Distinguishing Between Workers’ Compensation and Disability Insurance In The State of California
California Workers Compensation
In California, state disability benefits are paid out by the Employment Development Department (EDD). This is the same entity that pays out unemployment benefits to employees that have been laid off. Some injuries are not covered by the state’s workers’ compensation system. This is where state disability benefits come in to fill the gap.
There are a few different reasons why an injury might not be covered by California’s workers’ compensation system. The injury could be non-work-related, such as sporting accident. The injury could also be work-related, but denied by the employer’s insurance carrier for workers’ compensation purposes.
The procedures for obtaining workers’ compensation benefits and state disability benefits are different. In the workers’ compensation context, an employee must simply report that an injury was sustained, and that is was work-related. While the employer’s insurance carrier does have a window of time to prove that a claimed injury either did not occur or was not work-related, it must presume that the injury did in fact occur and was in fact work-related. As such, the employer’s insurance carrier must provide both medical benefits and lost wage benefits to an injured worker who has filed a claim for workers’ compensation benefits.
If the employer’s insurance carrier is able to prove that the injury did not occur or was not work-related and thereby deny the workers’ compensation claim for benefits, an employee can then apply for state disability benefits. These benefits differ from workers’ compensation benefits in a number of ways. First, state disability benefits do not cover medical benefits. Thus, any medical expenses incurred must be paid either out-of-pocket or through private insurance. Obviously, this is a potentially dramatic drawback. State disability benefits do cover lost wages so long as a doctor confirms the existence of the injury, and specifies whether it was simply non-work-related or denied by the employer’s insurance carrier. Unlike in the workers’ compensation context, the doctor need not be in the physician network of the employer’s insurance carrier. Finally, one further drawback of state disability benefits for lost wages is that they are typically paid out at a slower rate than workers’ compensation disability benefits. All in all, while not as extensive as workers’ compensation benefits, state disability benefits are still a valuable safety net for Californians who have lost wages due to missing work while recovering from an injury.
What To Do If You Have Been Injured In A Workplace Accident In The State Of California
Have you been injured while working in the state of California? The state’s workers’ compensation system can be difficult to navigate – an especially stressful reality in light of the health and financial ramifications of an injury requiring medical treatment and absences from work for recovery. To ensure that you understand your legal rights and obtain the maximum compensation you are entitled to for your health and financial security, contact an experienced California workers’ compensation attorney.