First-responders face the risk of permanent disability because of the potential dangers involved in their duties. California’s workers’ compensation law provides permanent disability benefits to workers who suffer a lasting disability from a work injury or sickness that impacts their ability to earn a living, even if that claimant may return to work.
Employers must provide a DWC 1 claim form to workers within one day of their injury. Workers must submit this form within one year. Once that form is submitted, a worker is entitled to a presumption that their injury or sickness was work-related if the claim is not accepted or denied within 90 days, payment of up to $10,000 in treatment costs while the claim administrator reviews the claim, an increase in late disability payment and a procedure for resolving disagreements over whether the injury or illness was work-related, over the medical care and whether PD benefits will be granted.
A doctor will decide whether the injury or sickness qualifies as a PD and their report will turn into a PD rating. A PD rating involves a medical report on how the injury affects the claimant’s ability to engage in normal life activities. A formula will calculate the disability percentage equal to a dollar amount.
Once the worker’s condition stabilizes, the PD is evaluated. The condition will be classified as permanent and stationery or maximal medical improvement. The doctor will send their report to the claims administrator and advise whether the worker has a PD and whether it is work-related or caused by a pre-existing condition.
A qualified medical examiner will resolve any disagreements with the doctor’s findings. The employer pays this expense and requests must meet time deadlines.
The claims administrator will begin to make payments after the doctor finds there is a PD even if the final percentage was not calculated. After the PD amount is determined, a workers’ compensation judge must approve a settlement or award of benefits. A claim may be resolved through a lump sum settlement or a settlement containing a sum of money and future medical treatment.
This process involves numerous procedure and deadlines. An attorney can assist first-responders with seeking their entitled compensation.