Returning to Work and Accommodations

All employers work hard to make sure that their employees are as safe as possible at work.  Employers invest in the latest safety technology, form safety committees, and provide training all in an effort to reduce the chances an employee will sustain a work related injury.  Unfortunately, this cannot always be avoided.  If your employee is injured and files a claim for workers’ compensation, it is possible that he or she will have to take some time off work to recuperate.  When the employee returns to work, the employer needs to be aware of the responsibilities they have to the employee to potentially provide accommodations to the employee.

Employers in California have an “affirmative duty” to make “reasonable accommodations” for a known disability.  The employer’s duty to provide an accommodation is triggered when the employer has reliable reason to believe the employee has a disability.  The employer does not have to witness the disability personally and the employee has no obligation to specifically request an accommodation before the employer needs to take action.  The employer needs to accommodate the employer’s disability and work restrictions, but the employer is not required to take measures that would constitute an undue hardship.  The employer is also not required to make sure that the accommodations make it possible for the employee to immediately return to the same job or even a job with the same income.  The employer is not required to make a new job position just for the injured employee, but the employer does have to investigate all the available job openings that the employer could qualify for.  For example, if an employee sustains a back injury that makes it impossible for him to perform his usual duties as a jail warden, the employer is at liberty to offer the employee a desk job at a different facility that would accommodate the restrictions on the warden’s physical activity.  The employer has an obligation to engage in an interactive process with the injured employee to ascertain what sort of accommodation may be required.  The employer should look for alternate positions and continue the dialogue with the employee until he or she terminates the process.  The employer should document these exchanges to make sure that there is evidence of the efforts made to accommodate the employee in case the employee brings a suit against the employer for discrimination or retaliation.

Employers should be aware that they cannot treat non-industrial disability restrictions any differently than a disability or restriction a worker may have as a result of a work-related injury.  Employers must be consistent in how they handle all disability issues.

Workers’ compensation is a long process with a lot of requirements for all parties.  Contact us today for a consultation to talk about your business.

How Is Disability Determined?

The workers’ compensation system is designed to make sure that an employee who sustains a work-related injury receives compensation for the injury.  This means not only wage replacement, but also the employer or the employer’s insurance company, will be required to pay for the reasonable medical expenses related to the injury.  The type of disability that an employee sustains as a result of the injury will have an enormous impact on the type and duration of benefits that he or she is entitled to receive.  Accordingly, understanding how disability is determined can be an important step toward protecting your business.

There are four different types of disability: temporary total disability, temporary partial disability, permanent total disability, and permanent temporary disability.  Only a doctor can make the determination as to a worker’s type of disability.  During the workers’ compensation process, the injured employee will be seeing medical professionals not only for the treatment of his or her injuries, but also for assessment.

An employee may be entitled to temporary disability benefits where he or she must miss at least three days of work or where he or she must be hospitalized overnight.  Again, only a doctor can make the determination as to whether or not these courses of treatment are necessary.  Moreover, only a doctor can make the determination that a worker is totally temporarily disabled, meaning he or she is totally unable to work for a temporary amount of time, or that he or she is only partially temporarily disabled, which would mean he or she is still able to work, but in a limited capacity.

By contrast, permanent partial disability would mean that the injured worker will never be able to work at the full capacity that he or she was able to do before the worker sustained the industrial injury.  The injured worker will still be able to work, but not in the same manner or to the same extent.  Permanent total disability means the injury results in the injured worker’s total inability to work in that field ever again.  A doctor will diagnose a permanent disability only after he or she makes the determination that the worker will not be able to heal any further.

Determining disability is a nuanced process.  Call us today so we can talk with you about what your business can expect from the process.

Permanent Total Disability

All good employers work hard to make sure their employees have the safest possible working conditions.  Keeping safety manuals up to date, providing regular safety training, and making sure that all equipment is kept in good repair are just a few ways that employers can help safeguard their employees and guard against workplace accidents.  Unfortunately, despite the most careful steps, workplace accidents usually will happen.  When an employee sustains a work-place accident, he or she can apply for workers’ compensation.  Employees will receive one of four disability classifications after seeing medical professionals: temporary partial disability, temporary total disability, permanent partial disability, and permanent total disability.

A doctor can classify permanent disability anywhere on a scale of zero to one hundred.  Only a classification of one hundred will result in the employee being classified as permanently totally disabled.  It is important to note that the classification of the disability at one hundred does not mean that the employee’s condition will not deteriorate or worsen in the future.  Instead, it means that the doctor has determined that the employee’s injuries meet the minimum threshold necessary for total disability.

There are two ways that an employee may demonstrate that he or she is permanently and totally disabled.  California labor code 4662(a) provides that certain conditions mean a conclusive presumption of permanent total disability.  These conditions are: 1) loss of both eyes or sight in both eyes; 2) loss of both hands or loss of use of both hands; 3) an injury resulting in practically total paralysis; or 4) an injury to the brain resulting in permanent mental incapacity.  For this presumption to apply, the incident resulting in the injury must be an industrial accident.  A prior injury cannot contribute, for example, to the loss of sight in both eyes. Rather, the industrial accident subject to the current workers’ compensation claim must have resulted in the loss of sight in both eyes.

The other way for an employee to demonstrate permanent total disability is under Labor Code 4662(b), which provides that all other claims of permanent total disability must be determined “in accordance with fact.”  Although the labor code does not specifically define what this means, case law indicates that Labor Code 4660 will govern how the finding of permanent total disability will be made.

We have extensive experience in assisting our clients to understand the different types of disability in workers’ compensation suits and how they may impact their business.  Contact us today for a consultation to talk about your business and its future

Do I Have to Pay for My Worker’s Prior Disability if He Gets Injured? (Apportionment)

As an employer, you know that making sure you provide workers’ compensation benefits for your employees is important and in most circumstances is required by California law.  Workers’ compensation provides protection for the employee because it establishes a no-fault system under which an injured worker can receive compensation for his or her work related injuries.  It also provides protection for the employers, as this no fault system means that the employer does not have to worry about being sued by their employees for recovery for injuries sustained during the course and scope of employment.  Although you certainly understand that workers’ compensation is designed to compensate your injured employee for injuries sustained at your business, it is also important to understand your potential responsibility if the employee had sustained an injury previously at a different business.

Apportionment is designed to allow disability percentages to be assigned to previous injuries to the same body part injured and at issue in the current workers’ compensation case.  California Labor Code § 4664(a) states “The employer shall only be liable for the percentage of permanent disability directly caused by the injury arising out of and occurring in the course of employment.”  The law goes on to provide that if there is a pervious determination of permanent disability, then it is presumed that the permanent disability still exists at the time the next workers’ compensation claim is made.  If the request for apportionment is successful, the amount of workers’ disability benefits received by your employee in the current case will be reduced.  To successfully show apportionment, there are specific requirements concerning the doctor’s assessment.  First, a doctor must make a specific determination of apportionment.  This determination must be done using percentages of what existed at the time of the injury.  The doctor must also analyze the permanent disability based on the causation of the disability, not causation of the injury itself.  Third, the opinion must be based on facts and not on speculation.  Fourth, the opinion must be based on a “reasonable medical probability.”  Finally, the doctor must explain how and why he or she reached the particular conclusion.  There are other requirements for a successful claim such as showing the employee was actually compensated for the previous injury and the injury continued to be a source of disability after the accident.

We have extensive experience helping our clients understand apportionment and how to protect their business.  Contact us today for an appointment.

What Is Permanent Disability?

As a business owner, you take every measure possible to reduce the chance of injury to your employees as much as possible.  Unfortunately, no matter how much you strive for an injury-free work place, it is overwhelmingly likely that an injury will eventually occur.  If during the course and scope of employment, your employee sustains an injury, he or she will likely be entitled to receive workers’ compensation benefits.  The type and percentage of disability is a central component of disability claims.

The California Department of Industrial Relations defines permanent disability as “any lasting disability from your work injury or illness that affects your ability to earn a living.”  If an employee is permanently disabled, he or she will be entitled to permanent disability benefits, regardless of whether that injury renders him or her unable to work in the future.  In most cases, permanent disability is determined through Whole Person Impairment (WPI).  This will be determined after the employee is examined by his or her doctor or a Qualified Medical Evaluator.  The doctor or QME will determine the percentage of impairment level, meaning how the injury will impact the employee in his or her ability to work.  The QME will use the standards established by the American Medical Association in making this determination.  The impairment level will then be reduced to a percentage, using a formula which also takes into account the employee’s age and occupation. In cases involving psychological injuries, the injury must either be categorized as catastrophic or the employee must have witnessed a violent crime in the course and scope of employment.  Taking all of these elements into account, the disability evaluator or the judge will then use the statutory formula and decide the amount of permanent disability the employee is entitled to receive.  The amount the employee will be entitled to receive will also be impacted by the date of the injury in addition to the wages paid to the employee before he or she was injured.  The permanent disability benefits typically begin being paid after the end of temporary benefits and the doctor indicates that the injury has “stabilized.”  This means that the injury will not heal or improve any more.

If you have questions about disability payments to your employees, contact us today.  We look forward to discussing workers’ compensation with you and what we can do to help protect you.

What is Permanent Disability?

When an employee sustains a work-related injury, he or she may be entitled to receive payment from his or her employer through the workers’ compensation system.  In California, the workers’ compensation system is a no-fault system.  This means that the employee does not have to prove that the injury was the fault of the employer before being entitled to compensation.  The type, amount, and duration of workers’ compensation benefits that an employee may be entitled to is partly governed by whether the injury results in a permanent disability.

A permanent disability is defined as any lasting disability from an employee’s work-related injury or illness that affects the employee’s ability to earn a living.  In the event an employee sustains a permanent disability, he or she will be entitled to permanent disability benefits even if he or she can return to work.  In order to be determined to have a permanent disability, the employee must submit to a medical examination.  The doctor will decide if the employee has a permanent disability.  The doctor will wait until your injury has stabilized and is not likely to worsen or improve before evaluating the permanent disability.  The term for this state is either “permanent and stationary” or “maximal medical improvement.”  Once the employee’s injury reaches this state, the doctor will send a report to the insurance claim administrator reporting whether the employee has a permanent disability, and whether that disability is, in fact, work-related.  The doctor will decide how much of the permanent disability is attributable to the work-related incident, and how much is attributable to any pre-existing conditions.  The doctor will also write a report about the employee’s impairment, which refers to how much the injury actually affects the day-to-day activities of the employee.  The doctor will assign a number to the impairment, which is then plugged into a special calculation in order to calculate the percentage of disability.   Whole Person Impairment generally means how much the impairment will affect the employee’s ability to function in the future.  The employee’s age and occupation will also affect the calculation, as well as diminished future earning capacity, for injuries incurred after January 1, 2013.  The disability will be stated as a percentage, which will determine a specific dollar amount the employee will receive.  After the amount is calculated, an award of benefits will be granted, but must first be approved by a workers’ compensation judge.

Calculating and awarding permanent disability is complicated, and you need an experienced attorney working with your business through this process.  If one of your employees may be permanent disabled as a result of a work-related injury, contact us today at (714) 516-8188 to discuss it.

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