Fresno Temporary Disability Workers’ Compensation Claims

If you suffered injuries at work, you are likely entitled to temporary disability benefits from the workers’ compensation program. However, getting your benefits and keeping them until you are ready to return to your job could be a challenge. Teaming up with an experienced workers’ compensation attorney could make a tremendous difference.

A legal professional could guide you through the process of filing a Fresno temporary disability workers’ compensation claim. Our team could offer advice if the insurer has denied your claim or support you if the program is forcing you to return to work before you feel able to resume your duties.

Temporary Disability Benefits Explained

When a worker sustains an injury at work that prevents them from doing their job, they can often claim temporary disability benefits. For these payments to be an option, the insurance company must agree that the accident that happened was work-related. If an insurer disputes an injury is work-related, a Fresno attorney could contest the denial by providing evidence of the accident that caused the temporary disability.

The injured person’s doctor must also agree that the injury prevents the worker from doing their specific job. In many cases, the doctor will advise restricted activity for a specific period.

The Value of Temporary Disability Payments

Temporary disability benefits pay two-thirds of the worker’s average weekly wage while they cannot work up to the statutory maximum. If an employee can work part-time or the employer has an open job position that meets the medical restrictions, the employee receives two-thirds of the difference between the wages they currently earn and their pre-injury salary.

Sometimes an employee might argue that the workers’ compensation program is underestimating their average weekly wage. This situation is especially likely to arise if a significant portion of an employee’s pay comes from commissions or tips. A Fresno lawyer could help an employee in that situation demonstrate their actual pay and convince the workers’ compensation program to calculate temporary disability benefits based on a fair weekly rate.

The program has minimum and maximum weekly rates, so a lower-paid employee might receive more than two-thirds of their salary, and a higher-paid employee will receive less. California Labor Code §4656 allows workers’ compensation to pay temporary disability benefits for a specific injury for 104 weeks of any five-year period. Payments end when the employee returns to work, applies for permanent disability, or when the 104-week time limit expires.

Potentially Contentious Issues in Temporary Disability Claims

Disputing whether an injury is work-related is not the only issue that might cause a workers’ compensation insurer to deny a claim or halt temporary disability payments. Insurers also frequently try to get employees to return to unrestricted work before they feel ready. Additionally, a worker might decide to challenge a physician’s opinion of their disability.

Second Medical Opinions

If a worker disagrees with a doctor’s opinion, they can usually request a second opinion from a Qualified Medical Examiner (QME) or an  Agreed Medical Examiner (AME). The worker will receive an examination without charge, and the QME or AME will give an opinion about whether an employee can return to work. However, an insurer also could request a review if they feel the injured person should be ready to return to work.

Request for Adjudication

If a second medical opinion does not resolve the matter, an employee could request a hearing. The hearing takes place before an administrative officer who hears evidence from both sides and decides whether the employee should continue to receive temporary disability benefits. A worker considering requesting a hearing regarding their temporary disability workers’ comp should weigh their options with an experienced Fresno attorney.

Work With a Fresno Attorney on Your Temporary Disability Workers’ Compensation Claim

When you sustain a work-related injury, a Fresno temporary disability workers’ compensation claim could be a lifesaver. It might provide the funds you need to pay the rent and feed your children while you recover.

State law entitles you to workers’ compensation benefits if you get hurt on the job, and an employer’s insurance company cannot deny your disability claim without reason. If you are having trouble getting the benefits you deserve, call our legal team today.