Public employees are subjected to separate sets of rules and regulations regarding their workers’ compensation. For instance, local or state employees are governed either by the same California regulations as private employees or special state statutes while federal laws govern federal workers. Other employees like seamen and railroad workers have their separate rules and regulations altogether.
Understanding these regulations so that you can claim your workers’ compensation when injured on the job can be complicated for most public employees. At The Workers Compensation Attorney Group in Long Beach, our work is to help employees interpret workers’ comp laws and help them file a workers’ compensation benefits claim.
If you are a public employee, you have been injured at work, and want to claim your benefits, contact us as soon as possible. Our expert attorneys can help you to receive the compensation you deserve.
Regulations Governing Workers’ Compensation of Different Public Employees
Four separate acts protect the workers’ compensation benefits of federal government employees. A federal worker that has been disabled or killed due to a work-related illness or injury is protected by FECA (Federal Employee’s Compensation Act). This Act protects federal workers regardless of how long they have been on their positions or the job.
Federal employees are eligible for damages for lost income and medical bills coverage. Additionally, they are eligible for vocational rehabilitation in case they’re partially disabled. Federal compensation benefits are managed by the OWCP, the office of Workers’ Compensation Programs, and the payment made through the Employees’ Compensation Fund.
Local & State Employees
In case you are a local government or a state employee, California state statutes that regulate workers’ compensation determine whether or not you’re covered under the state’s program or other provisions. You can learn information about your coverage by looking for the compulsory poster detailing workers’ compensation, which is usually placed at your place of work. The poster provides contact information and information about your coverage. They are posted in an area where each worker can access.
If you are employed by the state of California, you will reach out to the human resources department of California, if you have any questions or claims. If you are employed by the city government or Local County, the same rule applies. That is, contact the department of human resources for any claims or questions as well. If these offices do not solve your problems, seek help from a workers’ compensation lawyer who will help defend your rights.
Seamen, Railroad, and Other Unique Occupations
Multiple federal acts govern the workers’ compensation benefits of special employees. For instance, the Federal Employer Liability Act provides damages for workers that are involved with interstate transportation, like railroad employees who are injured while working. Another act is the Jones Act. This provides recovery for longshoremen, seamen and other maritime employees involved in navigable waters activities. Similar recovery is also provided by the Longshore and Harbor Workers’ Compensation Act.
Other acts that have a significant role in compensating specific employees are; the Death on the High Seas Act, the Defense Base Act, and the Outer Continental Shelf Lands Act. These three acts protect those workers that work on projects of public works, or defense bases outside the United States.
Public Employees’ Compensation Benefits
This kind of benefit is available to injured employees to relieve or treat his/her work-related injury. It includes chiropractic, surgical, medical, and acupuncture treatment. Hospital treatment, which incorporates medicines, nursing, surgical and medicine supplies, apparatus like prosthetic and orthotic devices, and crutches are also included (Labor Code 4600). One’s medical treatment methods and procedures must be subjected to Utilization Review.
These payments are made based on two-thirds of the worker’s average weekly wages. If you are eligible for this, the State Fund will disburse it to you after every two weeks. The legislature is the one that sets the maximum and minimum temporary disability rates.
Injured workers that have enough leave credits may supplement their temporary disability payments. However, their temporary disability payments added together with their supplemental checks cannot exceed their net income.
Temporary disability payments are directly sent to you by the State Fund. The payments have no voluntary or compulsory deductions withheld. The supplementation payments, on the other hand, are paychecks disbursed by the office of the state controller and paid through your employer. They are subject to all compulsory deductions, which include retirement contributions, taxes, union dues, and garnishments. Voluntary deductions like dental, health, and life insurance may also be made. These deductions will only be made on your payments if you have enough leave credits. Compulsory deductions are given priority over the voluntary ones.
Note that you are eligible for nonstop dental, life insurance, and health benefits even if you opt not to supplement your temporary disability payments.
Temporary disability benefits
These are payments to compensate for lost income. They are given to you while recovering from a work-related illness or injury, and you are incapable of returning to work. As per Labor Code 4650.5, the payments have to commence within two weeks after you notify your employer that you have suffered an on-the-job illness or injury, except if the employer challenges your claim for compensation benefits.
No payment should be expected for the first three days except if; the disability goes past two weeks, you are hospitalized or are a victim of criminal assault. You will be granted Administrative Time Off for the time that you lost on the day you got injured.
Permanent disability benefits
The purpose of these payments is to compensate for the disfigurement or permanent physical injury you suffer while on the job. You can get a permanent disability rating and go back to work on full duty.
Supplemental job displacement benefits
If you have a permanent partial disability and you are unable to go back to work, you may be entitled to a supplemental job displacement benefit voucher. The voucher amount is subject to the severity of the permanent partial disability. You will be given this at your claim settlement hearing.
The voucher amount is $6,000. You can use it to cater for skill enhancement or retraining at a school accredited or approved by the state, expenses related to the education, and the fee of your rehabilitation counselor. You will be given this voucher when you reach the maximum level of medical improvement.
These benefits are given to the surviving partial and total dependents of the dead employee. The payments are made in installments until the whole amount is paid. Additionally, the employer has to pay a reasonable amount for burial expenses that are not to be more than $10,000.
Special Compensation Benefits for Specific Public Workers in California
California public employees who place themselves at risk on their jobs like those working in firefighting or law enforcement are bound to get special compensation benefits or make use of the lower standard of proof to get their entitled compensation benefits if they are injured at work.
The special benefits affect the ability of the injured employee to claim his/her entitled benefits. They may also be given to the family of the employee if the employee passes away in the line of duty. In California, all public workers receive regular compensation benefits.
The following are the special compensation benefits and advantages to certain public workers;
Benefits of Leave of Absence
Public workers that are sworn members of the California Highway Patrol Department and fire-fighting are eligible for a year of complete salary instead of them receiving temporary disability. Benefits for leave of absence is a special and additional benefit for the employees that face inherent dangers while working. The benefits are different from medical or family leave.
For instance, James is a fireman. While in his line of duty, he dislocates his knee. His doctor diagnoses a temporary disability that will last about six months. Since he’s a public worker and in a firefighting department, he receives a full salary pay for six months instead of him getting temporary disability.
Public employees that are not covered here are eligible for temporary disability. The benefits are 2/3 of their average weekly wages.
The benefits of leave of absence don’t apply to the following situations:
- To employees of the firefighting or law enforcement who are not involved in activities of firefighting or law enforcement: For instance, clerks, machinists, telephone operators, stenographers, and mechanics.
- After the employment ends: These benefits don’t apply in case the public worker has retired, resigned, or if he or she has been dismissed.
This is when a public worker is permanently incapable of continuing with work because of a work-related injury he or she sustained. It’s a separate benefit that still is from an on-the-job injury.
Safety officers of California who sustain a work-related injury are entitled to disability retirement irrespective of their age or the time they were employed. The employee that is injured has to be a member of the Public Employees Retirement System of California (CalPERS) or in a county retirement system for him or her to stand a chance.
You are eligible to claim disability retirement benefits only if one of these situations applies. You have to apply:
- While still on the job,
- Within four months of doing the job,
- While absent from your duties because of military service,
- If you are mentally or physically incapacitated from your last date of reporting on the job to the date of application,
- While on a permitted leave of absence.
Note that CalPERS may request the appeals board of the workers’ compensation to determine whether or not there’s a work-related injury, but they can’t inquire on any other findings; you will undergo a distinct medical examination to determine the findings.
Presumption of a Work-Related Injury
Public workers involved in firefighting or police activities don’t have to provide evidence that any of these diseases are work-related; hernia, pneumonia, cancer, and heart trouble.
If you are in these professions and you are diagnosed with either of the conditions mentioned above, it is automatically assumed that the condition was as a result of work. For other employees, they have to prove how the condition is connected to work.
As provided by CalPERS, there are specific safety officers who are eligible for special death benefits. The surviving members of the family of this employee are to claim the benefits.
These benefits go to the deceased’s spouse throughout his/her entire lifetime. The deceased’s children that are below 22 years old are also entitled to these benefits. The death benefits amount is normally a given percentage of the salary of the deceased.
A CalPERS member is not eligible for the ordinary death benefits of workers’ compensation. They are only given up to $10,000 for burial expenses.
For instance, Stella’s husband, a detective, died after sustaining a work-related injury. Stella may try to obtain up to $200, 000 of ordinary death benefits. However, the death benefits provided by CalPERS will grant her a certain percentage of her dead husband’s salary for her entire life. The percentage of the salary she will receive will most likely be higher than what the ordinary workers’ compensation program would have given her.
Health Insurance Benefits
If you are a firefighter or a law enforcement officer and you die in the line of duty, your spouse is entitled to health insurance compensation benefits.
Ordinary workers’ compensation benefits attempt to fairly recover damages for all employees that have sustained work-related injuries in California. However, due to the risk that certain public workers are exposed to in their line of duty, they are eligible for additional types of benefits.
If you are a public employee, you need to know what kind of benefits you are entitled to and ensure that you are compensated appropriately. An experienced workers’ compensation attorney can help you claim the benefits.
CalPERS and Workers Compensation
CalPERS is an agency in California that has the mandate to manage health benefits and the pensions for public workers of the state, the retired employees, and their families. In case you have been employed by California State, or you have an agency that contracts with this body, you are most likely entitled to get retirement benefits from CalPERS.
If you have been injured at work, in addition to filing your ordinary workers’ compensation claim, you can also file a disability retirement claim to CalPERS. It is possible for you to receive benefits from these two systems at concurrently.
Note that your claim for a disability retirement can be better compared to your compensation claim. This is because if your disability retirement claim is approved, you will be entitled to monthly retirement benefits for your entire life or up to when you heal from your illness or injury. On the other hand, in most cases, compensation claims benefits don’t offer disability payments that last a lifetime.
CalPERS and an ordinary workers compensation program work hand in hand because if you’re a public worker and member of the CalPERS, you might be entitled to disability retirement benefits. Similarly, in case you’ve sustained a work-related injury that leads to permanent disability such that you cannot perform your regular job-related duties, you may need to seek disability retirement benefits.
Your compensation claim can be a big boost that can help you get disability retirement benefits. This is because it will help you to prove the needed aspects for you to obtain the benefits. Your compensation claim will provide medical opinions regarding your injury. Your case will enable you to acquire the medical records you need to support your application of disability retirement.
Note that being granted workers’ compensation benefits doesn’t automatically qualify you for disability retirement. The medical proof needed to get disability retirement benefits has to meet the definition of disability as provided by CalPERS.
How to File a Workers’ Compensation Claim for Public Servants
Just like an employee of the private sector, a county, local government or state employee files his or her compensation claim with the insurance company chosen by his/her specific employer. Since there are different requirements concerning whom a public employee reports his or her work-related illness or injury to, these employees should consult their seniors on the process of filing a workers’ compensation claim.
The first thing you should do when you sustain a work-related injury or illness is to report your condition to your supervisor or a selected workers’ compensation administrator immediately, even if the illness or injury appears to be minor. The reason for this is, public employees are often exposed to hazardous conditions at their place of work and they may not at first notice complications caused by what seems like a minor illness or injury they suffer. For instance, even though it may look like a bruise, the injured employee could be bleeding internally or may have fractured bones.
Why a Public Employee’s Workers’ Compensation Claim May be Denied
Not all compensation claims that are filed under the workers’ compensation program are successful. Most of them get denied, and these are the reasons for denial;
No adequate evidence to show that the illness or injury is work-related - There are situations where it is difficult to prove that your illness or injury occurred in the place of work. Medical examinations, together with supporting proof, should be enough to substantiate your claim, but some employers would want more proof. You should consult with your attorney before you file the claim. The attorney will help you with the whole process, including choosing the best evidence to present.
Failure to file your claim on time - In California, the timeframe for filing a workers’ compensation claim for public employees is six months. Your claim will most likely be denied in case you file it after the stipulated period.
Failure to seek medical treatment - Several of compensation claims have to be backed by medical proof. If you fail to see a doctor so that your injury is diagnosed and treated, your employer can easily deny the injury being work-related, which may damage the process of getting your benefits.
Failure to timely notify the employer of your injury - In California, you have 30 days to inform your employer of your work-related injury. If you don’t comply with the timeframe and tell after so much time has passed, your claim will most likely be denied.
Your employer may contest your injury - In certain cases, your employer can challenge the claim that your illness or injury resulted from work. The employer may claim that the injury happened because of your recklessness, and it is in no way connected to the kind of tasks you perform on the job. If the employer has solid evidence, you may lose your case and your claim denied. You need to have a skilled attorney who may be able to gather solid proof to dispute your employer’s claims. Remember the state and your company also have attorneys representing them.
Your injury or illness is not covered by the workers’ compensation program - Certain illnesses or injuries are not compensable under the workers’ compensation program. For instance, injuries that are stress- related are denied by most workers’ compensation insurance. However, the state of California provides that these injuries be covered by compensation claims.
Find a Public Employee Workers’ Compensation Attorney Near Me
If you’re a public employee who has sustained a work-related injury or illness, you are probably having a hard time trying to get your injuries treated and figuring out the next steps you need to take to claim your benefits. Even further, you are probably confused about what laws apply to you and whether your union can help. For all these concerns, a workers’ compensation attorney can help.
At The Workers Compensation Attorney Group, we have expert attorneys who will assess your case, help you to understand the law, and help you with the entire process of filing a workers’ compensation claim. Call our Long Beach workers compensation attorney at 714-716-5933 and share with us the details of your case. We serve clients in Long Beach, CA, seeking help on matters with the workers’ compensation law.