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Are Long-Term Injuries Covered by Workers’ Comp?

Woman in wheelchair

Workers’ compensation helps you get back on your feet after suffering an injury at work or while working. It is meant to provide for medical bills and possibly some wage replacement until you can come back to your regular or new work duties. But what happens if you suffer a serious injury that will last for months? Years? Can workers’ compensation provide benefits for long-term injuries?

The simple answer is that workers’ compensation can provide benefits for long-term injuries. However, where you live, your benefits, your wages, and the severity of your injuries can all affect how long those benefits will ultimately last.

“Permanent & Stationary” Medical Condition

Doctors will often describe a patient’s medical condition as “permanent and stationary” if they are not believed to be capable of recovering further. In some contexts, this status is also called maximum medical improvement (MMI).

If your doctor has said you have reached your MMI or permanent and stationary status, they should create a report that explains your situation in detail. Within this report, there will likely be information about your necessary future medical treatments, how likely it was that your disability was caused directly by your work injury, and whether you have new work limitations because of your lasting injury. This report will be sent to the insurance company managing your workers’ compensation claim, which starts the next step in the process.

Disability Ratings & Long-Term Benefits

Based on the information in your disability report, and how much your disability changes your “activities of daily living (ADL),” you will be assigned a disability rating. If your injuries are expected to never fully recover, then it will technically be a permanent disability rating. Other components of your disability and living will also affect your disability rating, including your age, your typical job expectations, and more.

Your final disability rating will be interpreted as a percentage. 100% is the only way you can be considered permanently and totally disabled. Any other percentage rating will mean you are permanently and partially disabled. This difference might seem slight, but it is actually quite important.

When you are considered to have a permanent partial disability, you can receive wage replacement benefits through a workers’ compensation insurer for only so many weeks. The total count of weeks will differ based on your disability rating. In California, permanent disability payments without total disability can last up to 14 years but can be as brief as 4 weeks. But if you are considered to have a permanent total disability, then you could be eligible to receive lifelong disability benefits with no expiration through lifetime pension payments.

Getting Fair Compensation for Your Work Injury

Insurance companies do not like paying permanent total disability benefits to claimants because the money the claimant is owed can be substantial. They would also prefer not to pay out a permanent partial disability claim. You can expect some resistance when trying to file a claim. You might even be offered a settlement to close your claim quickly, but that settlement amount is probably much smaller than what you deserve.

To file and manage a claim confidently, you should team up with a professional workers’ compensation attorney. Using their familiarity with the law and with insurance company tactics, they can navigate your claim and insist that you are offered a maximized amount of benefits after an injury stops you from working for an extended time.

If you need legal help in Northern California for a workers’ comp claim, call the Law Offices of Larry S. Buckley at (530) 413-0245 today. We offer free consultations to inquiring clients, so there is no risk to learn more about your case.