Navigating Switching To Permanent Disability Payments in California Workers’ Compensation

Navigating Switching To Permanent Disability Payments in California Workers' Compensation

Introducing Changes to Your Temporary Disability Benefits

This is episode 41 of the Inland Empire workers compensation lawyer livestream podcast. My name is Attorney Alexander Napolin. I’m joined by my co host attorney Jorge Ibuado. We are Southern California workers compensation lawyers. And today on the 41st episode of our podcast and live stream, we are discussing temporary disability payments stopping, and permanent disability advances beginning and you might not know what that means. This is related to your money if you’ve been injured at work, and you’re getting checks and they’re changing, and you’re not sure exactly what’s going on. You want to listen to this short episode that Jorge and I have put together. But remember, it’s not legal advice. This is general information only. If you have been injured and you’re looking for legal advice, you need to call a lawyer, you need to dial our injury helpline. That’s 844-984-8414. And we’ll give you a free consultation. Okay, so general information only. Let’s discuss your benefits. Jorge, you want to hop in here and discuss temporary disability stopping?

Possible Reasons For Temporary Disability Benefits Stopping

Definitely. First of all, I think we should talk about what temporary disability is. We have discussed it in a prior video. So if you have not seen that video, please go check that out, we’ll put in a link in the description. But temporary disability benefits are benefits that you receive when you cannot work, you’re temporarily totally disabled. Which means that a doctor has certified you that you cannot return to work at this time because you are having ongoing treatment. So that’s temporary disability, a difference between temporary disability and temporary partial disability is with temporary partial disability, you have work restrictions, where if they cannot be accommodated, it jumps back into temporary disability the same type of benefits, they will cover us temporary disability if your employer cannot accommodate the work restrictions being put on by a doctor. So once again, if you don’t understand temporary disability benefits, or partial temporary partial disability benefits, please check out our video. We did a great video on that. But today we’re going to discuss what happens when you are receiving those temporary disability benefits. And you get a notice in the mail, that they’re going to be ending there are there are some reasons why this could be stopping one, the doctor could have declared you to have reached maximum medical improvement. Okay, that means that the treatment has ended. So you are no longer temporarily disabled. Another one could be that maybe you missed a couple of doctor’s appointments, and you don’t have a report that’s going to certify your TD status. Right, Alex? So those are the two main ones. Can you think of any other ones where just a temporary disability might stop for what we call applicants right? The patient, the person trying to get workers compensation benefits? Well, they might go back if you’re off of work, and you’re just getting benefits, maybe a doctor hasn’t released you back to work, but you find another job, you just go work somewhere else, right? You’re not supposed to be collecting temporary disability benefits. But primarily, it’s going to be a lack of reporting, or like George mentioned, you have reached maximum medical improvement. And that’s where another benefit starts. That’s where your money can change a little bit.

Right. And we’ll talk about that. But you bring up a great point, Alex, you know, if you go back to work completely, then definitely they’re going to stop. That’s the reason why they’re going to stop. But also if you get a different job, you can’t be receiving temporary total disability or or temporary partial disability, if you have another job. Now the temporary partial disability, you might be able to get that, you know, we have to talk about that even if you have another job, unless you’re working with it with those restrictions that the doctor gave you. You’re ignoring those and working, there’s going to be an issue, there’s going to be more of an issue. Talk to your attorney about that. Talk to us about that.

A Basic Overview of Permanent Disability Benefits in California

Yeah, that’s why you need to have a lawyer. We’re going over general information. And if you’re thinking oh, maybe I could potentially go and work because I could find work that that you know were within my restrictions elsewhere. Even though my employer can accommodate it, you need to speak to a lawyer to determine what you can and cannot collect while doing that. Right. So let’s use this scenario. Your doctor has declared to you that you have reached maximum medical improvement. Now we discussed it in a different video. What that means. That basically means that your doctor is saying that your condition is not likely to improve or get worse within a year so they can’t do anything more for you at that time. They’re not going to be giving you ongoing treatment, you have reached that maximum medical improvement status. So they are going to be switching you from temporary disability to permanent disability benefits. Okay. How much you are entitled to for your disability for your injury. That number is not negotiated, right Alex? So that number is a set number that correlates directly to the permanent disability that you are owed. Right? That was my explanation. I don’t know if it’s too technical. What do you think anything else our viewers should know about permanent disability? It’s the money that you get at the end of the case when you’re no longer temporarily disabled. Right? I mean, you don’t necessarily get it just because you’re permanently stationary. Right? I mean, there has to be the, you have to have a percentage of disability, so you have to have something permanently wrong with you. Right? It means the doctors couldn’t make you 100% Better. And now you get some money. And that’s kind of an arbitrary figure. It doesn’t necessarily, it’s not arbitrary. In the sense, there is a way to calculate it. But it’s not necessarily related to how much money you’re not going to be able to earn because of your permanent injury. It’s an estimate that the government creates, and it’s the permanent disability benefit. Yeah. And once again, we’re talking about this, in broad terms, and as a whole, this can get very, very nuanced and very complicated. So any questions, please reach out to us. But the permanent disability, as Alex explained, is the money that you’re gonna get at the end of your claim. Now, I do want to point out, Alex, because a lot of people are very confused about, oh, I have a permanent disability, that means I’m disabled for the rest of my life. That doesn’t mean you can’t go on and live your life, does it mean you’re not going to be able to work, but it’s something that they use to gauge what your injury was worth, so they can compensate you correctly. And this has been set out by the AMA Guides by the Workers Compensation Appeals Board. And in all the people that make the rules and regulations of how it’s managed here in California. 

Breakdown Of Percentages Regarding Permanent Disability in CA

It doesn’t mean that you’re permanently unable to work, yeah, it means that you have a disability that hinders your ability to earn money, right, permanently. But it might only be a small hindrance, like percent, like you have your fingers at a surgery on it. And it’s mostly straight, but it has a little range of motion issue. And we might get a 1% on that finger. Because technically, if you hadn’t had the injury worker who hadn’t had the injury has a better use of their hand, but it’s still a little 1%, it gives you a little pain, sometimes you might only get a couple of percentages of disability, it’s a permanent situation that you have you have a disability, that’s not going to get better or worse within a year, right. That’s what Maximum Medical Improvement means. That’s what that’s what permanent disability means in the context of worker’s comp. And a lot of our clients don’t understand that when they get a permanent disability rating that doesn’t, that they think that that means I’m permanently disabled from working Correct, yes, that you have a permanent disability to a body part that affects your ability to earn money. And the government has said that’s 2% based upon the guides that we have, and you get a certain amount of money for that. 2%. And there’s actually a chart correct. The chart says 2%, you get two grand. Yeah, oh, or about that right or less.

I mean that’s what we do as your lawyers, we argue about these things, how much percentage you should be, maybe there’s a range, maybe your primary treating physician disagrees with your QME you can get different percentages, you can get different dates for your start and stop it on your temporary disability because it changes, right very technical aspects. And if you have questions, you should dial the injury helpline. Definitely. And now we’re gonna get into what can cause your payments to change from temporary disability to permanent disability, we spoke about that maybe Maximum Medical Improvement report by either your PTP or the neutral doctor, the QME. So what happens, you get a payment stoppage of temporary disability letter from your adjuster saying we’re going to stop your payments of however much they were paying you remember, it’s two thirds of your wages that you were making prior or around the time of your injury. So it’s two thirds of the wages. That’s how much you get for your TD. They’re stopping that. And they might send you a separate letter altogether, saying benefits starting for permanent disability. There might be times when they say that they’ve reached maximum medical improvement. Whether the TD- I’m sorry, the PTP- does it or the Q me and the insurance company, defense attorney or adjuster might not agree with that. But they’ll still use that to cut off temporary disability benefits and start paying permanent disability payments. Now why would they do that?

Permanent Disability Benefits are Finite

Well it’s because the temporary disability payments that you receive, they’re not deducted from the final settlement, right? But the permanent disability advance in the temporary to and going back to that temporary disability can go up to 104 weeks and we’ve discussed that in prior videos. We’ll put a link to that Write up here. And we’ll put in the description below if you want to learn more about that, but the permanent disability has, it’s a finite number. And once the insurance company starts advancing it to you, because they believe that there’s a medical report that entitles them to, or requires them to do that, actually. Now, if you are back at work 100%, and you’re earning full salary or wages, then maybe they don’t have to advance, but they generally will start advancing if you’re not working, right, that’s a finite amount of money.

When To Contact A Workers’ Compensation Lawyer Regarding Your Benefits

Right. And what we really need you to understand, and the reason we’re making this video is, so you understand that these permanent disability payments are going to come back and be they’re going to come back to you. And they’re going to ask you to account for those. And what I mean by that, when you get paid temporary disability, that’s payments made to you by the insurance company, because you can’t work, you’ll never have to deal with paying those back. Unless there’s been an issue with that. And we can discuss that later. But for the most part, let’s just say temporary disability payments, generally, you’ll never have to pay back. However, permanent disability advances when they start paying you permanent disability prior to your claim being completely over and being closed. Those are coming out of whatever permanent disability is owed to you at the end. And a lot of people don’t understand this. And they’re saying, well, all they paid me was when you know my temporary disability or they paid me my benefits while I couldn’t work. It’s true, you might not have been able to work, but they were a different type of benefits. They were advancing to you what you would be owed at the end of your claim. They’re no longer paying you temporary disability. Now that’s my explanation. Alex, do you have one because it can be kind of difficult for our viewers.

Yeah, we were discussing this before we started this episode that to our clients, there’s no there’s often no change in their situation between getting the temporary disability benefits and then switching over getting the permanent disability advances. There’s no real change in their situation. So they’re still off of work, they’re still unable to work. And maybe they wonder, well, why should these things be changing when nothing with me has changed. So it’s often a big shock to workers who are receiving temporary disability and then suddenly, even though they’re still not back at work, they’re now receiving permanent disability advances, and the permanent disability advances come out of the final settlement. And that’s why you need a lawyer looking at all of this stuff. Determining what dates are your, are you actually temporarily disabled, are you permanently disabled? Can it be fought and you need to call the injury helpline if you’re having these questions, you dial 844-984-8414 and get a free consultation. We’ll give that to you. Well, that concludes this episode of the Inland Empire workers compensation lawyer livestream podcast, we’re airing every Sunday at 3pm. Check out our other videos for general information on all different areas of workers comp if you’re an injured worker, that’s who we represent. My name is Alexander Napolin, I’m an attorney here in Southern California and my co host Jorge Ibuado are available to give you free consultation. Dial the injury helpline 844-984-8414. We’d be happy to speak with you.

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