What You Should Do Immediately After A Lost-Time Work Injury
First things first: You must report the injury to your employer and see a doctor. If you make it clear to your employer that you were injured at work and need to get medical attention, your employer should refer you to a preferred clinic or emergency room for medical attention. The employer should have information posted in the personnel office or break room with advice about what to do and where to go if you are injured, even if they do not verbally provide the information when you report the injury. If you are transported immediately to a hospital following serious injury, have your emergency contact notify your employer if possible.
If you need to miss work or if your doctor gives you limitations which your employer cannot or will not accommodate, file for State Disability. Although work injuries are covered by Workers Compensation laws, State Disability Insurance benefits (SDI) may be paid. A Workers Compensation Insurance company has 90 days from the time you file a claim for work injury to accept or deny the claim, and while your claim is under investigation, no temporary disability (TTD) will be paid. If you are unable to work, it means you have no income during this time. EDD may begin making SDI payments during the investigative period, or if the insurance company denies your Workers Compensation claim. Even if your work injury claim is accepted, it is still a good idea to apply for SDI anyway, since doing so may assist you in obtaining SDI payments if you remain temporarily disabled but your TTD payments stop after 104 weeks. The only cautionary note here is that you may not receive both SDI and TTD at the same time for the same days off work, or you will have to pay back the duplicated benefits.
SDI benefits include up to 52 weeks of partial pay at approximately 55% of normal earnings. There is a seven day waiting period. For claims beginning on or after January 1, 2019, the weekly benefits range from $50 to a maximum of $1252.00 Benefit payments are normally issued within two weeks of EDD receiving a properly completed claim form, including the medical certification signed by your doctor unless more information is needed. Go online to edd.ca.gov/disability/ for detailed information and the online claim process.
Not everyone is eligible to receive State Disability (SDI) payments, first and foremost because not every employer participates in the system (government entities typically do not, but have alternative benefits available);. You can verify whether you have participated by looking at a pay stub, which will show a deduction for SDI premiums paid to the State.
You are eligible to receive disability benefits (SDI) from the State of California Employment Development Department (EDD) if you are unable to work for at least eight consecutive days, have lost wages because of your disability, and were employed or actively looking for work at the time your disability began. You must also be under the care of a licensed physician and be able to show enough earnings during a “base period” in the year immediately preceding your claim.
Claims for State Disability payments may be rejected or penalized if not made within 49 days of the date your disability begins. The first day you become unable to work is the date your disability begins. This disability will have to be certified by a doctor but does not have to be established as a work injury.
If, or when, your lost time work injury claim is accepted, you should receive temporary total disability (TTD) payments. These payments are made every two weeks, starting with the 4th day of disability at 2/3 of your average weekly earnings at the time of your injury, and are payable for a cumulative total of up to 104 weeks within 5 years of the date you were injured. For 2019, the TTD benefits range from $187.71 per week and the maximum TTD rate is $1,251.38 per week. Typically, you will be required to obtain medical certification for TTD every 45 days. For more information about TTD payments, go to www.workpains.com and search “articles” and look for “disability benefits”