Temporary Disability Benefits in the Workers' Compensation System

In California, the purpose of temporary disability benefits is to ensure that workers who are injured on the job receive the financial compensation they deserve. These temporary benefits work to make up some of the lost earnings an employee would have received if not for their injury. Benefits are only paid for work-related injuries and require an accredited doctor to declare that you either cannot work or are limited in the kind or amount of work you can do.

Temporary Disability Benefits in Practice

For example, if an employee who works in an office as a receptionist sustains a cumulative, repetitive trauma injury to their wrists is told by their doctor that they can no longer do any kind of repetitive work with their hands, they would be entitled to temporary disability if their employer does not have any work that complies with those restrictions.

However, if an employee worked in a warehouse and injured their back, resulting in their doctor saying that they could work but could not lift more than ten pounds, and if the employer can accommodate this limitation, then the injured worker would not be entitled to temporary disability given that the alternative assignment does not require lifting over ten pounds.

How Long Can I Receive Benefits?

California temporary disability benefits are determined by the work restrictions given by your doctor and what your employer can do to accommodate those restrictions. 

Additionally, California has put into place a few limitations on how long you can receive temporary disability benefits.

Temporary disability benefits most likely will end if you fully return to work. They could also end if your doctor advises that you are able to return to work with limitations and the employer can accommodate that limitation.  Finally, benefits may end if your condition stabilizes to where you are eligible for permanent disability benefits.

In most cases, temporary disability benefits are limited to a total of 104 weeks within a five-year period from the date of injury and must be paid within that five-year period. 

However, if you have any of the following conditions, you can receive up to 240 weeks of temporary disability benefits:

• Acute and chronic hepatitis B or C
• Amputations
• Severe burns
• HIV
• High-velocity eye injuries
• Chemical burns to the eyes
• Pulmonary Fibrosis
• Chronic Lung Disease

What Information Must You Legally Be Given?

The claims administer must keep you informed through letters in regards to your Temporary Disability Benefits. These notices will tell you the methodology behind why you were paid what you were, provide explanations for any lack of payment or delays, detail reasons for any alteration and furnish information regarding cessation of Temporary Disability benefits. They must also give you a list of all the Temporary Disability benefits that have been disbursed.

What is the Labor Code?

Once you qualify for temporary disability benefits, also known as TTD disability, the amount you receive is determined by the Labor Code. This code judges how much you get based on when the injury occurred. The lowest and highest amounts enforced by the Labor Code determine ttd disability payments and benefits. Typically this amount does not change while you are unable to work, with one notable exception.

What is Labor Code 4661.5?

Within the Labor Code, there is a specific ruling called LC § 4661.5. The ruling makes it so that if someone receives temporary disability payments for two years or more after their workplace injury, the amount they receive is calculated based on the rates set in the Labor Code at the time of each payment. The exception comes when the calculation would give the employee less money, in which case they will still get the higher amount they were entitled to earlier. In order to receive this increased rate, you must have earnings (or the right to increased earnings) that would support the increased temporary disability rate.

This often occurs when an employee gets injured and goes through periods where they are on modified work, have taken off of work completely, resumed work, and then finally had surgery over two years later.  If your potential earnings go up or if you receive a raise after your workplace injury, you may still be eligible for a higher temporary disability payment based on your new earnings status. If you are a part of a union this applies to you as well. If your union is able to negotiate a better deal during your two-year period, you will not miss out on increased earnings because of your injury or illness.

Certainly, if you are a union employee, it is likely that you will benefit from this exception.

Supplementing Your Temporary Disability with Other Benefits

It is important to note that temporary disability payments are not meant to be a full wage replacement benefit. Your weekly temporary disability payment rate is based on two-thirds of your average weekly wage on the date of your injury. This cannot exceed the maximum rate established by the labor code for that year.

While this rate is likely to change every year based on inflation, a two-thirds rate is still going to be lower than what you were previously making, especially for high-earning employees. However, you can still supplement your temporary disability benefits up to an amount that approximates your full salary by working with your employer to utilize accrued leave credits such as vacation or sick time. This can help to close the gap between what your wages should be and what you are missing from only receiving temporary disability.

Other Monetary Benefit Considerations

There are also certain situations where you may be entitled to more than the state rate or additional benefits. One of the most common situations is when an employee is part of a union that negotiates contractual terms entitling them to more than the state rate.

The Education Code Consideration

The Education Code carves out the ability for additional benefits for both certificated (teachers and certain administrators) and classified (teaching assistants, aides, custodians, etc.) school district employees. While most employees receive only temporary disability benefits, a school district employee may receive full pay while off work due to an industrial injury.

This is because the Education Code provides special payments that include the normal Workers' Compensation benefits as well as 60 days of industrial accident/illness leave, sick leave, vacation leave, paid holidays, and a form of leave called "differential leave". 

That means that a school district employee is allowed up to 60 days of full salary replacement on top of temporary disability payments, all of this supplemented by the use of the employee's sick, vacation, and holiday leave.

Differential leave allows a school district employee who is absent from his or her duties for five months or fewer to have the amount deducted from their salary not exceed what was paid to the employee who substituted to fill their position.

Special Benefits for Public Safety Officers

Most public safety employees can also receive additional benefits under the Labor Code (Section 4850). These specified public safety and fire employees are paid their full salary following an industrial injury rather than the normal two-thirds rate for a period not exceeding one year. After that year, they are then given temporary disability payments at the normal rate for the remainder of their disability.

What is Labor Code Section 4650?

When dealing with a workplace injury it is always best to have as much knowledge as possible on what Labor Code sections affect you. In terms of temporary disability, Section 4650 is a necessary point of knowledge. Labor Code Section 4650 gives us guidelines for what happens if an insurance company does not pay employees their disability benefits on time.

If the payments are late, Section 4650 states that insurance companies must add 10% to the employee’s payment. A late payment is defined as not being paid within 14 days of the established due date, or if they're not made every two weeks. This applies to anyone who receives disability payments. This rule also counts for firefighters and police officers.

What About State Disability Insurance Benefits from EDD?

If there is ever a period of delay or dispute during your Workers’ Compensation case in your attempt to claim temporary disability benefits you may be able to apply for the EDD (California Employment Development Department) State Disability Insurance (SDI) program. This can only be the case if you have previously paid into the program.

If at a later date, Workers' Compensation is in fact responsible for paying benefits when SDI was paid, Workers' Compensation will pay SDI back at no expense to you.  In rare cases, if your SDI rate is greater than your Workers' Compensation temporary disability rate, you may be able to receive stipends from both sources at the same time.  If you remain disabled and after you have exhausted your two years of Workers' Compensation payments, you may still be able to apply for and obtain up to a year of SDI payments.

Our team of attorneys at Gordon, Edelstein, Krepack, Grant, Felton & Goldstein (GEKLAW) helps workers in California do just that and guides you through the legal process so that you are informed of your rights regarding payment of temporary disability benefits for a work-related injury.