Beyond Comp: Benefits and Protections beyond Comp
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E.D.D. (State Disability Insurance):
California State Disability Insurance (SDI) is a partial wage-replacement insurance plan for California workers. SDI provides short-term benefits to eligible workers who suffer a loss of wages when they are unable to work due to a non-work related illness (See Below IMPORTANT NOTE) and injury, or a medically disabling condition from pregnancy or childbirth. The majority of California workers are covered. There are some individuals who are exempt. To qualify, the worker must meet all of the following requirements, be unable to perform their regular or customary work, have a loss of wages because of their disability, be disabled for more than eight calendar days, be under the care and treatment of a doctor or practitioner who certifies that they are disabled, file a timely claim, be employed or actively looking for work when their disability begins, and have earned a specified amount from which SDI taxes were withheld during a previous 12 month base. The benefits can last up to one year. For disabilities beginning 1/1/00, the weekly benefit ranges from $50.00 to $490.00.
IMPORTANT NOTE: Although SDI is for non-industrial illnesses, if A WORKER IS NOT BEING PAID from the workers’ compensation claims administrator TTD benefits, the worker should immediately apply for SDI and advise SDI that they have applied for workers’ compensation, but are receiving them.
Please note that the State, recently, has begun tracking individuals who are receiving State Disability. A worker should be prepared to attend an examination on behalf of the State which may determine whether they are entitled to remain on benefits. If the worker disagrees with the determination, they are entitled to appeal. A worker should look in their local phone book under the State of California to obtain the number for their local department.
Social Security Benefits:
In event of either disability or death, benefits may be available from Social Security for both the disabled person and his or her family. If a worker is no longer able to work because physical or mental reasons, they may be eligible for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) disability payments, or for Medi-Cal. A worker may apply for SSDI or SSI at any Social Security Office and for Medi-Cal at the local welfare department. The disability requirement for the program is that the worker must be unable to perform any “substantial” work due to a physical or mental condition which has lasted or can be expected to last for at least a year, or can be expected to result in death. The worker’s impairment must be severe enough to prevent them from working not only their job but in any other occupation considering their age, education, training, and work experience. To eligible, the worker must have contributed funds into the Social Security Trust fund. It is recommended that the worker contact Social Security to determine whether they are eligible for the benefits. Further, the worker may also be entitled to Medi-Care. Also, to qualify for Social Security, not all of worker’s disabilities need be industrial. You can qualify on non-industrial disabilities alone as well as a combination of both.
IMPORTANT NOTE: If a worker believes that he or she may qualify, they should file their paperwork as soon as possible. Further, both a Social Security Claim and a Workers' Compensation claim may be pursued at the same time.
Government Pensions:
A worker who is employed by either the State, a County, a City or Municipality, may be eligible for a government pension. Government Pensions may provide benefits in addition to workers’ compensation benefits. This may include medical benefits. In addition, certain pensions which are considered service-connected (industrial) may provide additional benefits beyond that of a regular non-service connected pension. A worker should contact their human resources department to find out what pension, if any, is available to them. If you need to get in contact with a pension attorney, please click on the please contact me section.
Third Party Claims:
If another person or company was at fault or contributed to the workers’ injury or disability, the worker may file a civil lawsuit against the person or company that is responsible. For example, the worker, while on company business, may have been rear-ended. Another example is a worker who is operating a piece of equipment and is injured because the equipment is faulty. A lawsuit for product’s liability may be indicated against the manufacturer of the product. If you wish to consult an attorney concerning whether you have such an action, please click on the please contact me section. Note: a Civil action may be pursued at the same time as the workers' compensation case is proceeding.
Short Term and Long Term Disability Policies:
A worker should check to see if they have purchased or participated in a short or long-term disability policy. If so, it is recommended that the worker review the policy and contact the Administrator for the policy to inquire as to what benefits are available. Further, a worker should inquire from their employer to see if they have a Short Term or Long Term Disability Policies within the company.
Department of Social Services:
The California Department of Social Services has a number of programs which may assist the disabled, including, but not limited to welfare. Contact the local department for further information.
Unemployment provides weekly unemployment insurance payments for workers who lose their job through no fault of their own. Eligibility for benefits requires that the claimant be able to work, be seeking work, and be willing to accept a suitable job. A claimant’s benefits are based upon the claimant’s earnings during the base period. The base period is 12 months long and is broken into quarters. The quarter in which the highest wages are required determines the weekly benefit amount. Currently, the maximum weekly benefit is $230.00 per week for 26 weeks. The weekly minimum payment is $40.00 per week. There are extended periods available. A workers should contact their local Unemployment office for complete information and directions on how to apply.
NOTE: For injured workers, unemployment benefits would most likely sought if they have been released from their doctor from being TTD, and has had their employment terminated. Also, it would also be likely sought after the completion of vocational rehabilitation benefits after the maintenance allowance has ceased. There may be further programs available from unemployment such as in assistance in finding employment as well as training. Contact your local office for details.
Department of Fair Employment and Housing (DFEH)
The Fair Employment and Housing Act covers a variety of matters, including those involved with pregnancy and child birth. The specific items which DFEH handles which might be pertinent to an industrially injured worker are that the DFEH (a) prohibits discrimination in all aspects of employment including hiring, termination and terms and conditions; (b) prohibits harassment of employees or applicants and requires employers to take all reasonable steps to prevent harassment from occurring; (c) requires that all employers provide information to each of their employees describing the forms of sexual harassment, its illegality, the internal and external complaint processes and legal remedies; (d) requires employers to reasonably accommodate employees or job applicants with disabilities in order to enable them to perform the essential functions of the job; (e) requires employers of 50 or more persons to allow eligible employees to take up to 12 weeks leave in a 12 month period an employee’s serious health condition, or to care for a parent, spouse or child with a serious health condition (Employers are required to post a notice informing employees of their family and medical leave rights.); (f) requires employment agencies to serve all applicants equally; (g) to refuse discriminatory job orders; to refrain from prohibited pre-employment inquiries or advertising; (h) prohibits discrimination by unions in membership or employment referrals; and (i) prohibits retaliation against any person who has filed a complaint with the Department, participated in a Department Investigation or opposed any activity prohibited by the Act.
The law provides for a variety of remedies which may include, hiring, back pay, promotion, reinstatement, cease and desist orders, damages for emotional distress, reasonable attorneys fees and costs, expert witness fees, administrative fines and court ordered punitive damages.
People who believe that they have experienced employment discrimination may file a DFEH complaint. Complaints must be filed within one year from the date of the alleged discrimination. Persons wishing to file a lawsuit directly in court must obtain a “right to sue” from the DFEH. For information on the processes, call the DFEH within California at 1-800-884-1684, outside of California 1-916-227-0551. Alternatively, a person may seek redress through the Equal Employment Opportunity Commission which is a federal agency and operates under Federal Law. It is recommended that a worker consult a specialist before deciding whether to pursue a DFEH complaint versus an EEOC complaint.
If you would like to consult with an attorney concerning this, please click on the please contact me section of this site.
Victims of Crime (VOC)
The Victim’s of Crime program from the State of California provides assistance to individuals who have been a victim of a qualifying crime involving physical injury, threat of physical injury or, in certain crimes, presumed injury. To be eligible, the crime must have occurred in California. Alternatively, if the victim was a resident of California, a crime out of the State will also qualify. The crime must be reported to the appropriate entities and there must be cooperation with the authorities. The claim can be denied because of the nature of the victim’s involvement in the events leading to the crime. To contact the VOC Program, call them at 800-777-9229 or 800-VICTIMS (842-8467). You can write to the Program at the following address: State Board of Control, Victims of Crime Program, P.O. Box 3036, Sacramento, CA 95812-3036.
NOTE: If a worker has received funds from VOC in connection with their work injury, VOC will file a lien against the workers' compensation claim.
Family Medical Leave Act (FMLA)
FMLA covers all private employers, including non-profit organizations with 50 or more employees and all public employers, including federal, state, city, and local agencies and schools. Persons are eligible for FMLA time off if all of the following apply, the worker works for a covered employee, the worker worked for this employer for at least 12 months or 52 weeks (the period does not have to be consecutive), the workers worked at least 1,250 hours over the period of 12 months, and the worker worked at a location where 50 or more workers are employed or where the number of workers within 75 miles is 50 or more. The worker may take up to 12 work weeks of unpaid FMLA leave in each 12-month period for the following reasons, including for a serious health condition that makes the worker unable to perform their job, to care for a seriously ill child, spouse or parent. The 12 weeks do not have to be consecutive and may be taken at different times for different reasons. FMLA leave does not have to be paid. If the worker has accrued vacation, personal, or sick leave, the worker may be able to use them. Serious medical conditions include on and off the job injuries and illness which incapacitate the worker or a family member for more than three consecutive calendar days. FMLA is enforced by the Wage and Hour Division of the U.S. Department of Labor (DOL) Contact your employer or the DOL for exact information to see if you qualify. Also, the State of California also has a similar provision under CFRA.
Labor Commissioner
The Labor Commissioner has the authority to enforce the Labor Laws of the State of California. The Labor Commissioner has the authority to investigate employee complaints and hold hearings on wage claims and related issues. The claims that the Labor Commission can hear are wage claims, mechanics liens, misrepresentations of conditions of employment, unreturned bond money, unreturned worker tools, vacation pay and severance pay claims, lost wages from certain unlawful discharges, other wage and benefit claims. A worker can file either through the State or the Federal agency concerning their charge. If there is a collective bargaining agreement with binding arbitration, the dispute may be resolved between the union and management.
Union Contract:
Workers belonging to Unions may have additional protections and benefits in addition to Workers’ Compensation Laws. Workers should consult their union officials for additional information and review their contracts and/or Memorandums of Understanding (MOU).
Employee Handbook:
A workers’ employer may provide additional benefits beyond Workers’ Compensation. If a worker has a company that has an employee’s handbook or manual, it is strongly suggested that it be reviewed to see if additional benefits are provided in event of disability or absence.
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