AMA Guides: The impairment ratings provided in the AMA Guides are “designed to reflect functional limitations… that is, they, ..reflect the severity of the medical condition and the degree to which the impairment decreases an individual’s ability to perform activities of daily living.”
California State Disability Insurance is a partial wage replacement insurance plan for California workers. Worker’s covered by SDI are covered for two benefits: Disability Insurance and Paid Family Leave. Worker’s who suffer a loss of wages when they are unable to work qualify for State Disability if qualified. You must be unable to do your regular or customary work for at least eight (8) consecutive days to collect State Disability.
To qualify you must be employed or actively looking for work at the time you become disabled. You must have lost wages. You must be under the care of a licensed physician or some weird alternative who certifies you for the State Disability benefits. During the year 2014 benefits have a minimum weekly payment
of $50.00 and a maximum of $1075.00 per week. Under State Disability, the disabled person may collect for up to 52 weeks generally. Contact the Employment Development Department at edd.ca.gov.
Persons injured at work can apply for State Disability as a backup for Temporary Total Disability through Worker’s Comp. You can’t collect both at the same time but you can always refuse State Disability if being paid TTD. Additionally, by applying for State Disability you will preserve you right to file in the future when your temporary disability from Worker’s Comp is exhausted.
Government Code Section 12900 et seq (FEHA) provides that it shall be a unlawful employment practice for any employer to refuse to grant a request by any qualified employee to take up to a total of 12 workweeks in any 12 month period for family care and medical leave.
Privately retained doctor’s reports and opinions are admissable in disability hearings but cannot be the sole basis for an award of compensation. In other words, the WCAB can consider these non MPN doctors opinions but cannot award compensation solely on their opinion. These opinions can be considered by MPN physicians or by QME doctors who have evaluated the applicant and who concur.
Labor Code Sections 5410 and 5804 provide that the WCAB has no jurisdiction to alter or amend an award beyond five (5) years from the date of applicant’s injury, when applicant did not file a timely petition to reopen for new and further disability or for a change of law.
An opinion of a Vocational Rehabilitation expert must be based on a labor market survey or research or exploration into the issue of whether applicant can work outside his home to constitute substantial evidence and be relied on by the WCAB.
In determining the degree of Permanent Disability the medical examiner may consider the synergistic effect of applicant’s injury, any surgeries, whether further surgery would be beneficial, the effects of pain medication and the conclusion of a vocational rehabilitation expert that the applicant is not feasible for vocational retraining and has no future earning capacity, and is thus, permanently totally disabled.
Labor Code Section 4664 states that if an applicant has received a prior permanent disability award, that award is presumed to be in existence at the time of any subsequent industrial injury. In other words, the disability from the first injury will be subtracted from the second injury.
Labor Code Section 5412 provides that the date of injury on a cumulative injury is the date upon which the employee first suffered disability therefrom and either knew, or in the exercise of reasonable diligence should have known, that such disability was caused by his present or prior employment