What Does California Workers’ Comp Pay?

Workers’ compensation, a no-fault insurance plan that covers most work-related illnesses and injuries, usually pays two-thirds of a victim’s average weekly wage for the duration of a temporary or permanent disability. But that’s only part of what workers’ comp pays. Additionally, workers’ compensation covers all reasonably necessary medical expenses. After a serious injury, hospitalization alone could cost over $100,000. So, the medical payment benefit is usually more valuable than lost wage replacement.

California workers’ comp pays nothing if a limited defense, such as intoxication at the time of injury, applies. Furthermore, workers’ compensation doesn’t cover many work-related accidents or injuries. More on that below.

Most workers’ compensation cases settle out of court. However, the settlement process is often long and frustrating. For victims without legal advocates, especially disabled victims, the process is daunting as well. A Workplace Injury Lawyer lays out legal options in a language victims understand, not Legalese. In addition, a lawyer is a very strong voice during legal proceedings. The proof is in the pudding.

The average attorney-negotiated settlement is about three times higher than the average non-attorney-negotiated settlement.

Lost Wage Replacement: A Closer Look

The average weekly wage determines the amount of lost wage replacement. When most people see AWW (average weekly wage), they think GPA (grade point average). Student GPAs only include current grades, not the grades they might have in future classes. The AWW is different.

Assume Mike is a pro football linebacker for the semi-pro Beach City Giants. He gets hurt on the last day of training camp. Since most athletes earn practically nothing during training camp, his current wages are almost nothing. But, when the regular season starts, his earnings skyrocket.

If Mike’s injury forces him to miss any playing time, his workers’ comp payments must reflect his higher future wage, not his lower prior wage. The same principle applies if Mike drives a forklift and his injury or illness forces him to miss performance bonus milestones, overtime opportunities, or other irregular income spikes.

Many illness or injury victims can work part-time or light-duty as they recover. Usually, part-time and light-duty wages are much lower. Workers’ comp has you covered in these cases.

Assume Mike can suit up for the game and is available for emergency duty. Since he doesn’t play, his pay is much lower. Workers’ comp pays two-thirds of the difference between his regular, full-time pay and his part-time, emergency backup pay.

The AWW is difficult to calculate in permanent disability cases. If Mike’s future career is a Kurt Warner story, his earnings could be mind-boggling. If the Giants cut Mike and he stocks shelves at the Hy-Vee, his future earnings are negligible.

Usually, Workplace Accident Lawyers Riverside partners with an accountant or another outside professional in these situations, to determine a fair amount of future income.

Workers’ Comp and Back Pay

The illness disability onset date and/or the long delay before an ALJ appeal hearing could significantly affect the amount of workers’ comp back pay.

If a victim has a work-related illness, such as toxic exposure lung disease, the disability onset date could be months, or most likely years, before the claim date. Most people work as long as possible and only claim workers’ comp as a last resort.

Assume that, in May 2024, Mary breathes toxic chemicals which cause breathing problems. Although she can hardly breathe, she keeps working until May 2025. She might be entitled to a year of back pay. Most likely, her claim is retractive to the date of disability, not the date of filing.

The same principle applies if Mary files a claim in May 2025 and a personal injury attorney cannot settle it until May 2026. Her lost wage replacement is retroactive to the filing date, not the settlement date.

Bystander Claims

Workers’ compensation benefits are only available to employees. These benefits are unavailable to non-employees, even if their illnesses or injuries were work-related conditions.

Take-home asbestos poisoning is a good example. Assume David, a renovation construction worker, was exposed to asbestos at work. He unintentionally carried these fibers home where they infected his wife Denise. Denise cannot file a workers’ compensation claim with David’s employer.

However, Denise can partner with a Personal Injury Attorney California and file a negligence claim against David’s employer. If she proves negligence, or a lack of care, she’s entitled to compensation for her economic losses, such as medical bills, and noneconomic losses, such as pain and suffering. Additional punitive damages may be available as well.

A car crash is an even better example of a bystander claim. If Phyllis the delivery driver crashes into Allan, Allan can file a negligence claim against Phyllis. If aggressive driving, like speeding, or operator impairment, like driver distraction, caused the crash, Allan is most likely entitled to the aforementioned compensation.

Most likely, Phyllis’ employer is financially responsible for damages, because of the respondeat superior (let the master answer) doctrine. This rule states that employers are financially responsible for damages if their employees negligently cause injury during the course and scope of their employment.

Contact Our Workplace Injury Lawyer Today!

Workers’ comp usually pays medical bills and replaces lost wages. For a free consultation with an Experienced Personal Injury Attorney, contact the Law Offices of Eslamboly Hakim. The sooner you reach out to us, the sooner we start working for you.

Credit: Photo by Midjourney