Post on 10-Apr-2020
QuickReferenceGuide
Permanent Disability TablesLife Expectancy Table
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& More
www.atlassettlements.com
Ali MendiolaCA Insurance License # 0G02006
amendiola@atlassettlements.comCell: 714.496.5920
Se Habla Español Office: 213.344.4834Fax: 213.402.5910
17315 Studebaker Road | Suite 214 Cerritos, CA 90703
Mark MoralesCA Insurance License # 0J21271 mmorales@atlassettlements.comCell: 562.237.3235Office: 800.734.3910Fax: 949.833.3687
1851 E. First Street | Suite 1625Santa Ana, CA 92705
Ali MendiolaMark Morales
QuickReference
GuidePermanent Disability Tables
Permanent Partial Disability Weekly Rate
Temporary Total Disability (TTD) and Permanent Total Disability
Life Pension
SAWW Increases Table
Supplemental Job Displacement
Mileage Reimbursement Rates
Life Expectancy Table
Death Benefits
Medicare Coverage Restrictions
MSA Submission Chart
Links & Resources
4 -11
12
13
14
15
15
15
16 - 17
18
19
20
21
4
123456789
1011121314151617181920212223242526272829303132333435363738394041424344454647484950
3.006.009.00
12.0015.0018.0021.0024.0027.0030.2534.2538.2542.2546.2550.5055.5060.5065.5070.5075.5080.5085.5090.5095.50
100.75106.75112.75118.75124.75131.00138.00145.00152.00159.00166.00173.00180.00187.00194.00201.00208.00215.00222.00229.00236.00243.00250.00257.00264.00271.25
690.001380.002070.002760.003450.004140.004830.005520.006210.006957.507877.508797.509717.50
10637.5011615.0012765.0013915.0015065.0016215.0017365.0018515.0019665.0020815.0021965.0023172.5024552.5025932.5027312.5028692.5030130.0031740.0033350.0034960.0036570.0038180.0039790.0041400.0043010.0044620.0046230.0047840.0049450.0051060.0052670.0054280.0055890.0057500.0059110.0060720.0062387.50
870.00 1,740.00 2,610.00 3,480.00 4,350.00 5,220.00 6,090.00 6,960.00 7,830.00 8,772.50 9,932.50
11,092.50 12,252.50 13,412.50 14,645.00 16,095.00 17,545.00 18,995.00 20,445.00 21,895.00 23,345.00 24,795.00 26,245.00 27,695.00 29,217.50 30,957.50 32,697.50 34,437.50 36,177.50 37,990.00 40,020.00 42,050.00 44,080.00 46,110.00 48,140.00 50,170.00 52,200.00 54,230.00 56,260.00 58,290.00 60,320.00 62,350.00 64,380.00 66,410.00 68,440.00 70,470.00 72,500.00 74,530.00 76,560.00 78,662.50
Permanent DisabilityIndemnity Table 2013 - 2016
Toll Free: 800.734.3910
% Weeks of Payment 2013 PD 2014 - 2016 PD
51525354555657585960616263646566676869707172737475767778798081828384858687888990919293949596979899
279.25287.25295.25303.25311.25319.25327.25335.25343.25351.25359.25367.25375.25383.25391.25399.25407.25415.25423.25433.25449.25465.25481.25497.25513.25529.25545.25561.25577.25593.25609.25625.25641.25657.25673.25689.25705.25721.25737.25753.25769.25785.25801.25817.25833.25849.25865.25881.25897.25
64227.5066067.5067907.5069747.5084037.5086197.5088357.5090517.5092677.5094837.5096997.5099157.50
101317.50103477.50105637.50107797.50109957.50112117.50114277.50125642.50130282.50134922.50139562.50144202.50148842.50153482.50158122.50162762.50167402.50172042.50176682.50181322.50185962.50190602.50195242.50199882.50204522.50209162.50213802.50218442.50223082.50227722.50232362.50237002.50241642.50246282.50250922.50255562.50260202.50
80982.5083302.5085622.5087942.5090262.5092582.5094902.5097222.5099542.50
101862.50104182.50106502.50108822.50111142.50113462.50115782.50118102.50120422.50122742.50125642.50130282.50134922.50139562.50144202.50148842.50153482.50158122.50162762.50167402.50172042.50176682.50181322.50185962.50190602.50195242.50199882.50204522.50209162.50213802.50218442.50223082.50227722.50232362.50237002.50241642.50246282.50250922.50255562.50260202.50
5
Atlas | Quick Reference Guide
% Weeks of Payment 2013 PD 2014 - 2016 PD
6
123456789
1011121314151617181920212223242526272829303132333435363738394041424344454647484950
3.006.009.00
12.0015.0018.0021.0024.0027.0030.2534.2538.2542.2546.2550.5055.5060.5065.5070.5075.5080.5085.5090.5095.50
100.75106.75112.75118.75124.75131.00138.00145.00152.00159.00166.00173.00180.00187.00194.00201.00208.00215.00222.00229.00236.00243.00250.00257.00264.00271.25
690.001,380.002,070.002,760.003,450.004,140.004,830.005,520.006,210.006,957.507,877.508,797.509,717.50
10,637.5011,615.0012,765.0013,915.0015,065.0016,215.0017,365.0018,515.0019,665.0020,815.0021,965.0023,172.5024,552.5025,932.5027,312.5028,692.5030,130.0031,740.0033,350.0034,960.0036,570.0038,180.0039,790.0041,400.0043,010.0044,620.0046,230.0047,840.0049,450.0051,060.0052,670.0054,280.0055,890.0057,500.0059,110.0060,720.0062,387.50
690.001,380.002,084.792,878.293,671.794,465.295,258.796,052.296,845.797,705.418,763.419,821.41
10,879.4111,937.4113,061.5414,384.0415,706.5417,029.0418,351.5419,674.0420,996.5422,319.0423,641.5424,964.0426,352.6627,939.6629,526.6631,113.6632,700.6634,353.7936,205.2938,056.7939,908.2941,759.7943,611.2945,462.7947,314.2949,165.7951,017.2952,868.7954,720.2956,571.7958,423.2960,274.7962,126.2963,977.7965,829.2967,680.7969,532.2971,449.91
586.501,173.001,759.502,346.002,932.503,519.004,105.504,692.005,278.505,913.886,695.887,477.888,259.889,041.889,872.75
10,850.2511,827.7512,805.2513,782.7514,760.2515,737.7516,715.2517,692.7518,670.2519,696.6320,869.6322,042.6323,215.6324,388.6325,610.5026,979.0028,347.5029,716.0031,084.5032,453.0033,821.5035,190.0036,558.5037,927.0039,295.5040,664.0042,032.5043,401.0044,769.5046,138.0047,506.5048,875.0050,243.5051,612.0053,029.38
Permanent DisabilityIndemnity Table 2006 - 2012
Toll Free: 800.734.3910
% Weeks of Payment PD +15% PD -15%PD
Permanent DisabilityIndemnity Table 2006 - 2012
51525354555657585960616263646566676869707172737475767778798081828384858687888990919293949596979899
279.25287.25295.25303.25311.25319.25327.25335.25343.25351.25359.25367.25375.25383.25391.25399.25407.25415.25423.25 433.25449.25465.25481.25497.25513.25529.25545.25561.25577.25593.25609.25625.25641.25657.25673.25689.25705.25721.25737.25753.25769.25785.25801.25817.25833.25849.25865.25881.25897.25
64,227.5066,067.5067,907.5069,747.5071,587.5073,427.5075,267.5077,107.5078,947.5080,787.5082,627.5084,467.5086,307.5088,147.5089,987.5091,827.5093,667.5095,507.5097,347.50
116,977.50121,297.50125,617.50129,937.50134,257.50138,577.50142,897.50147,217.50151,537.50155,857.50160,177.50164,497.50168,817.50173,137.50177,457.50181,777.50186,097.50190,417.50194,737.50199,057.50203,377.50207,697.50212,017.50216,337.50220,657.50224,977.50229,297.50233,617.50237,937.50242,257.50
73,565.9175,681.9177,797.9179,913.9182,029.9184,145.9186,261.9188,377.9190,493.9192,609.9194,725.9196,841.9198,957.91
101,073.91103,189.91105,305.91107,421.91109,537.91111,653.91134,176.98139,144.98144,112.98149,080.98154,048.98159,016.98163,984.98168,952.98173,920.98178,888.98183,856.98188,824.98193,792.98198,760.98203,728.98208,696.98213,664.98218,632.98223,600.98228,568.98233,536.98238,504.98243,472.98248,440.98253,408.98258,376.98263,344.98268,312.98273,280.98278,248.98
54,593.3856,157.3857,721.3859,285.3860,849.3862,413.3863,977.3865,541.3867,105.3868,669.3870,233.3871,797.3873,361.3874,925.3876,489.3878,053.3879,617.3881,181.3882,745.3899,430.88
103,102.88106,774.88110,446.88114,118.88117,790.88121,462.88125,134.88128,806.88132,478.88136,150.88139,822.88143,494.88147,166.88150,838.88154,510.88158,182.88161,854.88165,526.88169,198.88172,870.88176,542.88180,214.88183,886.88187,558.88191,230.88194,902.88198,574.88202,246.88205,918.88
7
Atlas | Quick Reference Guide
% Weeks of Payment PD +15% PD -15%PD
8
123456789
1011121314151617181920212223242526272829303132333435363738394041424344454647484950
3.006.009.00
12.0015.0018.0021.0024.0027.0030.2534.2538.2542.2546.2550.5055.5060.5065.5070.5075.5080.5085.5090.5095.50
100.75106.75112.75118.75124.75131.00138.00145.00152.00159.00166.00173.00180.00187.00194.00201.00208.00215.00222.00229.00236.00243.00250.00257.00264.00271.25
660.001,320.001,980.002,640.003,300.003,960.004,620.005,280.005,940.006,655.007,535.008,415.009,295.00
10,175.0011,110.0012,210.0013,310.0014,410.0015,510.0016,610.0017,710.0018,810.0019,910.0021,010.0022,165.0023,485.0024,805.0026,125.0027,445.0028,820.0030,360.0031,900.0033,440.0034,980.0036,520.0038,060.0039,600.0041,140.0042,680.0044,220.0045,760.0047,300.0048,840.0050,380.0051,920.0053,460.0055,000.0056,540.0058,080.0059,675.00
660.001,320.001,994.142,753.143,512.144,271.145,030.145,789.146,548.147,370.398,382.399,394.39
10,406.3911,418.3912,493.6413,758.6415,023.6416,288.6417,553.6418,818.6420,083.6421,348.6422,613.6423,878.6425,206.8926,724.8928,242.8929,760.8931,278.8932,860.1434,631.1436,402.1438,173.1439,944.1441,715.1443,486.1445,257.1447,028.1448,799.1450,570.1452,341.1454,112.1455,883.1457,654.1459,425.1461,196.1462,967.1464,738.1466,509.1468,343.39
561.001,122.001,683.002,244.002,805.003,366.003,927.004,488.005,049.005,656.756,404.757,152.757,900.758,648.759,443.50
10,378.5011,313.5012,248.5013,183.5014,118.5015,053.5015,988.5016,923.5017,858.5018,840.2519,962.2521,084.2522,206.2523,328.2524,497.0025,806.0027,115.0028,424.0029,733.0031,042.0032,351.0033,660.0034,969.0036,278.0037,587.0038,896.0040,205.0041,514.0042,823.0044,132.0045,441.0046,750.0048,059.0049,368.0050,723.75
Permanent DisabilityIndemnity Table 2005
Toll Free: 800.734.3910
% Weeks of Payment PD +15% PD -15%PD
Permanent DisabilityIndemnity Table 2005
51525354555657585960616263646566676869707172737475767778798081828384858687888990919293949596979899
279.25287.25295.25303.25311.25319.25327.25335.25343.25351.25359.25367.25375.25383.25391.25399.25407.25415.25423.25 433.25449.25465.25481.25497.25513.25529.25545.25561.25577.25593.25609.25625.25641.25657.25673.25689.25705.25721.25737.25753.25769.25785.25801.25817.25833.25849.25865.25881.25897.25
61,435.0063,195.0064,955.0066,715.0068,475.0070,235.0071,995.0073,755.0075,515.0077,275.0079,035.0080,795.0082,555.0084,315.0086,075.0087,835.0089,595.0091,355.0093,115.00
116,977.50121,297.50125,617.50129,937.50134,257.50138,577.50142,897.50147,217.50151,537.50155,857.50160,177.50164,497.50168,817.50173,137.50177,457.50181,777.50186,097.50190,417.50194,737.50199,057.50203,377.50207,697.50212,017.50216,337.50220,657.50224,977.50229,297.50233,617.50237,937.50242,257.50
70,367.3972,391.3974,415.3976,439.3978,463.3980,487.3982,511.3984,535.3986,559.3988,583.3990,607.3992,631.3994,655.3996,679.3998,703.39
100,727.39102,751.39104,775.39106,799.39134,176.98139,144.98144,112.98149,080.98154,048.98159,016.98163,984.98168,952.98173,920.98178,888.98183,856.98188,824.98193,792.98198,760.98203,728.98208,696.98213,664.98218,632.98223,600.98228,568.98233,536.98238,504.98243,472.98248,440.98253,408.98258,376.98263,344.98268,312.98273,280.98278,248.98
52,219.7553,715.7555,211.7556,707.7558,203.7559,699.7561,195.7562,691.7564,187.7565,683.7567,179.7568,675.7570,171.7571,667.7573,163.7574,659.7576,155.7577,651.7579,147.7599,430.88
103,102.88106,774.88110,446.88114,118.88117,790.88121,462.88125,134.88128,806.88132,478.88136,150.88139,822.88143,494.88147,166.88150,838.88154,510.88158,182.88161,854.88165,526.88169,198.88172,870.88176,542.88180,214.88183,886.88187,558.88191,230.88194,902.88198,574.88202,246.88205,918.88
9
Atlas | Quick Reference Guide
% Weeks of Payment PD +15% PD -15%PD
123456789
1011121314151617181920212223242526272829303132333435363738394041424344454647484950
3.006.009.00
12.0015.0018.0021.0024.0027.0030.2534.2538.2542.2546.2550.2554.2558.2562.2566.2570.5075.5080.5085.5090.5095.75
101.75107.75113.75119.75126.00133.00140.00147.00154.00161.00168.00175.00182.00189.00196.00203.00210.00217.00224.00231.00238.00245.00252.00259.00266.25
555.001,110.001,665.002,220.002,775.003,330.003,885.004,440.004,995.005,596.256,336.257,076.257,816.258,556.259,296.25
10,036.2510,776.2511,516.2512,256.2513,042.5013,967.5014,892.5015,817.5016,742.5017,713.7518,823.7519,933.7521,043.7522,153.7523,310.0024,605.0025,900.0027,195.0028,490.0029,785.0031,080.0032,375.0033,670.0034,965.0036,260.0037,555.0038,850.0040,145.0041,440.0042,735.0044,030.0045,325.0046,620.0047,915.0049,256.25
4.008.00
12.0016.0020.0024.0028.0032.0036.0040.2545.2550.2555.2560.2565.2570.2575.2580.2585.2590.2595.25
100.25105.25110.25115.50121.50127.50133.50139.50145.75152.75159.75166.75173.75180.75187.75194.75201.75208.75215.75222.75229.75236.75243.75250.75257.75264.75271.75278.75286.00
800.001,600.002,400.003,200.004,000.004,800.005,600.006,400.007,200.008,050.009,050.00
10,050.0011,050.0012,050.0013,050.0014,050.0015,050.0016,050.0017,050.0018,050.0019,050.0020,050.0021,050.0022,050.0023,100.0024,300.0025,500.0026,700.0027,900.0029,150.0030,550.0031,950.0033,350.0034,750.0036,150.0037,550.0038,950.0040,350.0041,750.0043,150.0044,550.0045,950.0047,350.0048,750.0050,150.0051,550.0052,950.0054,350.0055,750.0057,200.00
10
Permanent DisabilityIndemnity Table 1996 - 2004
Toll Free: 800.734.3910
% Weeks of Payment 2003 PD Weeks of
Payment 2004 PD
420.00840.00
1260.001680.002100.002520.002940.003360.003780.004235.004795.005355.005915.006475.008040.008680.009320.009960.00
10600.0011280.0012080.0012880.0013680.0014480.0016277.5017297.5018317.5019337.5020357.5021420.0022610.0023800.0024990.0026180.0027370.0028560.0029750.0030940.0032130.0033320.0034510.0035700.0036890.0038080.0039270.0040460.0041650.0042840.0044030.0045,262.50
07.01.1996 - 12.31.2002 PD
Permanent DisabilityIndemnity Table 1996 - 2004
51525354555657585960616263646566676869707172737475767778798081828384858687888990919293949596979899
274.25282.25290.25298.25306.25314.25322.25330.25338.25346.25354.25362.25370.25378.25386.25394.25402.25410.25418.25426.50435.50444.50453.50462.50471.50480.50489.50498.50507.50516.50525.50534.50543.50552.50561.50570.50579.50588.50597.50606.50615.50624.50633.50642.50651.50660.50669.50678.50687.50
50,736.2552,216.2553,696.2555,176.2556,656.2558,136.2559,616.2561,096.2562,576.2564,056.2565,536.2567,016.2568,496.2569,976.2571,456.2572,936.2574,416.2575,896.2577,376.2598,095.00
100,165.00102,235.00104,305.00106,375.00108,445.00110,515.00112,585.00114,655.00116,725.00118,795.00120,865.00122,935.00125,005.00127,075.00129,145.00131,215.00133,285.00135,355.00137,425.00139,495.00141,565.00143,635.00145,705.00147,775.00149,845.00151,915.00153,985.00156,055.00158,125.00
294.00302.00310.00318.00326.00334.00342.00350.00358.00366.00374.00382.00390.00398.00406.00414.00422.00430.00438.00446.25455.25464.25473.25482.25491.25500.25509.25518.25527.25536.25545.25554.25563.25572.25581.25590.25599.25608.25617.25626.25635.25644.25653.25662.25671.25680.25689.25698.25707.25
58,800.0060,400.0062,000.0063,600.0065,200.0066,800.0068,400.0070,000.0071,600.0073,200.0074,800.0076,400.0078,000.0079,600.0081,200.0082,800.0084,400.0086,000.0087,600.00
111,562.50113,812.50116,062.50118,312.50120,562.50122,812.50125,062.50127,312.50129,562.50131,812.50134,062.50136,312.50138,562.50140,812.50143,062.50145,312.50147,562.50149,812.50152,062.50154,312.50156,562.50158,812.50161,062.50163,312.50165,562.50167,812.50170,062.50172,312.50174,562.50176,812.50
11
Atlas | Quick Reference Guide
46,622.5047,982.5049,342.5050,702.5052,062.5053,422.5054,782.5056,142.5057,502.5058,862.5060,222.5061,582.5062,942.5064,302.5065,662.5067,022.5068,382.5069,742.5071,102.5098,095.00
100,165.00102,235.00104,305.00106,375.00108,445.00110,515.00112,585.00114,655.00116,725.00118,795.00120,865.00122,935.00125,005.00127,075.00129,145.00131,215.00133,285.00135,355.00137,425.00139,495.00141,565.00143,635.00145,705.00147,775.00149,845.00151,915.00153,985.00156,055.00158,125.00
% Weeks of Payment 2003 PD Weeks of
Payment 2004 PD07.01.1996 - 12.31.2002 PD
12
1 - 99.75 105 70 210.50 140
Permanent Partial Disability Weekly Rate
Toll Free: 800.734.3910
PD % Rate Earnings RateEarnings
01.01.84
Minimum MaximumDate of Injury
(On or After)
1 - 24.7525 - 99.75
105105
7070
210222
140180
01.01.91
1 - 14.7515 - 24.7525 - 69.7570 - 99.75
105105105105
70707070
210222237252
140148158168
07.01.94
1 - 14.7515 - 24.7525 - 69.7570 - 99.75
105105105105
70707070
210231246297
140154164198
07.01.95
1 - 14.7515 - 24.7525 - 69.7570 - 99.75
105105105105
70707070
210240255345
140160170230
07.01.96
1 - 69.7570 - 99.75
150150
100100
277.50345
185230
01.01.03
1 - 69.7570 - 99.75
157.50157.50
105105
300375
200250
01.01.04
1 - 6970 - 99
157.50157.50
105105
330405
220270
01.01.05
1 - 6970 - 99
195195
130130
345405
230270
01.01.06
1. PD is not increased by SAWW LC 4453(b)2. Permanent disability weekly payments are paid at 2/3 of weekly earnings -- not to
exceed the above maximum rate and must be at least the minimum rate.3. Permanent disability weekly payments are paid for the number of weeks specified in
the first table based upon the percentage rating.
1 - 54 55 - 6970 - 99
240240240
160160160
345405435
230270290
01.01.13
1 - 99 240 160 435 29001.01.14
Permanent Partial Disability Weekly Rate
13
Atlas | Quick Reference Guide
Temporary Total Disability (TTD) and Permanent Total Disability
806.11
Year
2005
SAWW
838.422006
880.002007
914.602008
956.202009
984.832010
979.902011
1003.552012
1059.382013
1067.252014
1. Aggregate disability payments for a single injury occurring on or after 4/19/04 shall not extend for more than 104 compensable weeks within a period of two years from the date of commencement of TTD. Aggregate disability payments for a single injury occurring on or after 1/1/2008 shall not extend for more than 104 compensable weeks within a period of five years from the date of commencement of TTD.
2. Certain acute or severe disabilities* extend for 240 weeks. LC 46563. TTD payments made two or more years from the date of injury are made at the rate
in effect on the date each payment is made. LC 4661.54. For injuries occurring on or after 1/1/05 commencing 1/1/07 the limits are increased
annually by percentage increase of State Average Weekly Wage (SAWW). LC §4453(a)(10)
5. Temporary disability payments are paid at 2/3 of the weekly earnings within the limits specified in the above table. LC §4653
* Acute and Chronic hepatitis B and C; amputations, severe burns, HIV, high-velocity eye injuries; chemical burns to eyes; pulmonary fibrosis; chronic lung disease
126.00840.00
Min 189.00Max 1260.00
126.00840.00
Min 189.00Max 1260.00
132.25881.66
Min 198.37Max 1322.49
137.45916.33
Min 206.17Max 1374.49
143.70958.01
Min 215.55Max 1437.01
148.00986.69
Min 222.00Max 1480.04
148.00986.69
Min 222.00Max 1480.04
151.571010.50
Min 227.36Max 1515.75
160.001066.72
Min 240.00Max 1600.08
161.191074.64
Min 241.78Max 1611.96
Earnings TTD Payment
14
Life Pension
Toll Free: 800.734.3910
23.6526.0228.3830.7533.1135.4837.8540.2142.5844.9447.3149.6752.0454.4056.7759.1361.5063.8666.2368.6070.9673.3375.6978.0680.4282.7985.1587.5289.8892.25
31.1534.2737.3840.5043.6146.7349.8552.9656.0859.1962.3165.4268.5471.6574.7777.8881.0084.1187.2390.3593.4696.5899.69
102.81105.92109.04112.15115.27118.38121.50
38.6542.5246.3850.2554.1157.9861.8565.7169.5873.4477.3181.1785.0488.9092.7796.63
100.50104.36108.23112.10115.96119.83123.69127.56131.42135.29139.15143.02146.88150.75
38.6542.5246.3850.2554.1157.9861.8565.7169.5873.4477.3181.1785.0488.9092.7796.63
100.50104.36108.23112.10115.96119.83123.69127.56131.42135.29139.15143.02146.88150.75
77.3185.0492.77
100.50108.23115.96123.69131.42139.15146.88154.61162.34170.08177.81185.54193.27201.00208.73216.46224.19231.92239.65247.38255.11262.84270.57278.31289.04293.77301.50
PD % 07.01.96 01.01.03 01.01.0607.01.95
707172737475767778798081828384858687888990919293949596979899
Date of Injury (On or After)
1. When the permanent disability is 70% or greater, life pension weekly payments are made at the above rate, depending the percentage of disability. Formula: Life pension = ( % - 60 ) x .015 x (Weekly Earnings within maximum, table immediately above) LC 4659
2. There have been no increases in maximum weekly earnings since 1/1/2006.3. Start date of life pension payments is not reflected in the above tables because
life pension payments do not commence until permanent partial payments end. For a date of injury in 2003 with a permanent partial disability of 70% life pension payments would not start until 426.5 weeks after the permanent and stationary date. Payments would not begin until 8.17 years after the P&S date.
4. For DOI on or after 1/1/2003 the rate of payment is not known until the start of payments due to COLA increases. COLA increases commence on Jan 1 after the start of the life pension.
5. “For injuries occurring on or after January 1, 2003, an employee who becomes enti-tled to receive a life pension or total permanent disability indemnity … shall have that payment increased annually commencing on January 1, 2004, and each January 1 thereafter, by an amount …” LC 4659(c)
07.01.94
107.69
Injury Date (On or After)
01.01.84
Weekly Earnings Maximum
157.6907.01.94207.6907.01.95257.6907.01.96257.6901.01.03515.3801.01.06
15
Atlas | Quick Reference Guide
Statewide Average Weekly Wage(SAWW)
$1,095.70
Year
2015
SAWW
$1,067.25 2014$1,059.38 2013$1,003.552012$979.902011$984.832010
Supplemental Job DisplacementBenefit Voucher
Up to $4,000
PPD Award
Less than 15%
Voucher Amount
Up to $6,000Between 15% and 25%Up to $8,000Between 26% and 49%
Up to $10,000Between 50% and 99%
For injuries before 1/1/13 the amount of the voucher for the supplemental job displace-ment benefit will be as follows:
• Voucher expires in 2 years or 5 years from date of injury.• On or after 1/1/13 voucher is $6,000. LC 4658.7
Mileage Reimbursement Ratesfor Medical and Med-Legal
44.5
Incurred in Year
2006 - July 1
Cents Per Mile
48.5200750.52008 - Jan 1502010512011
55.52011 - July 155.5201256.52013562014
57.52015
2.66%0.74%5.56%2.41%0.00%2.99%
SAWW Increase
$956.202009$914.602008$880.002007$838.422006
4.55%3.93%4.96%4.01%
10 Year Average 3.01%
542016
$1,120.67 2016 2.28%
16
Toll Free: 800.734.3910
Life Expectancy Tables | SSA.gov, 2013
0123456789
1011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859
76.2875.7874.8273.8472.8571.8770.8869.8968.967.9
66.9165.9264.9263.9362.9461.9660.9960.0259.0558.0957.1456.2
55.2754.3353.4
52.4751.5450.6149.6848.7547.8246.8945.9645.0344.1
43.1742.2441.3140.3839.4638.5337.6136.7
35.7834.8833.9833.0832.1931.3230.4429.5828.7327.8927.0526.2325.4124.6123.8223.0322.25
81.0580.4979.5278.5477.5576.5675.5774.5873.5872.5971.670.6
69.6168.6267.6366.6465.6564.6763.6862.7
61.7260.7559.7758.8
57.8256.8555.8854.9153.9452.9752.0151.0450.0849.1148.1547.1946.2345.2844.3343.3742.4341.4840.5439.6
38.6637.7336.8135.8934.9734.0633.1632.2731.3830.4929.6228.7427.8827.0126.1625.31
78.6778.1477.1776.1975.2074.2273.2372.2471.2470.2569.2668.2667.2766.2865.2964.3063.3262.3561.3760.4059.4358.4857.5256.5755.6154.6653.7152.7651.8150.8649.9248.9748.0247.0746.1345.1844.2443.3042.3641.4240.4839.5538.6237.6936.7735.8634.9534.0433.1532.2531.3730.5029.6428.7727.9327.0826.2525.4224.6023.78
Male Female AllAge
17
Atlas | Quick Reference Guide
60616263646566676869707172737475767778798081828384858687888990919293949596979899
100101102103104105106107108109110111112113114115116117118119
21.4820.7219.9719.2218.4817.7517.0316.3215.6114.9214.2413.5712.9212.2711.6511.0310.439.859.288.738.2
7.687.196.726.275.845.435.044.684.344.033.743.473.233.012.822.642.492.362.242.122.011.91.81.71.6
1.511.421.341.261.181.111.040.970.9
0.840.780.720.670.61
24.4623.6222.7821.9521.1320.3219.5218.7317.9517.1816.4315.6814.9514.2313.5312.8312.1611.5
10.8610.249.649.058.487.947.426.926.445.995.575.174.8
4.454.133.843.573.343.122.932.762.6
2.452.3
2.172.031.911.781.671.561.451.351.261.171.08
10.920.850.780.720.670.61
22.9722.1721.3820.5919.8119.0418.2817.5316.7816.0515.3414.6313.9413.2512.5911.9311.3010.6810.079.498.928.377.847.336.856.385.945.525.134.764.424.103.803.543.293.082.882.712.562.422.292.162.041.921.811.691.591.491.401.311.221.141.060.990.910.850.780.720.670.61
Male Female AllAge
Life Expectancy Tables Cont. | SSA.gov, 2013
18
Toll Free: 800.734.3910
01.01.84
12 or more
10
0NA
1 or more1 or more
70,00095,000
70K + 4x annual support but not more than 95K4x annual support but no more than 70K
Total Partial Benefit MaximumDate of Injury
Death Benefits
1. Death benefits are determined at the date of injury not date of death. LC 4702(a)2. Death benefits are paid in payments at the same rate as temporary total disability unless
otherwise ordered by WCAB except the minimum payment is $224.00 per week. LC 4702(b)
3. Rate of payment is the rate in effect at the date of injury and remains that rate for the first two years following the date of injury. After two years from the date of injury any payments are increased to the temporary total disability rate currently in effect at the date of payment. LC 4661.5
4. Temporary total disability maximum and minimum are increased yearly by SAWW. If the date of injury is in 2007 the payment rate is 2/3 AWW up to maximum of $881.66. If the date of injury is in 2008 the maximum rate is $916.33. LC 4453(a)(10) Payments below maximum and above $224.00 are not increased yearly by a COLA.
5. Payments will be the same for the first two years after date of injury, then if 2/3 of weekly wage is above maximum, the payment will increase to the maximum. Payment rate will continue to increase each year until 2/3 of weekly wage is below the maximum, and then the payment rate will be constant at 2/3 of weekly wage.
6. Where there is one or more totally dependent minor children, payments shall continue after the benefit is paid until the youngest child attains the age of 18, until the death of a child or the child is physically or mentally incapacitated from earnings. LC 4703.5
7. Maximum burial expense 1/1/91 – 12/31/12: $5,000; on or after 1/1/13: $10,000.00 LC 4701
8. Dependents conclusively presumed wholly dependent when: (1) Minor child or a child of any age is found to be physically or mentally incapacitated from earning who was either living with deceased parent or the deceased parent is legally liable at the time of injury; (2) Spouse earning less than $30,000 in the preceding 12 months at time of death. (3) Where there are two or more total dependents there is no increase for partial dependents. (4) If there are no total dependents and one or more partial dependents, the partial dependents share in accordance with their relative extent of dependency.
9. Temporary or permanent disability payments, if any, stop at death. Accrued and unpaid compensation is paid to the dependents. Accrued disability compensation is in addition to death benefits if the employment injury contributed to or caused the death. LC 4700
10. The period within which to commence proceedings for the collection of death benefits is one year from death where death occurs within one year of DOI; or one year from date of last furnishing of any benefits or one year from death where death occurs more than one year from DOI. No such proceedings may be commenced more than 240 weeks from the date of injury. LC 5406
Dependents
01.01.91
12 or more
10
0NA
1 or more1 or more
70,00095,000
70K + 4x annual support but not more than 95K4x annual support but no more than 70K
07.01.94
12
3 or more10
0NANA
1 or more1 or more
115,000135,000150,000
115K + 4 x annual support but not more than 125K4 x annual support but not more than 115K
07.01.96
12
3 or more10
0NANA
1 or more1 or more
125,000145,000160,000
125K + 4 x annual support but not more than 145K4 x annual support but not more than 125K
01.01.06
12
3 or more10
0NANA
1 or more1 or more
250,000290,000320,000
250K + 4 x annual support but not more than 290K8 x annual support but not more than 250K
19
Atlas | Quick Reference Guide
Medicare Coverage Restrictions
What Medicare Part A and Part B Do Not Cover
Original Medicare (Part A and Part B) does not generally cover the following services and supplies. This may not be a complete list and there may be exceptions.
• Alternative medicine• Cosmetic surgery• Dental care • Foot care• Hearing care• Health care outside of the United States and Territories • Homemaker services• Long-term care• Medical equipment & supplies (covered if used primarily
for medical purposes and is necessary for the patient)• Personal care• Personal comfort items• Prescription drugs• Vision care
What Medicare Part D Does Not Cover
Generally, Medicare Part D will only cover drugs that meet all of the following conditions:
• Only available by prescription• Approved by the Food and Drug Administration (FDA)• Sold and used in the United States• Used for a medically accepted purpose• Not already covered under Medicare Part A or Part B
Based on these criteria, there are certain drugs that Medi-care Part D does not generally cover:
• Weight loss or weight gain drugs• Erectile or sexual dysfunction drugs • Over-the-counter, non-prescription drugs• Hair growth drugs, or drugs used for cosmetic reasons• Fertility drugs• Drugs used for symptomatic relief of coughs or colds• Prescription vitamins and minerals
20
MSA Submission Chart
Toll Free: 800.734.3910
Medicare Eligible/Recipient:
Age 65 or older; oron SSDI for 24 months ormore; or End Stage Renal Failure.
“Total”Settlement
$25,000or
Less
Work–loadthreshold MSA
allocation shouldbe contained in
settlement documents, but CMS submissionfor WCMSA approval
not necessary.
Settlement Amount
Allocation/SubmissionStatus
MedicareEligible/Recipient:
Age 65 or older; or SSDI for 24 months; ormore; or End Stage Renal Failure.
“Total”Settlement
$25,000or
More
WCMSAallocationmust be
submitted andapproved by
CMS.
Not Medicare eligible, but has a reasonableexpectation of eligibilityin (30) months:
Age 62.5 or older; or has applied or plans to apply for SSDI; orhas applied for SSDI but was denied and is appealing denial.
Morethan
$250,000
WCMSAallocationmust be
submitted andapproved by
CMS.
Not Medicare eligible,but has a reasonable expectation of eligibilityin (30) months:
Age 62.5 or older; orhas applied for SSDI; orhas applied for SSDI but wasdenied and is appealing denial;or plans on applying for SSDI.
Less than
$250,000,but
more than
$25,000
Work–loadthreshold MSA
allocation shouldbe contained in
settlement documents, but CMS submissionfor WCMSA approval
not necessary.
Not Medicare eligible, and has no reasonableexpectation of eligibilityin (30) months:
Lessthan
$250,000
NoWCMSA
necessary.
Yes
Yes
Yes
Yes
Structure Indemnity
and/orPension
PotentialStructure?
“Total” settlement includes combined indemnity and medical paid out for settlement, regardless of timing.
Not Medicare eligible, but has a reasonableexpectation of eligibilityin (30) months:
Age 65 or older; or on SSDI for 24 months; ormore; or End Stage Renal Failure.
“Total”Settlement
$25,000or
Less
Work–loadthreshold MSA
allocation shouldbe contained in
settlement documents, but CMS submissionfor WCMSA approval
not necessary.
Yes
Not Medicare eligible, and has no reasonableexpectation of eligibilityin (30) months:
Morethan
$250,000
NoWCMSA
necessary.
Structure Indemnity
and/orPension
MSA Submission Chart
21
Atlas | Quick Reference Guide
Helpful Links & Resources
Judicial opinionshttp://www.courts.ca.gov/opinions.htm
WCAB decisions & Case Lookuphttp://www.dir.ca.gov/wcab/wcab_dars.htmhttps://eams.dwc.ca.gov/WebEnhancement
Forms WCAB / EAMS UANshttp://www.dir.ca.gov/dwc/forms.html
http://www.dir.ca.gov/DWC/EAMS/EAMS-LC/EAMSClaimsAdmins.asp
Carve-outhttp://www.dir.ca.gov/dwc/carveout.html
Labor codehttp://www.leginfo.ca.gov/.html/lab_table_of_contents.html
QME Regshttp://www.dir.ca.gov/samples/search/querydwc.htm
WCAB Rules of Practice & Procedurehttp://www.dir.ca.gov/t8/ch4_5sb2.html
Medical Treatment Utilization Schedulehttp://www.dir.ca.gov/t8/ch4_5sb1a5_5_2.html
Schedule for Rating Perm Disability 2005http://www.dir.ca.gov/dwc/PDR.pdf
SB863http://goo.gl/3ATHul
TPA listhttp://www.dir.ca.gov/sip/tpa-roster.pdf
CIGAhttp://www.caiga.org
Self-insured Listhttp://www.dir.ca.gov/sip/PrivateRoster.pdf
WCIRBhttps://wcirbonline.org/wcirb/
EDDhttp://www.edd.ca.gov/
EEOChttp://www.eeoc.gov/
CAAAhttp://caaa.org/
Records Order Formhttp://www.getrecords.com/Order/Main.aspx
State Barhttp://www.calbar.ca.gov/
Rating & Present Valuehttp://www.getmedlegal.com/
Notes:
Notes:
Experts in Complex Workers’ Comp Cases
Tailors Settlements to Client’s Individual Needs
Protects SSI & Medi-Cal Benefits
Prepares Life Pensions and COLA Projections
Represents All Insurance Companies Offering Annuities
Medicare Set-AsidePresent value calculations
Future medical value calculations
Death Benefit Projections
StructuredSettlements for clientsinjured on the job whomust maketheir fundslast a lifetime.
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