Workers Compensation Frequently Asked Questions – Page Six of Six

Workers Compensation Frequently Asked Questions – Page Six of Six

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What happens if I do not accept an offer of modified or alternative work?

If you are formally offered modified or alternative work for an injury after 2003 and your doctor says you can return to modified or alternative work, you risk having your permanent disability reduced by 15 percent. If you received a DWC form #AD10133.53, you should contact a workers’ compensation attorney immediately.

https://www.dir.ca.gov/dwc/DWCPropRegs/EAMS_regulations/EAMS%20FormsOct2008/VOC_RRTW/DWCADform10133_53.pdf

What does it mean to be a panel qualified medical evaluator (QME)?

If you are unrepresented, you have the right to request a list of panel qualified medical evaluators sent to you. You can choose one of these independent evaluators to review your condition. If you are represented by an attorney, different rules apply.

https://www.dir.ca.gov/dwc/MedicalUnit/OnlineQMEForm106/OnlineQMEForm106PanelRequest.html

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Who is a Party in a Workers’ Compensation Case?

Normally in civil cases, the parties are the actual people involved in the cases. This includes the victim and the offender. In workers’ compensation cases, the term party is broadly defined and includes the employer, injured worker, insurance company, and potentially any other party with a financial interest in your claim.

What does it mean to be Permanent and Stationary (P&S)?

One of the most significant times in your case is when the doctor states that your condition has reached maximum medical improvement. This stage is also commonly known as Permanent and Stationary or P&S. This event is significant because is often means your temporary disability payments will stop and your case is in a good position to settle.

What is considered a permanent disability?

If you have a permanent disability, this does not mean you cannot work. It simply means you have a condition that results in some type of limitation and that limitation may have an effect on your ability to earn a living.

https://www.dir.ca.gov/InjuredWorkerGuidebook/Chapter7.pdf

What is a permanent disability rating (PDR)?

A permanent disability rating is a calculation that, in theory, represents the amount of future diminished earnings capacity you may have. It is based upon things such as your occupation when you were injured, whether the sole cause was your job injury or something else, your permanent medical condition, and your age.

https://www.ssa.gov/policy/docs/ssb/v65n4/v65n4p16.html

Is there a formula for rating a disability?

The Department of Workers’ Compensation publishes schedules to calculate and rate permeant disabilities. A workers’ compensation attorney can assist you in the rating, or you can have your case rated directly by the rating unit at the WCAB.

http://www.dir.ca.gov/dwc/pdr.pdf

What are permeant disability benefits?

Permanent disability benefits can include future medical treatment and a monthly or cashed out payment for your reduced earning capacity. Unfortunately, the amount of reduced earning capacity payment is based on a schedule that is required to be used by the WCAB.

Can I get an advance on my workers’ compensation?

If you have been declared permanent and stationary, but no final decision has been made on your case, you may be possible to get a permanent disability advance from the insurance company. A workers’ compensation attorney can request this for you.

How are permeant disability benefits paid?

If you are entitled to permeant disability payments once your case is resolved, they are typically paid out bi-weekly. However, in some cases, you may be able to settle the case for a lump sum award instead.

Can I get penalties against my employer or insurance company?

If there is an unlawful delay in payment in your case, you may be entitled to a penalty paid by your employer or the insurance company. The penalty is often 10% of the unpaid benefits, but there are limits. Likewise, the delay must have been unreasonable and unfortunately penalties are common.

https://www.dir.ca.gov/dwc/educonf12/5814/Penalty.pdf

Can I appeal the workers’ compensation judge?

The appellate process in the workers’ compensation system is often referred to as a Petition for Reconsideration. A decision by the workers’ compensation judge is heard by the Workers’ Compensation Appeals Board Reconsideration Unit. However, for a Petition for Reconsideration to be approved, you typically have to show that the judgment misapplied the law. You generally do not have reconsideration or appeal rights if the judge simply decided factually against you.

http://research.lawyers.com/standards-of-review-on-appeal.html

What is a P&S report?

A P&S report is short-hand for a Permanent and Stationary Report. This report is written by your treating physician and discusses your medical condition with particular emphasis on when your condition stabilized and your potential limitations.

What does it mean to be a Qualified Injured Worker?

The phrase Qualified Injured Worker is a fairly outdated phrase, as only applies to employees injured prior to January 1, 2004. If you were injured prior to January 1, 2004 and had certain limitations, you may be entitled to vocational rehabilitation benefits.

What is a Qualified Rehabilitation Representative (QRR)?

A qualified rehabilitation representative is a person who has specialized education and training enabling them to evaluate and assist disabled workers’ in locating new jobs. Sometimes we refer to this person as a rehabilitation counselor, vocational rehabilitation counsel, or Voc. Rehab. Counselor.

https://www.careeronestop.org/ResourcesFor/Workers’WithDisabilities/workers’-with-disabilities.aspx

What is a Rehabilitation Consultant?

A Rehabilitation Consultant is different than a Rehabilitation Counselor. A Rehabilitation Consultant works directly for the Department of Workers’ Compensation. They oversee vocational rehabilitation procedures, make decisions about vocational rehabilitation benefits, and help resolve disputes about rights to vocational rehabilitation benefits.

https://www.bls.gov/ooh/community-and-social-service/rehabilitation-counselors.htm

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