Medical Treatment

Injured workers are entitled to receive all medical care reasonably required to cure or relieve the effects of the injury/illness, with no deductible or co-payments paid by the injured worker.

Reasonable medical treatment required to cure or relieve the effects of an industrial injury/illness means treatment that is based upon the guidelines adopted by the administrative director or, prior to the adoption of those guidelines, the update American College of Occupational and Environmental Medicine’s Occupational Medicine Practice Guidelines.

Generally, the employer controls the medical treatment for the first 30 days after the injury is reported, and the employee is then free to select any treating physician or facility. However, if the employee has notified the employer in writing prior to the injury that he or she has a “personal physician” – a physician or surgeon who has previously treated the employee – the employee may be treated by that physician from the date of injury. However, the choice of a treating physician differs if the employer has developed a State-certified Medical Provider Network.

Temporary Disability Benefits

Those workers unable to return to work within three days are entitled to temporary disability benefits to partially replace wages lost as a result of the injury. The benefits are generally designed to replace two-thirds of the lost wages, up to a maximum of $840 per week.

Temporary disability benefits are payable every two weeks, on a day designated with the first payment, until the employee is able to return to work or until the employee’s condition becomes permanent and stationary.

Many County employees are entitled to salary continuation benefits that are paid in lieu of State rate temporary disability benefits. Certain classes of County employees are entitled to statutorily derived benefits that exceed the State temporary disability rate.

Permanent Disability Benefits

Injured workers who are permanently disabled – those who have a permanent labor market handicap – are entitled to receive permanent disability benefits. A worker who is determined to have a permanent total disability receives the temporary disability benefit – up to $840 per week – for life.

A worker determined to have a permanent partial disability receives weekly benefits for a period which increases with the percentage of disability, from four weeks for a one percent permanent disability up to 694.25 weeks for a 99.75 percent disability.

Permanent partial disability benefits are also payable at two-thirds of the injured worker’s average weekly wages, but are subject to a much lower maximum.

As of Jan. 1, 2004, the rates are $220 per week for disabilities less than 69.75 percent, and $270 per week for disabilities rated at 70 to 99.75 percent. Those with a permanent partial disability of 70 percent or more also receive a small life pension – a maximum of $257.69 per week – following the final payment of permanent partial disability benefits.

The percentage of permanent disability is determined by using the Permanent Disability Rating Schedule and an assessment of the injured worker’s permanent impairment and limitations.

The Permanent Disability Rating Schedule specifies standard percentage ratings for permanent impairments and limitations, and provides for the modification of these standard ratings based on the injured worker’s age and occupation, and considers the employee’s diminished future earning capacity.

The standard rating is adjusted for occupation by increasing the rating if the permanent impairment or limitation will be more of an impediment in performing the worker’s occupation, and lowering the rating if it will have a lesser impact.

Supplemental Job Displacement Benefit

(For injuries on or after January 1, 2004)

This is a nontransferable voucher for education-related retraining or skill enhancement, or both, payable to a state-approved or accredited school, if the worker is injured on or after January 1, 2004.

To qualify for this benefit, the injury must result in a permanent disability, the injured worker does not return to work within 60 days after temporary disability ends, and the employer does not offer modified or alternative work. The maximum voucher amount is $10,000.

Death Benefits

In the event a worker is fatally injured, reasonable burial expenses, up to $5,000, are paid. In addition, the worker’s dependents may receive support payments for a period of time. These payments are generally payable in the same manner and amount as temporary disability benefits, but the minimum rate of payment is $224 per week.

The total aggregate amount of support payments depends on the number of dependents and the extent of their dependency. Generally, the maximum (where three or more total dependents are eligible) is $160,000; though additional benefits are payable if there continues to be any dependent children after the basic death benefit has been paid.