workers comp questions

[JenLHar]

What is the name of your state? California

My husband works for the county(they are self-insured). He hurt his knee at work and was approved for surgery(which has been done) and physical therapy (which he is still going to). He has not been released to go back to work yet. My question is can his employer make him use his vacation and sick time or is he supposed to get checks directly from the workers compensation insurance company? Right now they are doing both-using a little bit of his vacation and sick time each pay period and the rest from workers comp. He will have completely used up all of his vacation and sick time after the next pay period. Can his employer take away his medical benefits(or make him pay for COBRA benefits) if he does not go back to work soon? Also, should workers compensation pay just for his medical needs and wages or will he get settlement when he is released to go back to work? If so, how does that process work? Can he counter offer and ask for more than what they offer? We haven't needed an attorney up to this point as things have been moving along pretty well-he didn't have to wait long to have his surgery done, etc. Would it be worth it to get an attorney at this point? Thank you for your help.What is the name of your state?

 

[weenor]

What is the name of your state? California

My husband works for the county(they are self-insured). He hurt his knee at work and was approved for surgery(which has been done) and physical therapy (which he is still going to). He has not been released to go back to work yet. My question is can his employer make him use his vacation and sick time or is he supposed to get checks directly from the workers compensation insurance company?

If his doctor is saying that everything is work related then the insurance company should be paying him 662/3% of his average weekly wage. Is it possible that the employer is trying to make up the difference between what comp. is obligated to pay and his regular average weekly wage? If so, they can use vacation and sick time to make up the difference.

Right now they are doing both-using a little bit of his vacation and sick time each pay period and the rest from workers comp. He will have completely used up all of his vacation and sick time after the next pay period. Can his employer take away his medical benefits(or make him pay for COBRA benefits) if he does not go back to work soon?

Yes, if he does not return to work they are not obligated to cover him for the health insurance. Once they send him the COBRA notice the insurance premium amounts that had been paid by the employer are added to his average weekly wage to increase his comp. rate (if he is not already at the max allowed by law)

Also, should workers compensation pay just for his medical needs and wages or will he get settlement when he is released to go back to work? If so, how does that process work?

If he is given an impairment rating by the doctor, he will be entitled to that rating times the number of weeks in the schedules listed under the workers' compensation statutes, subject to the statutory weekly maximum amount.

Can he counter offer and ask for more than what they offer?

He can always counter. However, please know that the insurance company will likely pay very little over the amount provided by law. There is NO pain and suffering or mental anguish or any of that other stuff.

We haven't needed an attorney up to this point as things have been moving along pretty well-he didn't have to wait long to have his surgery done, etc. Would it be worth it to get an attorney at this point? Thank you for your help.What is the name of your state?

It may be worth it for you to get an attorney unless you understanding the workers' compensation statutes. The attorney is limited by law as to the amount he/she can charge (%), but they would be entitled to some money for handling the settlement negotiations. Note: it will do you no good to get a lawyer that doesn't understand workers' compensation.