Schedule for Rating Permanent Disabilities
State publication detailing information used to rate permanent disabilities.
State Disability Insurance – short-term financial assistance for disabled workers in California. Workers with job injuries may apply for SDI when workers’ compensation payments are delayed or denied. These benefits are administered by the State Employment Development Department.
Serious and Willful (S&W)
A statute that allows for an increase in compensation by one-half to an employee when the employee is injured by reason of the serious and willful misconduct by the employer. An employee must prove that the employer’s conduct involved the intent to injure or was a reckless disregard for the safety of the employees. The employer is responsible for the payment of an S&W penalty. The penalty is not insurable, although the defense of the action would be covered.
Agreement between injured worker and Claims Examiner about the workers’ compensation payments and future medical care that will be provided to worker. Settlement must be reviewed by a workers’ compensation administrative law judge to determine whether it is adequate.
Social Security Disability Benefits
Long-term financial assistance for totally disabled persons. These benefits are administered by the US Social Security Administration. They may be reduced by workers’ compensation payments that an injured worker receives.
Injury that was caused by one event at work.
State Average Weekly Wage
Average weekly wage that was paid in the previous year to employees in California who were covered by unemployment insurance, as reported by the US Department of Labor.
Statute of Limitations
A restriction on the period of time in which relief may be sought for industrial injuries. Various Labor Code sections provide time limitations that apply to the legal remedies of employers, as well as employees. Example: one year statute from the date of injury for the filing of a claim. A five year statute for the filing of new and further benefits.
State Division of Workers’ Compensation
Administers workers’ compensation laws and provides information and help to injured workers. Listed in the telephone book in the Government pages – State Government Offices/Industrial Relations
Also at www.dir.ca.gov/dwc
Once an injured worker has reached a permanent and stationary (P&S) medical status, stipulations are used to settle the injured worker’s claim for any ratable PD. Once approved by the workers’ compensation judge, any remaining PD benefits are paid out every two weeks to the injured worker, until the award is paid in full. If at the time of settlement it is determined that the injured worker will require on-going medical care, this too will be documented in the award.
The amount of pain and other symptoms reported by an injured worker, which cannot be directly measured or observed, that a doctor describes as contributing to the worker’s permanent disability.
Surveillance and video footage of an injured worker’s actual physical abilities. Subrosa may also be used in evaluating compensability issues, but is generally used when an injured worker’s subjective complaints greatly outweigh objective findings.