Form DWC-AD 10133.57 – Mandatory Form; Supplemental Job Displacement
Nontransferable Training Voucher Form
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If an injured worker is not accommodated and returned to work by his or her employer after an injury, the worker may qualify for this return-to-work assistance benefit, known as the Supplemental Job Displacement Benefit (SJDB), or "voucher."
Voucher Amounts
Under Labor Code Section 4658.5, this benefit is paid at $4,000, $6,000, $8,000, or $10,000, depending on the level of the final permanent disability rating.
When You Can Apply
An injured worker cannot qualify for or apply for this benefit until there has been a final determination of the percentage of permanent disability. This form (DWC-AD 10133.57) is used to request the voucher, and can be obtained here or requested from the claims examiner.
How GEKLAW Can Help
Because the voucher amount is tied directly to your permanent disability rating, getting that rating right matters — and so does making sure the benefit is actually provided. Our attorneys can help you pursue the return-to-work benefits you are entitled to.
