Orange County Wage Loss Benefits Explained: Temporary Disability, Permanent Disability & How to Appeal Underpayments

Getting adequate treatment and time to heal for your injury is essential if you have been hurt on the job in Orange County. That requires not just paying medical bills but also getting some help to make up for lost wages during your recovery. Orange County wage loss benefits are designed to do just that.

Wage loss benefits are a part of both temporary and permanent disability benefit packages. If you are not receiving the full amount of benefits you are due, you can work with a wage and hour attorney to address the discrepancy.

How Wage Replacement Benefits Work

Wage replacement benefits are designed to partially replace your lost income if you suffer a work-related injury or illness. To qualify for benefits, you’ll need to meet these criteria:

• The injury or illness was caused by your job or work environment.
• The injury or illness resulted in temporary or permanent disability.
• Your employer has been notified about the injury or illness.
• Your claim for workers’ compensation benefits has been approved.

Wage replacement benefits come in different forms:

1. Temporary disability benefits. These benefits last for a short duration while you are recovering from an injury or illness. They amount to two-thirds of your gross wages, subject to changing state minimums and maximums.
2. Permanent disability benefits. These benefits will be awarded if your workplace injury or illness results in a lifelong disabling condition. The amount of money you are awarded will depend on your age, occupation, pre-injury earnings, and the extent of your impairment.

Orange County wage loss cases can be confusing, and many claims are denied. That should come as no surprise, given that workers’ comp claims have an average payout of $47,316 as of 2022-2023. The average payout for injuries caused by work-related motor vehicle accidents was even greater at $91,433 per worker. Insurers clearly have compelling reasons to deny claims whenever possible.

Temporary Disability Payments

Temporary disability payments amount to two-thirds of your wages, depending on your income, but there are set minimum and maximum amounts that change annually. Currently, the minimum is $ 264.61 per week, and the maximum is $1,764.11 per week. No taxes will be deducted from your benefits, nor will retirement account contributions or union dues.

There are certain circumstances that can complicate the determination of payments for wage loss with temporary disability benefits. They include:

• Working a second job
• Working seasonal jobs
• Changes in wages that were supposed to go into effect following the injury
• Income that included tips, overtime, or other benefits
• Receiving benefits more than two years after the injury

If you can work a little bit while recovering, you may also receive temporary partial disability payments to supplement your wages instead of temporary total disability payments. The easiest way to handle situations like these is to work with a workers’ compensation attorney to ensure that you get the full amount of benefits to which you are entitled.

Permanent Disability Payments

Permanent disability payments work a little differently from temporary disability benefits. They’re determined based on:

• The date of your injury
• Your impairment level
• Your age and occupation

There is a set formula that disability evaluators use to calculate how much permanent disability you are entitled to.

What to Do if You’re Not Getting Full Payments

If you are not getting full payments, you should take action as quickly as possible and hire a wage and hour lawyer to help you address the issue. You’ll need to:

1. Review the decision. Contact the insurer to find out why your benefits have been reduced.
2. Contact your employer. If you disagree with the decision to reduce your workers’ comp benefits, you’ll need to contact your employer or their insurance carrier to provide documentation that supports your claim.
3. Request a re-evaluation. If the decision to reduce your benefits was based on incorrect information, request a re-evaluation.
4. File an appeal. If, after the re-evaluation, your benefits are still reduced, you’ll need to follow a formal appeal process. Your lawyer can handle these steps for you.

FAQs About Orange County Wage Loss Benefits

Do You Have to Pay Back Temporary Disability Benefits?

You generally don’t have to pay back temporary disability benefits. They are designed to replace part of your lost wages as a result of your workplace injury or illness. However, you may need to repay some amount of your benefits if you receive Social Security Disability Insurance backpay, you worked while collecting benefits and exceeded the limits, or your insurer overpaid you due to an error.

How Much Does Workers’ Comp Pay for Temporary Disability in California?

In California, workers’ comp pays for temporary disability benefits that cover roughly ⅔ of your average weekly wages. There are set minimum and maximum payments that change yearly. Your payments will last until you return to work or your condition stabilizes to the point where it is considered a permanent disability.

How Much Is the Total Permanent Disability Payout?

There is no fixed total permanent disability payout. The amount of money you get will depend on your injury date, prior wages, and disability rating. The workers’ compensation insurance agents will use a set formula to determine what you may receive in payments. A 100% disability rating could get you lifetime benefits, but even a lower rating could yield a high total disability payout.

What Are the Negatives of Short-Term Disability?

The negatives of short-term disability are that it is limited in coverage duration, replaces only a portion of your income, and has waiting periods before the benefits start. Short-term disability doesn’t guarantee job protection, either, and premiums can be costly for individual plans. If your employer pays the premiums, the benefits can be taxable.

Hire a Wage and Hour Lawyer in California

If you have been receiving less than you are due in Orange County wage loss benefits, it is time to hire a wage and hour lawyer. The team at Canlas Law Group, APLC, can help you understand wage and hour laws and how they apply to temporary and permanent disability. We can assist you in filing an appeal and provide you with ongoing legal support throughout the process. Contact us to schedule an initial consultation today.