Workers’ compensation benefits may be available to California law enforcement officers who suffer an on-duty injury or illness. This includes compensation for the injured officer’s medical treatment and loss of income. However, California provides special benefits to law enforcement that are not offered to workers in other industries.
Typically, employees who are diagnosed with an occupational disability and are unable to work or perform their job’s regular duties may receive temporary disability benefits amounting to two-thirds of their lost wages. However, law enforcement officers in California will continue to receive their full salary while they recover from an occupational disability.
Under California Labor Code § 4850, law enforcement officers who suffer a work-related disability, whether temporary or permanent, will continue to receive their regular income throughout the duration of their disability, not to exceed one year. However, these benefits will end sooner if the officer retires with a permanent disability pension or begins receiving disability pension payments. The officer will stop receiving disability benefit payments one year from the date he or she became disabled or when one of these events occurs, whichever happens first.
If a physician determines that a law enforcement officer is still disabled and unable to work after one year, the officer is entitled to two-thirds of his or her pre-injury income. The officer will continue to receive these benefits, known as aggregate disability benefits, for up to one year. However, law enforcement officers can only receive 104 weeks of aggregate disability benefits within a five-year period for each injury causing temporary disability, according to California Labor Code § 4656.
Once 104 weeks has passed since the officer first suffered an occupational injury, he or she can no longer receive aggregate disability benefits. However, officers may be entitled to receive up to 240 weeks of aggregate disability benefits for certain injuries and medical conditions, such as:
When a law enforcement officer is killed on-duty, California Labor Code § 4856 requires law enforcement agencies to continue providing health benefits to the officer’s spouse. In California, a fallen officer’s surviving spouse or dependents may receive:
In cases where a fallen officer has a child or cares for a dependent minor under the age of 18, the child may continue to receive health benefits coverage provided to the officer’s surviving spouse. However, if there is no spouse, the minor dependent may continue to receive benefits until he or she reaches 21 years of age.
According to California Labor Code § 4702, the following amount of survivors dependents will be equally dispersed among the officer’s total dependents:
If one total dependent and one partial dependent can be claimed by the officer at the time of his or her death, the total dependent will receive $250,000 and the partial dependent $20,000.
The officer’s surviving spouse may elect to receive monthly survivor’s benefit payments or a lump-sum payment. If the surviving spouse remarries, he or she will continue to receive survivor’s benefits but cannot add a new spouse or stepchildren to the benefits coverage plan.
If you believe you may qualify to receive workers’ compensation benefits for a law enforcement injury, contact Berry, Smith & Bartell. We have extensive knowledge of California’s Labor Code and the benefits provided to law enforcement officers injured in the line of duty. We will help you understand which benefits you may be entitled to receive.
Law enforcement officers will begin receiving workers’ compensation benefits the moment they become injured and seek medical attention. Your employer’s workers’ compensation insurance will cover the cost of your medical treatment for any occupational-related injury.
If you qualify for disability benefits, you will receive your first payment two weeks after being diagnosed with a temporary or permanent disability that prevents you from working. You will continue to receive disability benefit payments every two weeks after this date.
Unfortunately, insurance companies are known to provide benefit payments after the two-week deadline or will try to delay making the payment. When this happens, the insurance company may be fined for not providing payments on time.
Under [California Labor Code § 5814](https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=LAB§ionNum=5814.), when a workers’ compensation payment has been unreasonably delayed or refused, the benefit payment will be increased up to 25 percent or up to $10,000, whichever amount is less.
In the event that your workers’ compensation benefits payments have been delayed, it may be in your best interest to contact an experienced attorney. He or she will know how to pursue the benefits you deserve from an uncooperative insurer and will help you appeal the decision.
California law enforcement officers are often subjected to unpredictable and physically violent events due to their required duties. The high-risk environment many law enforcement officers are placed in puts them at-risk of suffering serious injury or death.
In fact, an average of 115 law enforcement officers in the U.S. suffered fatal on-duty injuries every year between 2003 and 2014. An additional 30,900 law enforcement officers suffered nonfatal occupational injuries, according to the Bureau of Labor Statistics (BLS).
Among the injuries suffered by law enforcement officers, soft-tissue damage, such as sprained and strained muscles, accounted for approximately 42 percent of reported on-duty injuries, according to a 2017 study. However, law enforcement officers are at risk of suffering several types of on-duty injuries, including:
In 2017, the Federal Bureau of Investigation (FBI) released its annual Law Enforcement Officers Killed and Assaulted report. The FBI found the two most common causes of on-duty injuries were car accidents and assaults. In addition, other common causes of law enforcement injuries include:
When a California peace officer suffers an on-duty injury, he or she may be entitled to benefits through his or her employer’s workers’ compensation insurance. However, law enforcement officers may be entitled to benefits for several types of medical conditions that are considered to be on-duty injuries.
In California, law enforcement officers are provided workers’ compensation benefits for several medical conditions that are considered presumptive on-duty injuries. According to California Labor Code § 3212, presumptive on-duty injuries include:
If you or a loved one has suffered an on-duty injury, contact Berry, Smith & Bartell to learn the workers’ compensation benefits you may be entitled to receive. We have a strong understanding of California’s Labor Code and will help you pursue the maximum benefits you qualify for.
All too often, law enforcement officers are denied the full benefits they need after suffering an on-duty injury. Fortunately, you may be able to appeal an insurer’s decision to deny your claim.
The appeals process begins when you submit an Application for Adjudication of Claim form to the Workers’ Compensation Appeals Board (WCAB). You must submit the claim within one year of either suffering an occupational injury or the last day you received medical benefits. You will receive a notice from the Division of Workers’ Compensation (DWC) when it receives your application. The notice will list your case number and directions on how to proceed.
When you receive your notice from the DWC, you must complete a Declaration of Readiness to Proceed application. Once you have completed the application, you must submit it to the DWC, which will then schedule your hearing. However, before your hearing, you will have one more opportunity to settle your disputed workers’ compensation claim.
The WCAB will schedule you and your employer’s insurer to attend a Mandatory Settlement Conference. During the conference, both parties will have a chance to present their case to a temporary judge in an attempt to resolve the dispute. The judge will review the case each side presents and attempt to reach a resolution. If neither party is willing to accept the settlement terms, the case will proceed to a hearing.
At the workers’ compensation hearing, both sides will once again present their case to an administrative law judge. Similar to a trial, the hearing will open with both sides presenting their case as to why the workers’ compensation claim should be approved or denied.
The administrative law judge will review several aspects of your case, including your medical records, evidence of your loss of income, your employment records, and reports from witnesses or medical or vocational experts. You may also testify on your behalf and be crossed examined by the insurer or its attorney.
If you are disputing a workers’ compensation claim, it is highly recommended that you seek representation from a qualified attorney. He or she will understand why your claim has been denied and begin building a case that supports you suffered an on-duty injury and deserve workers’ compensation benefits.
Your attorney will also represent you during the settlement conference and workers’ compensation hearing. He or she should have strong negotiating skills and will help you reach a fair settlement with the insurer or administrative law judge hearing your case.