you may be eligible for total temporary disability benefits to replace your lost wages.

Total Temorary disability benefits are available for injured workers who cannot return to work for a variety of reasons related to their work injuries. Generally, your doctor must recommend or authorize the time off work for you to receive temporary disability benefit payments. 

If your employer cannot accommodate a light duty work restriction provided by your doctor, then you are also entitled to total temporary disability benefit payments until your doctor states that you can return to work (or until your employer is able to accommodate your work restrictions).

When Does an Injured Worker Become Eligible for Total Temporary Disability Benefits?

As an injured worker in California, you become eligible for temporary disability benefits when your treating physician determines that you cannot work in your usual capacity for more than three days. You can also become eligible for temporary total disability benefits if you are hospitalized overnight. 

During the time period in which you are eligible for temporary total disability benefits, your employer (or their workers’ compensation insurance carrier) is required to issue payments at least every two weeks. In some cases, injured workers receive their payments weekly.

How Much Money Should I Expect to Receive for My Temporary Total Disability Benefit Payment?

Generally, total temporary disability benefit payments are paid out every other week at a rate of two-thirds of your average weekly wage. Your average weekly wage is calculated based on your earnings prior to your work injury. 

Additionally, it is crucial to understand that your average weekly wage is calculated using your gross, “pre-tax” wage rate. For example, if you earned $1,200 (before tax) per week before your work injury, since two-thirds of that amount is $800, you can expect to receive $800 per week for your temporary disability benefit payments, for as long as you are eligible. 

How Long Will I Receive Total Temporary Disability Benefit Payments?

In most cases, you will stop receiving total temporary disability benefit payments when your treating doctor releases you to return to work. Since this workers’ compensation benefit exists to provide injured workers with compensation for lost wages resulting from their injuries, this benefit ends when your doctor has determined that you can go back to work.

You should also know that your employer or their workers’ compensation insurance company is only obligated to pay temporary total disability benefits for a maximum of two years (or 104 weeks). Unfortunately, many injured workers are still unable to return to work after this two-year limit has been reached.

Sometimes, an injured worker’s injuries are so severe that they may never be able to return to work in their former capacity. If you have a serious injury of a permanent nature, at some point in time, your treating doctor might determine that you have reached maximum medical improvement. Your temporary total disability benefits will likely end when you are at maximum medical improvement.

What Can I Do If I Am Working a Light Duty Job That Pays Less Money Than I Earned Before My Injury?

While total temporary disability benefits are available to workers who are either unable to work at all or who have work restrictions that their employers cannot accommodate, partial temporary disability benefits are another potential benefit. Partial Temporary disability benefits are payable to workers who have been given light duty work restrictions. 

To be eligible for partial temporary disability benefits, you must be earning less money than you were prior to your injury. This benefit is paid out at a rate of two-thirds of the difference between your average weekly wage prior to your injury and the new average weekly wage that you are earning while working light duty.

Can I Receive State Disability Insurance Benefits and Temporary Total Disability Benefits at the Same Time?

Although you cannot receive state disability insurance benefits and total temporary disability benefits at the same time, it is a good idea for injured workers to go ahead and apply for state disability benefits (SDI) as soon as possible following a work-related injury or illness. Even though you cannot “double-dip” and receive both SDI and total temporary disability benefits through workers’ compensation, applying for SDI right away essentially preserves or “freezes” your application. Taking this step allows your SDI application to be revisited down the road (if necessary) in the event that you reach the maximum limit of total temporary disability benefit payments.

Why Is It So Important to Apply for State Disability Insurance Benefits As Soon As Possible After My Work Injury?

We typically advise our workers’ compensation clients to apply for state disability insurance (SDI) benefits immediately following a work-related injury or illness. The reason that it is so critical for injured workers to apply for SDI benefits right away is that if they were to wait to apply for SDI benefits, once their temporary total disability (TTD) benefits are maxed out after two years, they will likely be denied benefits. 

Since this benefit is calculated using earnings over the previous five quarters, an injured worker who is off-work and receiving TTD payments during this time will have no earnings to consider, and their application will likely be denied. However, if an injured worker applies for SDI benefits right away after their injury, although their application will initially be denied, it can be reopened down the road. By taking this approach, an injured worker may be able to obtain disability benefits for a full three years, rather than just the two years they would receive if limited to TTD benefits under workers’ compensation laws.

Do I Need an Attorney to Apply for State Disability Insurance and Workers’ Compensation Benefits?

Hiring an attorney to represent you in your workers’ compensation case can benefit you in many ways. A lawyer who frequently handles workers’ compensation cases will know the best ways for you to maximize your benefits and may also be able to help you achieve a better outcome. Contact us today at the Law Office of Kneisler and Schondel to find out how we can help you maximize your workers’ compensation benefits.