Blog

What do you need to know about State EDD Disability Insurance ?

State EDD Disability Insurance

When an injured Personal Injury claim is denied, delayed, or no total temporary disability benefits are being paid by the Personal Injury company, injured workers may apply for state disability benefits through EDD (State EDD Disability Insurance).

State EDD Disability Insurance provides eligible injured workers with short-term disability benefits for a work-free time due to an injury or illness in the workplace when the Personal Injury insurance company is not providing total temporary disability benefits. SDI may be available if there is a dispute regarding your eligibility for Personal Injury for total temporary disability benefits.

To be eligible for SDI, a person must be employed or actively seek work at the time of disability; must have lost income due to disability; earned at least $300 of which SDI deductions were retained for a perverse period, and be under the care of a medical professional for the first eight (8) days of disability. It is worth noting that the injured worker must remain under medical care to be eligible for SDI or total temporary disability through Personal Injury.  

*      PRACTICAL TIP: If your claim is not accepted, chances are you will file immediately for SDI  *

*      to preserve your claim later, even if you initially refuse.                                                               *

When receiving SDI, it is often referred to as EDD. If you have further questions about SDI and Personal Injury, please contact RP Law Group at (951) 394-3640 for a free consultation.

Understand that an injured worker should not receive both SDI and total temporary disability from the Personal Injury insurance company at the same time. EDD will file a levy against the Personal Injury case against the benefits you are paying. Any overlap in benefits is called an overpayment.

It should be noted that, while double payment of total temporary disability (TTD) and SDI is generally not allowed; there are cases where the SDI benefit rate is higher than the TTD rate, and EDD will pay the difference.

Ultimately, how is the SDI rate of profit calculated? SDI is based on past earnings and equals approximately 55% of your earnings to the maximum amount of weekly profits. Note that total temporary disability benefits equal 2/3 of the average weekly income.

When considering issues of these benefits, also keep in mind that EDD SDI will run for 52 weeks in most cases, and in accepted cases, the total temporary disability will be maximized by 104 weeks.

Whether it’s a total temporary disability, EDD, or other Personal Injury issue, RP Law Group is pleased to help answer your questions. Call RP Law Group at (951) 394-3640.

DEPOSITIONS – A Deeper Look

In this article we will take a deeper look at depositions – what they are and their use in workers’ compensation cases.

A deposition is a discovery tool which allows the opposing party to gather information regarding the claim. A deposition is basically just questioning and answering questions under oath. While typically in workers’ compensation cases a deposition will be taken of the injured worker, a deposition may also be taken of witnesses and experts such as the doctors, i.e. the treating doctor or the Qualified Medical Evaluator.

Under Labor Code Section 5710 depositions may be taken. A deposition may be taken for many reasons. Generally, depositions are taken to gather information about the applicant’s injuries, prior injuries, medical treatment, etc. Usually it is the attorneys or hearing representatives involved in the case that take the deposition.

Typically, the injured worker will be prepared ahead of time for the deposition. Also present during a deposition may be a representative from the employer, i.e. someone from Human Resources or a supervisor.

As needed, there will an interpreter as well as the court reporter that takes down the transcript of the deposition and sends it out afterward.

Depositions may be used for impeachment or as evidence at a workers’ compensation trial. The testimony in a deposition is given the same weight as live testimony. Also, the deposition may be used to attack a witness’s credibility if testimony differs at the time of trial.

As a discovery tool in workers’ compensation cases depositions focus largely on the applicant’s injury claim; addressing such things as what hurts, how was the applicant hurt, was their prior injury. Insurance companies have a duty to investigate claims within the first 90 days of knowledge of a claim pursuant to Labor Code Section 5402. The deposition is one of the discovery tools commonly used.

Should you have any further questions, please do not hesitate to contact RP Law Group at (951) 446-1599 for a free consultation.

Cambiar su trabajo Comp Doctor

A menudo la pregunta viene en cuanto a la elección de un médico de compensación de trabajo.

En resumen, ¿tienes que usar el médico de trabajo, o puedes seleccionar el tuyo propio? En última instancia, su mejor opción puede ser permanecer con el médico que seleccione dentro de la red de la compañía de seguros.

Uno de los beneficios de seleccionar un médico dentro de la Red de Proveedores Médicos es que no le costará sus copagos de seguro. Sin embargo, si usted está viendo a un médico dentro de la red de la compañía de seguros y desea cambiar de médico, puede solicitar un cambio de médico tratante del ajustador de seguros o, tu abogado.

Si se acepta el caso de compensación de trabajo, seleccionar un médico fuera de la Red de Proveedores Médicos podría afectar negativamente sus beneficios.

La elección del médico tratante en su caso de composición de trabajo es muy importante porque no sólo ese médico supervisará su tratamiento médico a medida que se recupere de su lesión laboral, sus opiniones guiarán las consecuencias legales de su caso. Es muy importante que informe al médico de todos sus problemas de composición de trabajo médico, incluso si no parece tan importante; si está fuera de su especialidad se puede solicitar una referencia.

Algunos consejos al reunirse con su médico:
* Describa su lesión laboral
* Mencione todas las partes del cuerpo lesiones
* Siempre obtenga una copia de su resbalón fuera del trabajo / discapacidad

Si tiene más preguntas, no dude en ponerse en contacto con RP Law Group al (951) 394-3640 para una consulta gratuita.

Changing Your Work Comp Doctor

Work Compensation Doctor

Often the question comes as to choosing a Work Compensation Doctor. In short, do you have to use the work comp doctor, or can you select your own? Ultimately, your best choice may be to stay with the doctor you select within the insurance company’s network.

One of the benefits of selecting a doctor within the Medical Provider Network is that it will not cost you your insurance co-payments. However, if you are seeing a doctor within the insurance company’s network and wish to change physician you can request a change of treating doctor from the insurance adjuster or your attorney.

If the work comp case is accepted, selecting a physician outside of the Medical Provider Network could adversely affect your benefits.

The choice of treating doctor in your work comp case is very important because not only will that physician oversee your medical treatment as you recover from your work injury, his opinions will guide the legal consequences of your case. It is very important that you inform the doctor of all your medical work comp issues even if it doesn’t seem that important; if it is outside his specialty a referral may be requested.

A few tips when meeting with your physician:
* Describe your work injury
* Mention all injury body parts
* Always get a copy of your off-work/disability slip

Should you have any further questions, please do not hesitate to contact RP Law Group at (951) 394-3640 for a free consultation.

¿Qué es un bono?

Una vez que esté listo para resolver su caso, puede tener derecho a volver a entrenar.

Por lo tanto, ha recibido una determinación de incapacidad permanente en la reclamación de compensación de sus trabajadores y no puede volver a su trabajo habitual y habitual, pero puede hacer algo de trabajo.Así que¿Y ahora qué?

Una vez que esté listo para resolver su caso, puede tener derecho a volver a entrenar. El programa de rehabilitación profesional fue creado para proporcionar a los trabajadores lesionados calificados una oportunidad de capacitación y asesoramiento vocacional.

Para calificar para lo que formalmente se llama Bono de Beneficios Suplementarios de Desplazamiento de Trabajo, usted debe tener un premio de alguna discapacidad parcial permanente y su trabajo debe no haber ofertado trabajo modificado o alternativo. Para aquellos que califican el cupón debe ser emitido dentro de los 30 días de la concesión de incapacidad permanente.

El cupón que será de $6,000 se puede utilizar para propósitos específicos. De ese vale se puede usar un máximo de $1,000 para una computadora. Debe documentar el uso del bono para compras aprobadas como matrícula, tasas, libros, materiales, etc. Un consejero de rehabilitación vocacional puede ayudarlo con más detalles a este respecto, ayudar a encontrar un programa de capacitación aprobado, y para cualquier otra pregunta o inquietud que pueda tener sobre el cupón o el proceso, un asesor le proporcionará las mejores respuestas.

En esencia, el bono está diseñado para ayudar a los trabajadores lesionados calificados a obtener el reciclaje y el retorno al empleo remunerado. El programa actual fue revisado en 2004 y permite a un trabajador lesionado calificado obtener reentrenamiento por su cuenta o con la ayuda de un consejero de rehabilitación vocacional.

Por supuesto, si se le emite un cupón y no puede decidir con el programa que debe hacer un consejero de rehabilitación vocacional puede ayudar, pero sabe que tiene hasta un año para el beneficio de regreso al trabajo del estado y hasta dos años para usar el cupón.

Si tiene preguntas sobre este u otros problemas de compensación de trabajadores, comuníquese con RP Law Group al (951) 394-3640 para una consulta gratuita.

Recursos adicionales:

Profesional diversificado

División de Compensación al Trabajador

Géminis – División de Cupones

Centro de Asesoramiento de Ortega

  • Lo anterior está destinado únicamente a fines informativos y no debe interpretarse como asesoramiento jurídico, ya que cada caso es diferente. Comuníquese con RP Law Group al (951) 394-3640 para una consulta gratuita.

What Is a Voucher?

What Is Voucher?

So, you’ve received a permanent disability determination in your workers’ compensation claim and you cannot return to your usual and customary job but you can do some work. So what now?

Once you are ready to settle your case you may be entitled to retraining. The vocational rehabilitation program was created to provide qualified injured workers a training and vocational counseling opportunity.

To qualify for what is formally called Supplemental Job Displacement Benefits Voucher you must have an award of some permanent partial disability and your job must have failed to offer modified or alternate work. For those who qualify the voucher should be issued within 30 days of the award of permanent disability.

The voucher which will be $6,000 can be used for specific purposes. Of that voucher, a maximum of $1,000 may be used for a computer. You must document the use of the voucher for approved purchases such as tuition, fees, books, materials, etc. A vocational rehabilitation counselor can help you with more specifics in this regard, help you find an approved training program, or for any other questions or concerns you may have regarding the voucher or the process a counselor would provide you the best answers.

At its core, the voucher is designed to aid qualified injured workers to obtain retraining and return to gainful employment. The current program was revised in 2004 and allows a qualified injured worker to obtain retraining on his/her own or with the aid of a vocational rehabilitation counselor.

Of course, if you are issued a voucher and cannot decide which program you should do, a vocational rehabilitation counselor can help, but know that you have up to one year for the state return to work benefit and up to two years to use the voucher.

If you have questions on this or other workers’ compensation issues, contact RP Law Group at (951) 394-3640 for a free consultation.

Additional resources:

Diversified Vocational

Division of Workers’ Compensation

Gemini – Voucher Division

Ortega Counseling Center

  • The foregoing is meant for informational purposes only and should not be construed as legal advice as each case is different. Please contact RP Law Group at (951) 394-3640 for a free consultation.

Volver a las dificultades laborales

Por lo tanto, la oferta de trabajo alternativo / modificado viene en.  ¿Qué significa eso?

El trabajo alternativo o modificado se ofrece cuando se determina que el empleado lesionado es permanente y estacionario con restricciones de trabajo y busca ser acomodado por el empleador.  Existe un formulario prohibido para que el empleador lo use para ofrecer trabajo alternativo/mod; sin embargo, se puede hacer a través de una carta general también.

En algún momento, el médico del trabajador lesionado probablemente devolverá al solicitante a trabajar, a menudo con restricciones laborales, es decir, sin estar de pie o sin levantar más de 20 libras.

Una vez que el trabajo lesionado recibe restricciones de trabajo, se deben proporcionar al empleador para que se pueda determinar cualquier posible adaptación.

La única cosa importante a tener en cuenta es que cualquier oferta de trabajo alt/mod, el trabajador lesionado debe tener en cuenta cualquiera de las restricciones del solicitante.  Ahora muchas de las ofertas alt/mod tienen un marco de tiempo dentro del cual responder.  Esto debe observarse si el trabajador lesionado tiene la intención de aceptar la oferta.

Si ha recibido una oferta de trabajo alternativo/mod y tiene preguntas sobre el alojamiento y cómo afecta al caso de compensación de sus trabajadores, no dude en ponerse en contacto con RP Law Group al 951-394-3640.

No, el empleador no tiene que crear un puesto, pero si hay un trabajo abierto dentro de las restricciones laborales del solicitante, se debe ofrecer la solicitud. El empleador está obligado a hacer un esfuerzo de buena fe para ver si un puesto podría ser modificado/acomodado.

Si una oferta de trabajo alternativo/mod se hace correctamente, se reducirá la responsabilidad de un bono de desplazamiento de trabajo suplementario.

Cualquier persona que desee más información puede consultar la siguiente guía del Departamento de Relaciones Industriales:

Dir.ca.gov/chswc/Reports/2010/HandbookRTW_2010.pdf

* Esto está destinado únicamente a fines informativos y no debe interpretarse como asesoramiento jurídico, ya que cada caso es diferente. Comuníquese con RP Law Group al (951) 394-3640 para una consulta gratuita.

Return to Work Issues

Return to the Work Related Issues

So, the offer of alternate/modified work comes in.  What does it mean?

Alternative or modified work is offered when the injured employee is determined to be permanent and stationary with work restrictions and looking to be accommodated by the employer. There is a proscribed form for the employer to use in offering alt/mod work; however, it can be done via general letter as well.

At some point, the injured worker’s doctor will likely return the applicant to work, often with work restrictions, i.e. no prolonged standing or no lifting more than 20 pounds.

Once the injured worker is given work restrictions, those should be provided to the employer so that any possible accommodation may be determined.

The one important thing to keep in mind is that any offer of alt/mod work, the injured worker should take into account any of the applicant’s restrictions.  Now many of the alt/mod offers have a time frame within which to respond.  This needs to be observed if the injured worker intends to accept the offer.

If you have received an offer of alt/mod work and have questions about accommodation and how it affects your Personal Injury case, don’t hesitate to contact RP Law Group at 951-394-3640.

No, the employer does not have to create a position, but if there is an open job within the applicant’s work restrictions, the application should be offered. The employer is required to make a good faith effort to see if a position could be modified/accommodated.

If an offer of alt/mod work is properly made, it will cut the liability for a Supplemental Job Displacement Voucher.

Anyone wishing further information may check out the following Department of Industrial Relations’ guide:

Dir.ca.gov/chswc/Reports/2010/HandbookRTW_2010.pdf

  • This is intended for informational purposes only and should not be construed as legal advice, as each case is different. Contact RP Law Group at (951) 394-3640 for a free consultation.

El Adjustador

El Ajustador usted reporta su lesión de trabajo y luego comienza a recibir cartas y llamadas del Ajustador. Pero, ¿quién es un Ajustador?

Un Ajustador es un individuo asignado a una reclamación de compensación de trabajadores por la compañía aseguradora. El Ajustador es responsable de su reclamo en la compañía de seguros. Es el trabajo del Ajustador para seguir las pautas legales y los requisitos, pero esa persona también está allí para mantener los costes abajo para la compañía aseguradora mientras que asegura el manejo apropiado de la demanda.

Un Ajustador de compensación de trabajadores es responsable de revisar el expediente de reclamo e investigará su reclamo para la autorización y beneficios del tratamiento médico. Por supuesto, es también el Ajustador que envía las peticiones para el tratamiento para la revisión de la utilización, la aceptación, la negación, la modificación, el etc.

Un Ajustador investigará su reclamo; Esto podría ser mediante la solicitud de una declaración grabada o el envío de formularios para la liberación de información médica; Esta es la práctica estándar. Debe leer detenidamente y considerar cualquier formulario antes de firmarlo y devolverlos.

Una vez que esté representado por un abogado, no estará hablando con el Ajustador. Una vez que usted tiene representación el Ajustador no debe tener ese contacto con usted aunque él/ella hizo en el principio. Usted seguirá enviando sus registros de kilometraje médico al Ajustador para la consideración del reembolso que sea apropiado.

Mientras que los Ajustadores no son malas personas, saben que están allí para la línea de fondo de la compañía de seguros y las reclamaciones les cuestan dinero cada día que están abiertas.

Si tiene alguna pregunta sobre la reclamación de compensación de trabajadores comuníquese con RP Law Group al (951) 394-3640 y hable con el abogado para una consulta gratuita.

The Adjuster

You report your work injury and then start getting letters and calls from the adjuster. But who is an adjuster?

An adjuster is an individual assigned to a Personal Injury claim by the insurance carrier — they are responsible for your claim at the insurance company. It is the adjuster’s job to follow the legal guidelines and requirements, but that person is also there to keep costs down for the insurance carrier and ensure proper handling of the claim.

Working With An Adjuster

A Personal Injury adjuster is responsible to review the claim file and will investigate your claim for medical treatment authorization and benefits. Of course, it is also the adjuster who sends requests for treatment for Utilization Review, acceptance, denial, modification, etc.

An adjuster will investigate your claim; this could be by requesting a recorded statement or sending you forms for release of medical information; this is standard practice. You should carefully read and consider any forms before signing and returning them.

Let Your Attorney Do The Talking

A benefit of working with an attorney is that you no longer have to speak with the adjuster yourself. Once you have representation, the adjuster is not supposed to have contact with you, even though he/she did in the beginning. However, you will still send your medical mileage logs to the adjuster for consideration of reimbursement as may be appropriate.

While adjusters are not bad people, it’s important to know that they are there for the insurance company’s bottom line. Claims cost them money every day they remain open. This is why it’s important to have qualified legal representation.

If you have any questions about your Personal Injury claim, contact RP Law Group at (951) 394-3640 and speak with an attorney right away for a free consultation.