Workman's Comp - What does it cover?

Mrapunzel · 05-03-2006, 05:29 PM

Hiyas all,

My dad is a vented C-1 Inc Quad, 11 months post. My parents and little brother have been living with me and my children for months now; we're starting the process of looking for a place for them to live. My mom is concerned about expenses, etc - while we can budget things to make it work, I've heard "rumors" of different things that Workman's comp in California will cover.

So, anyone know of or experience coverage of or assistance with the following things under W.C. in CA?

- Purchase of a transport van to get my dad back and forth to the hospital, specialists, appointments, (and family functions would be awesome, if allowed)

- A residence - rent, purchase, subsidized living, etc where all three of them can live? Both of my parents are past 55 and could get into a lot of the sr. living communities, but my youngest brother (still at home, obviously) is 9 years old. My mom doesn't work - taking care of my dad and homeschooling my little brother is more than a full time job.

Thanks in advance,

~ Moe

metronycguy · 05-03-2006, 06:43 PM

workers comp is complicated, you need a wc lawyer to help with certain coverage, sometimes you will need to have a hearing if the insurance company denies coverage. definitely take time picking attorneys , there are a lot of horrible wc attorneys. if their attorney doesn't answer questions , find a new one.
i see your father was injured in a MVA , hopefully there wil be some kind of settlement in that case that may pay for items that wc doesn't cover.

http://community.lawyers.com/messageboards/list.asp
is a message boards for wc in californis, i am not sure how good it is , the one for ny state is excellent.

Buck503 · 05-04-2006, 02:23 AM

I live in AZ and I recieve wm's comp. I'm not totally sure about
CA, but I know that here in AZ I get comped every 2 weeks and
all my medical expenses are covered, medicine, Dr.'s visits, equipment,
and vehicle/home adaptions. They are even paying my way through
school so I can work again. With the right attorney, there is a lot
to be had.

I met a couple guys in rehab who where also paralyzed as a result
of a car accident and because they were driving a company truck
they were awarded all the same benifits as I was.

Good luck

SCI-Nurse · 05-04-2006, 08:38 AM

Your father was injured on the job? This is a requirement for worker's comp coverage. In addition, it had to be a job that had CA state worker's comp coverage. Not all employers have this, and federal workers are covered by federal WC, not by CA state.

If he was injured on the job, then I would STRONGLY recommend that you get in touch immediately with a CA state certified worker's comp attorney. Not all attorney's are certified to represent you in CA State WC cases, and this is critical. I hope that your father has not signed any papers with his WC insurance carrier agreeing to any settlement yet. Many WC companies will assign him a nurse case manager as well. This person works for the insurance company, but is supposed to coordinate his care needs, and often will be the one who approves or at least recommends what is covered. Every state's WC program is very different. If you have been reading the papers you will know that our Govenator is very aggressively trying to cut back on what is covered by CA state WC, so it is a moving target right now.

Rarely is rent or purchase of a home covered. Modification of an existing home to make it more accessible may be covered. Sometimes a van will be covered. More often it is just the modifications to a van which you must purchase yourself. Usually at least some homecare PCA or nursing care is covered, but how much varies widely. Medical supplies, medications and durable medical equipment, as well as medical care and hospitalization costs are usually covered.

Is he on SSI or SSDI right now? State Disabililty? Medi-Cal? What are they using for health care insurance right now? If he is not employed, does he have private or group disability insurance? Are they eligible for IHSS for attendant care services?

Again, get an attorney if he qualifies. I am surprised if he is qualified that he is not already in "the system", as this usually gets started during the initial injury, and most regular insurance will ask right away if the injury occured on the job and require that a WC claim be filed at that point.

(KLD)

05-03-2006, 05:29 PM	#1
Mrapunzel Member Join Date: Sep 2005 Location: Southern California Posts: 78	Workman's Comp - What does it cover? Hiyas all, My dad is a vented C-1 Inc Quad, 11 months post. My parents and little brother have been living with me and my children for months now; we're starting the process of looking for a place for them to live. My mom is concerned about expenses, etc - while we can budget things to make it work, I've heard "rumors" of different things that Workman's comp in California will cover. So, anyone know of or experience coverage of or assistance with the following things under W.C. in CA? - Purchase of a transport van to get my dad back and forth to the hospital, specialists, appointments, (and family functions would be awesome, if allowed) - A residence - rent, purchase, subsidized living, etc where all three of them can live? Both of my parents are past 55 and could get into a lot of the sr. living communities, but my youngest brother (still at home, obviously) is 9 years old. My mom doesn't work - taking care of my dad and homeschooling my little brother is more than a full time job. Thanks in advance, ~ Moe __________________ Mrapunzel Fear Less... Hope More... Whine Less... Breathe More... Talk Less... Say More... Hate Less... Love More... And All Good Things Are Yours.

05-03-2006, 06:43 PM	#2
metronycguy Senior Member Join Date: Dec 2002 Location: ny Posts: 5,674	workers comp is complicated, you need a wc lawyer to help with certain coverage, sometimes you will need to have a hearing if the insurance company denies coverage. definitely take time picking attorneys , there are a lot of horrible wc attorneys. if their attorney doesn't answer questions , find a new one. i see your father was injured in a MVA , hopefully there wil be some kind of settlement in that case that may pay for items that wc doesn't cover. http://community.lawyers.com/messageboards/list.asp is a message boards for wc in californis, i am not sure how good it is , the one for ny state is excellent. __________________ mikepiedellonskye cauda equina

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05-04-2006, 02:23 AM	#3
Buck503 Senior Member Join Date: Apr 2006 Location: PNW Posts: 6,296	I live in AZ and I recieve wm's comp. I'm not totally sure about CA, but I know that here in AZ I get comped every 2 weeks and all my medical expenses are covered, medicine, Dr.'s visits, equipment, and vehicle/home adaptions. They are even paying my way through school so I can work again. With the right attorney, there is a lot to be had. I met a couple guys in rehab who where also paralyzed as a result of a car accident and because they were driving a company truck they were awarded all the same benifits as I was. Good luck

05-04-2006, 08:38 AM	#4
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,341	Your father was injured on the job? This is a requirement for worker's comp coverage. In addition, it had to be a job that had CA state worker's comp coverage. Not all employers have this, and federal workers are covered by federal WC, not by CA state. If he was injured on the job, then I would STRONGLY recommend that you get in touch immediately with a CA state certified worker's comp attorney. Not all attorney's are certified to represent you in CA State WC cases, and this is critical. I hope that your father has not signed any papers with his WC insurance carrier agreeing to any settlement yet. Many WC companies will assign him a nurse case manager as well. This person works for the insurance company, but is supposed to coordinate his care needs, and often will be the one who approves or at least recommends what is covered. Every state's WC program is very different. If you have been reading the papers you will know that our Govenator is very aggressively trying to cut back on what is covered by CA state WC, so it is a moving target right now. Rarely is rent or purchase of a home covered. Modification of an existing home to make it more accessible may be covered. Sometimes a van will be covered. More often it is just the modifications to a van which you must purchase yourself. Usually at least some homecare PCA or nursing care is covered, but how much varies widely. Medical supplies, medications and durable medical equipment, as well as medical care and hospitalization costs are usually covered. Is he on SSI or SSDI right now? State Disabililty? Medi-Cal? What are they using for health care insurance right now? If he is not employed, does he have private or group disability insurance? Are they eligible for IHSS for attendant care services? Again, get an attorney if he qualifies. I am surprised if he is qualified that he is not already in "the system", as this usually gets started during the initial injury, and most regular insurance will ask right away if the injury occured on the job and require that a WC claim be filed at that point. (KLD)