I recently received a great question concerning a bill from a school for an injured worker’s retraining. The bill totaled $6,000.00 and consisted of program tuition, course registration, books and supplies, and “other expenses.” I was asked whether defendant would have an obligation to pay for the injured worker’s computer up to $1,000.00 and miscellaneous expenses up to $500.00 in the future should he request it, in addition to paying the $6,000 bill.
Date of Injury
Assuming that the injured worker is entitled to supplemental job displacement benefits (SJDB), the first consideration for a carrier when issuing SJDB is the date of injury.
Prior to 1/1/04
Prior to January 1, 2004, injured workers were entitled to vocational rehabilitation pursuant to Labor Code section 139.5. However, Labor Code section 139.5 was repealed and became ineffective as of January 1, 2009. Therefore, workers’ entitlement to vocational rehabilitation benefits for injuries prior to 1/1/04 terminated as of 1/1/09.
Answer: SJDB not applicable to injuries prior to 1/1/04.
1/1/04 – 12/31/12
For injuries occurring between January 1, 2004 and December 31, 2012, the Supplemental Job Displacement Benefits were introduced. The law on the SJDB is covered by Labor Code section 4658.5.
Per subsection (a) of LC 4658.5, in order for the SJDB to apply, the injury must result in some permanent partial disability and the injured employee must not return to work for the employer with 60 days of the termination of temporary disability. The SJDB is in the form of a nontransferable voucher for education-related retraining or skill enhancement, or both, at state approved or accredited schools, as follows:
- Up to four thousand dollars ($4,000) for permanent partial disability awards of less than 15 percent.
- Up to six thousand dollars ($6,000) for permanent partial disability awards between 15 and 25 percent.
- Up to eight thousand dollars ($8,000) for permanent partial disability awards between 26 and 49 percent.
- Up to ten thousand dollars ($10,000) for permanent partial disability awards between 50 and 99 percent.
(b) The voucher may be used for payment of tuition, fees, books, and other expenses required by the school for retraining or skill enhancement. No more than 10 percent of the voucher moneys may be used for vocational or return to work counseling. The administrative director shall adopt regulations governing the form of payment, direct reimbursement to the injured employee upon presentation to the employer of appropriate documentation and receipts, and any other matters necessary to the proper administration of the supplemental job displacement benefit.
(c) Within 10 days of the last payment of temporary disability the employer shall provide to the employee in the form and manner prescribed by the administrative director information that provides notice of rights under this section. This notice shall be sent by certified mail.
(d) This section shall apply to injuries occurring on or after January 1, 2004.
Answer: Payment of the $6,000.00 bill depends on the percent of permanent partial disability awarded. If the PD award is under 15%, then only $4,000.00 should be paid in SJDB, and no money paid towards the additional requests for the computer or miscellaneous expenses. If the award is between 15% – 25% PD, the entire $6,000.00 bill should be paid. Any future request for a computer or other miscellaneous items should not be paid since the bill up to $6,000.00 has already been paid. If the PD award is greater than 25%, the additional future expenses would be included in the cost of the $8,000 or $10,000 voucher.
1/1/13 – Present
Labor Code section 4658.7 governs SJDB for injuries occurring on or after January 1, 2013.
Per subsection (b)(1), the employer must still make an offer of work similar to LC section 4658.5 for injuries between 1/1/04 – 12/31/12; however, the 60 day time period starts upon receipt of a final P&S report from a primary treating physician or AME/QME. The offer of work must also last for at least 12 months.
Instead of different voucher amounts depending on the amount of permanent partial disability awarded, LC section 4658.7 provides a flat rate of up to an aggregate of a $6,000.00 voucher regardless of the PD amount. The voucher can be applied to various expenses per 4658.7 as follows:
“(5) Purchase of computer equipment, up to one thousand dollars ($1,000)
(6) Up to five hundred dollars ($500) as a miscellaneous expense reimbursement or advance, payable upon request and without need for itemized documentation or accounting.”
Answer: The $6,000 voucher is inclusive of a worker’s choice to purchase computer equipment up to $1,000 and/or miscellaneous expenses up to $500. If the carrier pays the $6,000 bill from the school, the worker is not entitled to then also seek reimbursement over the $6000 amount in the form of a computer or other expenses.
SJDB issues are highly technical and fact specific. For quick reference, check out the FAQ from the Department of Industrial Relations’ website at https://www.dir.ca.gov/dwc/sjdb/SJDB_FAQ.html.
Questions? Please feel free to give me a call.
Natalie W. Houng is an associate attorney in Bradford & Barthel’s Los Angeles location. Mr. Houng can be reached at (310) 981-5004 or firstname.lastname@example.org
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