Law Offices of Edward J. Singer APLC

Home » Blog » Total Temporary Disability

SUBWAY FAST FOOD MANAGER RECEIVES KNUCKLE SANDWICH FROM CUSTOMER: INJURED WORKER IN THE NEWS,#115

Posted on May 13, 2024 by Edward Singer

The Nypost.com reported that, in California, a Subway Sandwich Store Customer committed an act of violence against a Store Manager. After he became enraged over a dispute over “extra meat” on an order, the customer proceeded to go around the counter and started striking the Subway Store Manager.

The manager is quoted as saying: “He punched me and all I could remember is just black.” It is reported that she sustained a black eye and a swollen cheek. It is also reported that the Manager claimed that her injuries have made her remain off of work for more than a week and that this has placed stress upon her family finances. She reported that her eye was shut and therefore she was not able to work. She reported that she is scared and that cannot feel half of her face. She feels that like there is some permanent damage as the face is numb. Nypost.com

The issues raised within this fact pattern will be addressed under California Workers’ Compensation Law.

How is The Manager Going to Receive Workers’ Compensation Benefits?

In this instance, it is essential that the claim be filed with Subway. The claim, which should be accepted, entitles her to get her medical treatment paid for as well as receive monetary compensation. Being the manager, this worker should be well aware of this process. She should complete a claim form and submit the matter to the Workers’ Compensation claims department as soon as possible. This will allow her to get medical attention right away.

What About Benefits For Her Time Off Of Work?

Her doctor, given her symptoms, should have made an assessment as to whether she is able to work. In this worker’s instance, the inability to drive may not be an indication that she cannot perform her job. If she was required to use a car to perform her job, it would appear that she would be considered eligible to be off of work. Surprisingly, the physical inability to transport to work may not be sufficient to justify disability benefits. One’s personal transportation choice, in many circumstances, is not considered part of the job description. Thus, this worker might require additional reasons as to why she cannot perform her job based upon her injuries.

When Do Her Workers’ Compensation Benefits Begin?

Per Labor Code Section 4650(a) (a) If an injury causes temporary disability, the first payment of temporary disability indemnity shall be made not later than 14 days after knowledge of the injury and disability, on which date all indemnity then due shall be paid, unless liability for the injury is earlier denied. In this instance, the Store Manager should get paid fourteen days after she was out. This is subject to her having the proper note.

Are There Any Red Flag Matters In This Case?

Yes. The fact that she went black and has no memory related to the matter may mean that she suffered a brain injury. This might indicate she suffered a concussion. A concussion could be justification for her being off of work. Likewise, the numbness on the side of her face is also concerning. It is important that this individual be evaluated by a neurologist. Thus, her Primary Treating Physician should make such a referral.

What If I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

MTA WORKER SMASHED IN HEAD: INJURED WORKER IN THE NEWS, #114

Posted on May 9, 2024 by Edward Singer

An MTA Train Conductor was randomly whacked in the head with a glass bottle. The 38-year-old MTA worker was taken to the hospital and was reported to be in stable condition. Nypost.com

This article will discuss this fact pattern within California Workers’ Compensation Law.

Does The Term “Stable” Have Any Meaning Within Workers’ Compensation?

No. The term “stable” does not mean anything within California Workers’ Compensation Law. The term “stable”, however, can be interpreted by Medical Providers to mean something else.

In California Workers’ Compensation, there is terminology in place to describe an Injured Worker’s disability state. These “legal” terms can trigger either the payment or the cessation for payment of benefits. For instance, for injuries which prevent an individual from performing their job. the term “totally temporarily disabled” would apply.

There are lesser forms of disability as well. For example, an Injured Worker could be assigned a work limitation such as “no lifting above 50 pounds.” Also, there is the term “permanent partial disability”. This means that the individual has some residual disability. This can include work limitations.

Permanent partial disability status will likely trigger the cessation of total temporary disability payments.

Finally, there is “permanent total disability.” This means that the individual is permanently incapable of working. This finding may trigger the payment of permanent disablity payments.

Finally, and relevant to the pending fact patter is the term “Maximum Medical Improvement.” (MMI) According to the AMA Guides to the Evaluation of Permanent Disability, 5^th Edition, Maximum Medical Improvement which “refers to a date from which further recovery or deterioration is not anticipated, although over time there may be some expected change.” The AMA Guides indicate that “an impairment should not be considered permanent until the clinical findings indicate the medical condition is static and well stabilized.” Thus, the question is whether someone who is “stable” would be considered as MMI. MMI status most likely terminates the payment of total temporary disability payments. In this fact pattern, it is possible that an evaluator could interpret the term “stable” as MMI.

What If I Need Advice?

DID THE WORKERS’ COMPENSATION SYSTEM LET A BATTERED TEACHER DOWN? INJURED WORKER IN THE NEWS, #103

Posted on November 22, 2023 by Edward Singer

The Workers’ Compensation System is not without controversy or flaws.

A Florida Instructor’s highly publicized work injury illustrates a benefit payment kerfuffle. How the workers’ compensation works has made a Teacher/Paraeducator struggle post-injury to make ends meet. A student had criminally assaulted her and, as a result, suffered severe injuries.

This article analyzes how a Seriously Injured Worker’s benefits can be terminated. The article’s analysis is under California Worker’s Compensation Law.

Despite suffering five broken ribs, receiving a severe concussion, sustaining a hearing loss, and having slowed speech, this brave Educator returned to the workplace. In the news account, she stated, “Unfortunately, a lot of my injuries that are not visible I’m going to have for the rest of my life.”. According to Dailymail.com, “[t]he educator said she has been struggling to resolve her workers’ compensation case.” She returned to work in a different job title. Since then, she has gone on unpaid leave. Nypost.com

How Do Temporary Disability Benefits Operate?

In the Workers’ Compensation System, temporary disability(TTD) benefits are paid when an individual cannot work their usual and customary occupation. The determination is made through a physician. There are times when an Injured Worker is determined to be able to perform limited work, i.e., light duty. In those instances, if the employer cannot accommodate the temporary work restrictions, the Injured Worker will continue receiving temporary disability benefits. With temporary disability benefits, there is a cap. For many injuries, the cap is at 104 weeks.

Did The Teacher’s Return To Work Impact Her Benefits?

Yes. In California Workers’ Compensation Law, an Injured Worker’s right to receive temporary disability benefits terminates when they return to work. This termination can occur when one returns to an alternative or modified work position. Thus, to receive renewed temporary disability benefits, the Injured Worker must re-establish their medical status via a medical provider. In the fact pattern presented, it would appear that the Teacher did not get medically certified despite going off of work again. Thus, no obligation was triggered to obligate the carrier to resume the payment of TTD benefits.

What If I Need Legal Advice?

If you want a free consultation regarding workers’ compensation, please get in touch with the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 30 years. Contact us today for more information.

At SpaceX, Worker Injuries Soar Amidst Elon Musk’s Race to Mars: Injured Workers in the News, #101

Posted on November 14, 2023 by Edward Singer

Elon Musk’s SpaceX Company has been beset with work injuries. According to the DailyMail.com, the injuries have included cuts or lacerations, broken bones, dislocations,, hands or fingers were ‘crushed,’ head injuries, skull fractures, concussions and a traumatic brain injury. Further, there have been burns and eye injuries.

There are allegations of safety failures.

Specifically, in California, the article reports that “[s]enior managers at the Hawthorne, California site had been repeatedly warned about the dangers of rushing the engine’s development, along with inadequate training of staff and testing of components.”

This article will discuss the nature of these work accidents and the special benefits that may apply.

What Special Benefits Can Be Received For Amputations, Burns or Eye Injuries?

In California, there are special extended total temporary disability benefits in the case of amputations, burns and eye injuries. With respect to burns or eye injuries, there are special criteria which apply. Labor Code 4656(c)(3), provides: (c)(3) Notwithstanding paragraphs (1) and (2), for an employee who suffers from the following injuries or conditions, aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury: (A) Acute and chronic hepatitis B. (B) Acute and chronic hepatitis C. (C) Amputations. (D) Severe burns. (E) Human immunodeficiency virus (HIV). (F) High-velocity eye injuries. (G) Chemical burns to the eyes. (H) Pulmonary fibrosis. (I) Chronic lung disease.”

Thus, for burn injury claims, an analysis must be made as to whether it could be considered as “severe”. With respect to eye injuries, there must be a causation analysis. Was the accident caused by a fast-moving object? Did chemicals cause burns to the eyes?

If There Had Been Repeated Warnings of Dangers, Can This Trigger Additional Compensation?

Labor Code Section 4553 provides for increased compensation if there is serious and willful misconduct. This requires a separate filing and has a different statute of limitation applicable. Serious and Willful Claims usually requires a finding from the Workers’ Compensation Appeals Board. Labor Code Section 4553 indicated “The amount of compensation otherwise recoverable shall be increased one-half, together with costs and expenses not to exceed two hundred fifty dollars ($250), where the employee is injured by reason of the serious and willful misconduct of any of the following: (a) The employer, or his managing representative. (b) If the employer is a partnership, on the part of one of the partners or a managing representative or general superintendent thereof.(c) If the employer is a corporation, on the part of an executive, managing officer, or general superintendent thereof.”

What If I Need Legal Advice?

Store Clerk Set On Fire by Shoplifter: Injured Workers in the News, #91

Posted on October 3, 2023 by Edward Singer

In California. a Bay Area Clerk suffered a horrendous work injury. He was set on fire by a homeless serial shoplifter. Dailymail.com It is reported that the Clerk suffered second and third degree burns to his face, neck, chest and shoulder.

This article will discuss the special benefit that an Injured Workers are entitled to receive when they suffer from a burn injury. This article will also how this special benefit can be a source of controversy.

What is the Special Benefit that Injured Workers Who Have Burn Injuries Can Receive?

California Workers’ Compensation Law provides for extended total temporary disability benefits for certain injuries. Burn injuries fall within this eligibility for extended benefit.

Labor Code Section 4656, under section (c) (1) provides that the “Aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability shall not extend for more than 104 compensable weeks within a period of two years from the date of commencement of temporary disability payment. (2) Aggregate disability payments for a single injury occurring on or after January 1, 2008, causing temporary disability shall not extend for more than 104 compensable weeks within a period of five years from the date of injury. (3) Notwithstanding paragraphs (1) and (2), for an employee who suffers from the following injuries or conditions, aggregate disability payments for a single injury occurring on or after April 19, 2004, causing temporary disability shall not extend for more than 240 compensable weeks within a period of five years from the date of the injury: (A) Acute and chronic hepatitis B. (B) Acute and chronic hepatitis C. (C) Amputations. (D) Severe burns. (E) Human immunodeficiency virus (HIV). (F) High-velocity eye injuries. (G) Chemical burns to the eyes. (H) Pulmonary fibrosis. (I) Chronic lung disease.

Based upon the statute, the Injured Worker must suffer from a “severe” burn injury in order to obtain the extended total temporary disability. The question is “what is a severe burn injury?” Due to the vagueness within the statute, one must look at case law.

What Does Case Law Indicate About Severe Burns?

In the case of Parco vs. WCAB 83 C.C.C. 1288 (writ denied), it was found that “Applicant claimed that he suffered industrial injury to his left thumb, left hand, and the skin on his left thumb while employed by Defendant Parco, Inc., as a machinist on 8/30/2013. The medical treatment records indicated that Applicant suffered second and third degree burns to his left hand and also underwent three surgeries on his left thumb. Qualified medical evaluator David Doty, M.D., testified in his deposition that, as a result of Applicant’s crush injury, tendon damage, and the fracture of the bone and subsequent surgery with bone removal, Applicant had a 7mm shortening of his left thumb.”

“At trial, the WCAB found “Based on the medical evidence, the WCJ found, in pertinent part, that the 104-week limit for TD benefits did not apply to Applicant, and that Applicant was entitled to additional TD payments through 1/5/2016 based on the exceptions to the TD limitation for amputations and severe burns set forth in Labor Code § 4565(c)(3)(C) and (D).”

“The WCJ recommended that reconsideration be denied. In her report, the WCJ pointed to medical evidence that Applicant suffered second and third degree burns on his hand. The WCJ explained that the Labor Code does not require the “most severe burns to constitute an exception to the cap on TD, but merely “severe burns,” and that second and third-degree burns were sufficiently severe to meet the exception.”

While the case addressed the amputation exception, the court also noted that “it appears that applicant suffered “severe burns” in the course of his injury. Either of these factors is an appropriate basis for implementing the exception to the 104 week limitation on temporary disability benefits. (Lab. Code § 4656 (3) (C) and (D).)” Defendant’s petition for writ of review was denied.

In sum, the matter of what constitutes a “severe burn” is still a source of controversy. With respect to the facts of the present case, it would appear that the substantial nature of the burns would likely tip the scale in favor of the exception. Specifically, the facial burn would be something that would likely sway a court as to the severity of the burn. In the present matter, it would appear that the nature and extent of the burns as well as the extent of the medical treatment most likely would be determinative.

What If I Need Legal Advice?