DEATH CLAIMS CALCULATING BENEFITS · 2018-01-01 · Payments continue until age of 19 if child is...

The Law Office ofBRADFORD & BARTHEL , LLP

DEATH CLAIMS CALCULATING

BENEFITS

Tim Mussack, AMA Analysis & Ratings

B&B Sacramento(916) 569-0790 – Office

[email protected]

Contact InformationBradford & Barthel, LLP - AMA Analysis & Ratings

Tim Mussack

(916) 569-0790

[email protected]

Marlene Phillips

(909) 476-0552

[email protected]

[email protected]

http://www.bradfordbarthel.com/areas-of-practice/bb-ratings/rating-referral-form/

www.bradfordbarthel.com 2

Death ClaimsIndustrial injury resulting in the death of a

worker

� How Common are Work Related Fatalities?

◦ OSHA – signed into law in 1970, effective 4/28/71

◦ OSHA reports that nationally, 38 workers died due to industrial accidents every day in 1970.

◦ In 2014, that number was just under 13 per day (nationally).

◦ In California:� 2013: 396 deaths during the year� 2014: 334 deaths during the year


Death Claims

� They are uncommon

� They are expensive

� Need reporting

◦ State

◦ Reserve authority

◦ Excess or reinsurance

� When one comes to you:

◦ Check your Labor Code

� Death benefits are discussed in LC 4700 through 4709

� Death of public officials (fire, law enforcement) LC 4720-4727)

� Dependents are discussed within LC 3501-3503


Death Claims Prompt, Thorough Investigation

� AOE/ COE

� Dependents

� Wages

� Subrogation Potential

� Apportionment to another carrier?


Death Claims – AOE-COE

• Did the death occur under unexplained circumstances on the employer’s premises? The EE/ IW is entitled to a presumption or inference that the death arouse out of the employment, since it is undisputed that the employment brought the IW/ decedent to the place where the death occurred. This does not shift the burden of proof. Clemmens v WCAB 33 CCC 186

• Was death caused in the course and scope of employment? AOE-COE test

• If the industrial injury hastens the death of an EE/ IW that is already suffering from a preexisting illness/disease/injury is a proximate cause of death. Crisp Petroleum Environmental, Inc. v WCAB (Bauer) (1999) 64 CCC 1153

Suicide - overdose


Death Claims AOE-COESpecial LC Sections for Public Safety

Officers & Firefighters

� Rebuttable Presumptions

� Various law enforcement officers & firefighters developing heart trouble, pneumonia and cancer are covered by a statutory presumption that these injuries are industrial. This presumption is rebuttable. LC 3212

•ER must rebut the heart presumption only with proof of causation by a nonindustrial event.

•LC 4663(e) bars apportionment in all public safety cases involving heart presumptions.

•Law enforcement officers & firefighters exposed to carcinogens- presumption of cancers.


Death Claims

• SubrogationWas the accident/ death at all attributable to another party? Subrogation?

ApportionmentGenerally there is no apportionment in a death case, and the full benefit is payable. (PG&E v. IAC, 56 c2d 219; Zenith Insurance v. WCAB, 124 CA3d 176; Barrett Bus. Services v. WCAB (Berreta), 74 CCC 287)

Liability may be apportioned between defendants when there are two or more periods of exposure or injury contributing to the death. (National Sur. Corp. v. WCAB (Duffy), 30 CCC 387)


Death Claims Wages; Dependents

� Accurate assessment of wages

� Thorough and accurate search for all dependents - Total and Partial

◦ (LC 4703 discusses distribution of death benefits)


Benefits DueBased on date of injury that caused death

� TTD and PD benefits that may have accrued prior to the death of the worker are payable (LC 4700) to dependents, heirs, or “persons entitled thereto”.

� Burial Expenses – “up to” limits (LC 4701)◦ 1/1/2006 = $5,000◦ 1/1/2013 = $10,000

• Death Benefits • to dependents – total/ partial (LC 4702)

• if no dependents - to DIR (LC 4706.5)


� Burial – “reasonable expenses”:

2006 – up to $5,000

2013 - up to $10,000

� No Total or Partial Dependents: $250,000.00 - paid to DIR (LC4706.5)

Note: LC 4702 (a)(6)(B)– “to the estate of the deceased employee” [disputed by carrier with subsequent supporting case law: Six Flags, Inc. v. WCAB – Second Appellate Court -filed 11/27/06; City of Los Angeles v. WCAB – Second Appellate Court – filed 11/12/09]

Death Claims - Death Benefitsfor injuries on or after 1/1/2006



� One Total Dependent and No Partial Dependents-$250,000.00

� Two Total Dependents-$290,000.00

� Three or More Total Dependents-$320,000.00

� One Total Plus One or More Partial Dependents-$250,000.00 plus 4x the annual amount spent to support any partial dependents not to exceed $290,000.00.

� One or More Partial Dependents - 8 x the annual amount spent to support the partial dependents not to exceed $250,000.00


Statute of Limitations for Death Claims

� If injured worker passes away within one year from the DOI, the statute for filing is one year from when they knew, or with reasonable diligence should have known, it was industrial injury (LC 5412)

� If death is more than one year from DOI, and benefits furnished:�One year from date of death. �One year from date of last disability benefits.

�No death claim may be filed if more than more than 240 weeks after the date of injury.

(LC 5406) www.bradfordbarthel.com 13

Determination of Dependency

CONCLUSIVELY PRESUMEDDependents conclusively presumed wholly dependent:

LC3501

1. Minor child (under the age of 18), or a child of any age found to be physically or mentally incapacitated from earning who was either living with deceased parent or for whom the deceased parent is legally liable at the time of the injury:

2. Spouse earning less $30,000 in the preceding 12 months at time of death.


Determination of Dependency

DETERMINED BY THE FACTS

LC 3502

� “In all other cases, questions of entire or partial dependency and questions as to who are dependents and the extent of their dependency shall be determined in accordance with the facts as they exist at the time of the injury of the employee.”


Factual Determination of Dependency

To establish partial dependency, you must show that the claimant looked to the contributions to maintain his or her accustomed mode of living and that the living standard can no longer be maintained. This is a factual determination made by the Court. (LC 3502, LC 3503)

Any dependent must be a good faith member of the family, or bear a relation of husband or wife, child, posthumous child, adopted child or step child, grandchild, father, mother, father-in-law or mother-in-law, grandfather or grandmother, brother or sister, uncle or aunt, brother-in-law or sister-in-law, nephew or niece. (L.C. 3502 and LC 3503)


Special LC Sections for Public Safety Officers & Firefighters

Payments continue until age of 19 if child is still attending high school and is receiving benefits as a child of an active sheriff, police, fire fighter, etc. Does not include individuals whose principal duties are clerical.

Under L.C. 4708, dependents of the following may be entitled to a scholarship:•A peace officer who dies as a result of external

violence or physical force.•A corrections officer killed as a result of the direct

actions of an inmate.•A firefighter killed in the line of duty.

L.C. 4720-4728.www.bradfordbarthel.com 17


� One Total Dependent and No Partial Dependents-$250,000.00

� Two Total Dependents-$290,000.00

� Three or More Total Dependents-$320,000.00

� One Total Plus One or More Partial Dependents-$250,000.00 plus 4x the annual amount spent to support any partial dependents not to exceed $290,000.00.

� One or More Partial Dependents - 8 x the annual amount spent to support the partial dependents not to exceed $250,000.00


Calculating Death Benefits

� Labor Code 4703.5:◦ "In the case of one or more totally dependent

minor children…and notwithstanding the maximum limitations specified in Section 4702 and 4703, payment of death benefits shall continue until the youngest child attains age 18in the same manner and amount as temporary total disability indemnity would have been paid to the employee…

� This has sometimes been referred to as the Minor Dependency Benefit

� It has no dollar amount capwww.bradfordbarthel.com 19


� LC 4702 (b)

“A death benefit in all cases shall be paid in installmentsin the same manner and amounts as temporary total disability indemnity would have to be made to the employee, unless the appeals board otherwise orders . However, no payment shall be made at a weekly rate of less than two hundred twenty-four dollars ($224).”

� It is paid every two weeks

� It is subject to the two-year rule and the SAWWincreases up to the employee’s average weekly wage at time of injury



In the same manner and amount as TTD:� ‘Two Year Rule’ - LC 4661.5

� …when any temporary total disability indemnity payment is made two years or more from the date of injury, the amount of this payment shall be computed in accordance with the [TTD AWE] in effect on the date each…payment is made…

� AWE/ TTD - LC 4453 (a)(10)

� TTD Benefits – minimum and maximum earnings (AWE) are affected by changes in SAWW (COLA) effective 1/1/2007.

� Death Benefits might be affected if the deceased worker was a minimum or maximum wage earner


Insert SAWW/ COLA projections at 3%

22

Death Benefit

Minimum

AWE

Minimum

TTD

Maximum

AWE

Maximum

TTD Minimum Maximum

2006 189.00$ 126.00$ 1,260.00$ 840.00$ 224.00$ 840.00$

2007 198.37$ 132.25$ 1,322.49$ 881.66$ 224.00$ 881.66$

2008 206.17$ 137.45$ 1,374.49$ 916.33$ 224.00$ 916.33$

2009 215.55$ 143.70$ 1,437.01$ 958.01$ 224.00$ 958.01$

2010 222.00$ 148.00$ 1,480.04$ 986.69$ 224.00$ 986.69$

2011 222.00$ 148.00$ 1,480.04$ 986.69$ 224.00$ 986.69$

2012 227.36$ 151.57$ 1,515.75$ 1,010.50$ 224.00$ 1,010.50$

2013 240.00$ 160.00$ 1,600.08$ 1,066.72$ 224.00$ 1,066.72$

2014 241.78$ 161.19$ 1,611.97$ 1,074.64$ 224.00$ 1,074.64$

2015 248.24$ 165.49$ 1,654.94$ 1,103.29$ 224.00$ 1,103.29$

2016 253.89$ 169.26$ 1,692.64$ 1,128.43$ 224.00$ 1,128.43$

2017 261.51$ 174.34$ 1,743.42$ 1,162.28$ 224.00$ 1,162.28$

2018 269.36$ 179.57$ 1,795.72$ 1,197.15$ 224.00$ 1,197.15$

2019 277.44$ 184.96$ 1,849.59$ 1,233.06$ 224.00$ 1,233.06$

2020 285.76$ 190.51$ 1,905.08$ 1,270.05$ 224.00$ 1,270.05$

2021 294.33$ 196.23$ 1,962.23$ 1,308.15$ 224.00$ 1,308.15$

2022 303.16$ 202.12$ 2,021.10$ 1,347.39$ 224.00$ 1,347.39$

2023 312.25$ 208.18$ 2,081.73$ 1,387.81$ 224.00$ 1,387.81$

2024 321.62$ 214.43$ 2,144.18$ 1,429.44$ 224.00$ 1,429.44$

2025 331.27$ 220.86$ 2,208.51$ 1,472.32$ 224.00$ 1,472.32$

2026 341.21$ 227.49$ 2,274.77$ 1,516.49$ 227.49$ 1,516.49$

2027 351.45$ 234.31$ 2,343.01$ 1,561.98$ 234.31$ 1,561.98$

2028 361.99$ 241.34$ 2,413.30$ 1,608.84$ 241.34$ 1,608.84$

2029 372.85$ 248.58$ 2,485.70$ 1,657.11$ 248.58$ 1,657.11$

2030 384.04$ 256.04$ 2,560.27$ 1,706.82$ 256.04$ 1,706.82$

2031 395.56$ 263.72$ 2,637.08$ 1,758.02$ 263.72$ 1,758.02$

2032 407.43$ 271.63$ 2,716.19$ 1,810.76$ 271.63$ 1,810.76$

2033 419.65$ 279.78$ 2,797.68$ 1,865.08$ 279.78$ 1,865.08$

2034 432.24$ 288.17$ 2,881.61$ 1,921.03$ 288.17$ 1,921.03$

2035 445.21$ 296.82$ 2,968.06$ 1,978.66$ 296.82$ 1,978.66$

2036 458.57$ 305.72$ 3,057.10$ 2,038.02$ 305.72$ 2,038.02$

2037 472.33$ 314.89$ 3,148.81$ 2,099.16$ 314.89$ 2,099.16$

2038 486.50$ 324.34$ 3,243.27$ 2,162.13$ 324.34$ 2,162.13$

2039 501.10$ 334.07$ 3,340.57$ 2,226.99$ 334.07$ 2,226.99$

2040 516.13$ 344.09$ 3,440.79$ 2,293.80$ 344.09$ 2,293.80$


� Any accrued and unpaid TTD and/ or PD to the dependents, heirs, or estate (LC 4700)

� Beginning on date of death, TTD Rate, based on AWE at the time of injury that causes death, although not less than $224/ week◦ WCAB can order otherwise (eg, higher weekly rate)

� 2 years after date of injury, benefit rate is subject to current AWE/ TTD, although not less than $224/ week

� Payable until Death Benefit as provided in LC 4702 (or 4706.5 with no dependents) is paid in its entirety, or until dependent minor benefit is paid (LC 4703.5) ◦ (whichever is greater).


Calculating Death Benefits3 examples

� Examples 1 and 2:

◦ DOI = 6/1/2013◦ DOD = 8/1/2013 (61 days after injury)◦ 3 Total Dependents = $320,000 � Youngest dependent DOB = 3/2/2009� Youngest dependent 18th birthday = 3/2/2027

� timeanddate.com or other calculators online assist in calculating days and dates


Calculating Death BenefitsExample # 1: AWE = $390;

TTD Rate = $260� TTD accrued = 6/1/2013 – 7/31/2013 = 61 days at $260/

week = $2,265.71

� Death Benefits - Minimum death benefit = $224/ week

◦ Beginning 8/1/2013 at $260/ week

� (8/1/13 – 12/31/13 = 153 days @ $260 = $5,682.86)

◦ 2 years after DOI = 6/1/2015 – minimum AWE/ TTD = $248.24/ $165.49. No increase based on current minimum AWE

◦ Every January 1, review for updated current minimum AWE/ TTD

� AWE/ TTD is fixed through 1/1/2016; we will project 3% annual increases thereafter


Calculating Death BenefitsExample # 1: AWE = $390; TTD Rate = $260

� 3/2/2027 – youngest dependent turns 18

◦ $320,000 has not been paid; payments continue until $320,000 is paid

� Based on projected 3% COLA increases annually, AWE/ TTD minimum will be greater than this employee’s AWE/ TTD on 1/1/2031 = $395.56/ $263.72

� Benefit Rate will increase effective 1/1/2031 based on (projected) TTD rate of $263.72



� Review for SAWW/ COLA increases for minimum AWE/ TTD for each January 1 thereafter (decreases would not be applied) from 6/1/2015 – 2 years post DOI.

� Project annual, and running totals of Death Benefits paid. For Commutations, the DIR uses 365.24 days for every year (this includes consideration for Leap Years).

� Projecting for annual 3% increases, the total of $320,000 is paid out approximately 9/2/2036. The Minimum Benefit Rate during 2036 would be projected to be $305.72.

� Total Death Benefit from 8/1/2013 – 9/2/2036 = $320,000.00


28

Date of Injury Date of Death Dependents

DOB of

youngest

18th

Birthday AWE TTD Rate

6/1/2013 8/1/2013 3 Total 3/2/2009 3/2/2027 $390 $260

Minimum

AWE

Minimum

TTD

Death

Benefit

Rate (no

less than

$224)

days at

rate

Calendar

year death

benefit total

Death Benefit

Running Total

2006 189.00$ 126.00$

2007 198.37$ 132.25$

2008 206.17$ 137.45$

2009 215.55$ 143.70$

2010 222.00$ 148.00$

2011 222.00$ 148.00$

2012 227.36$ 151.57$

2013 240.00$ 160.00$ TTD 260.00$ 61

2013 240.00$ 160.00$ Death Benefit 260.00$ 153 5,682.86$

2014 241.78$ 161.19$ 260.00$ 365 13,557.14$

2015 248.24$ 165.49$ *6/1/2015* $ 260.00 365 $ 13,557.14

2016 253.89$ 169.26$ 260.00$ 365.24 13,566.06$

2017 261.51$ 174.34$ 260.00$ 365.24 13,566.06$

2018 269.36$ 179.57$ 260.00$ 365.24 13,566.06$

2019 277.44$ 184.96$ 260.00$ 365.24 13,566.06$

2020 285.76$ 190.51$ 260.00$ 365.24 13,566.06$

2021 294.33$ 196.23$ 260.00$ 365.24 13,566.06$

2022 303.16$ 202.12$ 260.00$ 365.24 13,566.06$

2023 312.25$ 208.18$ 260.00$ 365.24 13,566.06$

2024 321.62$ 214.43$ 260.00$ 365.24 13,566.06$

2025 331.27$ 220.86$ 260.00$ 365.24 13,566.06$

2026 341.21$ 227.49$ 260.00$ 365.24 13,566.06$

2027 351.45$ 234.31$ *3/2/2027* 260.00$ 365.24 13,566.06$

2028 361.99$ 241.34$ 260.00$ 365.24 13,566.06$

2029 372.85$ 248.58$ 260.00$ 365.24 13,566.06$

2030 384.04$ 256.04$ 260.00$ 365.24 13,566.06$

2031 395.56$ 263.72$ 263.72$ 365.24 13,760.16$

2032 407.43$ 271.63$ 271.63$ 365.24 14,172.88$

2033 419.65$ 279.78$ 279.78$ 365.24 14,598.12$

2034 432.24$ 288.17$ 288.17$ 365.24 15,035.89$

2035 445.21$ 296.82$ 296.82$ 365.24 15,487.22$

2036 458.57$ 305.72$ *9/2/2036* 305.72$ 244.0267 10,657.69$

2037 472.33$ 314.89$

Concluded 9/2/2036 320,000.00$

Calculating Death BenefitsExample # 2: AWE = $2100; TTD Rate = $1066.72

(initial maximum rate)

� TTD accrued = 6/1/2013 – 7/31/2013 = 61 days at $1066.72/ week = $9,295.70

� Death Benefits – Maximum TTD rate as of 6/1/2013 = $1066.72/ week

◦ Beginning 8/1/2013 at $1066.72/ week

� (8/1/13 – 12/31/13 = 153 days @ $1066.72 = $23,315.45)

◦ 2 years after DOI = 6/1/2015 – minimum AWE/ TTD = $1,654.94/ $1,103.29. Benefit rate increase to current maximum $1,103.29 on 6/1/15.

� During 2015: Death Benefits due = $56,739.76

� 151 days at $1066.72/ weeks = $23,010.67

� 214 days during 2015 at $1,103.29/ week = $33,729.15www.bradfordbarthel.com 29

Calculating Death BenefitsExample # 2: AWE = $2100; TTD Rate = $1066.72

(initial max rate)

Every January 1, review for updated current minimum AWE/ TTD – after 6/1/2015 = 2 years post DOI

AWE/ TTD is fixed through 1/1/2016; we will project 3% annual increases thereafter

� Based on projected 3% COLA increases annually, rate during 2018 will be $1197.15 per week. During 2019, the benefit rate will be $1223.06 per week. $320,000 will be paid during the second week of 2019.

� 3/2/2027 – youngest dependent turns 18; benefits continue until then.


Calculating Death BenefitsExample # 2: AWE = $2100; TTD Rate = $1066.72 (max)

� Benefits continue until 3/1/2027 (this assumes that the youngest child survives until age 18, and is not “incapacitated from earning”)

� Projecting annual 3% COLA increase, death benefit rate will reach maximum of $1,400.00, based on the worker’s AWE of $2100, 1/1/2024.

� Benefit rate remains at $1,400 until conclusion of Dependent Child Benefit – 1/1/2024 – 3/1/2027 (this assumes minimum AWE will not increase above $2100)

� Total Death Benefit from 8/1/2013 – 3/1/2027 = $890,383.25


32

Date of

Injury

Date of

Death Dependents

DOB of

youngest

18th


6/1/2013 8/1/2013 3 Total 3/2/2009 3/2/2027 $2,100 $1,066.72

Maximum

AWE

Maximum

TTD

Death

Benefit

Rate (no

less than

$224)

days at

rate

Calendar

year death

benefit total

Death Benefit

Running Total

2006 1,260.00$ 840.00$

2007 1,322.49$ 881.66$

2008 1,374.49$ 916.33$

2009 1,437.01$ 958.01$

2010 1,480.04$ 986.69$

2011 1,480.04$ 986.69$

2012 1,515.75$ 1,010.50$

2013 1,600.08$ 1,066.72$ TTD 1,066.72$ 61

2013 1,600.08$ 1,066.72$ Death Benefit 1,066.72$ 153 23,315.45$

2014 1,611.97$ 1,074.64$ 1,066.72$ 365 55,621.83$

2015 1,654.94$ 1,103.29$ 1,066.72$ 151 23,010.67$

2015 1,654.94$ 1,103.29$ *6/1/2015* $ 1,103.29 214 $ 33,729.15

2016 1,692.64$ 1,128.43$ 1,128.43$ 365.24 58,878.25$

2017 1,743.42$ 1,162.28$ 1,162.28$ 365.24 60,644.45$

2018 1,795.72$ 1,197.15$ 1,197.15$ 365.24 62,463.87$

2019 1,849.59$ 1,233.06$ 1,233.06$ 365.24 64,337.55$

2020 1,905.08$ 1,270.05$ 1,270.05$ 365.24 66,267.58$

2021 1,962.23$ 1,308.15$ 1,308.15$ 365.24 68,255.53$

2022 2,021.10$ 1,347.39$ 1,347.39$ 365.24 70,302.96$

2023 2,081.73$ 1,387.81$ 1,387.81$ 365.24 72,411.96$

2024 2,144.18$ 1,429.44$ 1,400.00$ 365.24 73,048.00$

2025 2,208.51$ 1,472.32$ 1,400.00$ 365.24 73,048.00$

2026 2,274.77$ 1,516.49$ 1,400.00$ 365.24 73,048.00$

2027 2,343.01$ 1,561.98$ *3/1/2027* 1,400.00$ 60 12,000.00$

2028 2,413.30$ 1,608.84$

2029 2,485.70$ 1,657.11$

2030 2,560.27$ 1,706.82$

concluded 3/1/2027 890,383.25$

3/2/2027 = 18th birthday


◦ DOI = 6/1/2013

◦ DOD = 8/2/2013 (61 days after injury)

◦ 3 Total Dependents = $320,000

� Youngest dependent DOB = 3/2/2002

� Youngest dependent 18th birthday = 3/2/2020



� TTD accrued = 6/1/2013 – 7/31/2013 = 61 days at $800/ week = $6,971.43

� Death Benefits = $800/ week◦ Beginning 8/1/2013 at $800/ week� (8/1/13 – 12/31/13 = 153 days @ $800 =

$17,485.71)◦ 2 years after DOI = 6/1/2015 – minimum AWE/ TTD =

$248.24/ $165.49; maximum AWE/ TTD = $1654.94/ $1103.29. ◦ No increase based on current minimum and maximum

AWE◦ Every January 1, review for updated current minimum

AWE/ TTD� AWE/ TTD is fixed through 1/1/2016; we will project

3% annual increases thereafterwww.bradfordbarthel.com 34

Calculating Death BenefitsExample # 3: AWE = $1200;

TTD Rate = $800

� Based on projected 3% COLA increases annually, minimum TTD/ Death benefit will not exceed $800 per week until 2069.

� 3/2/2020 – youngest dependent turns 18

� Death benefit total as of 3/1/2020 = $274,852.56

� Death benefits continue until $320,000 is paid –approximately 4/1/2021


36

Date of

Injury

Date of

Death Dependents

DOB of

youngest

18th


6/1/2013 8/1/2013 3 Total 3/2/2002 3/2/2020 $1,200 $800

Minimum

TTD

Maximum

TTD

Death

Benefit

Rate (no

less than

$224)

days at

rate

Calendar

year death

benefit total

Death Benefit

Running Total

2006 126.00$ 840.00$

2007 132.25$ 881.66$

2008 137.45$ 916.33$

2009 143.70$ 958.01$

2010 148.00$ 986.69$

2011 148.00$ 986.69$

2012 151.57$ 1,010.50$

2013 160.00$ 1,066.72$ TTD 800.00$ 61

2013 160.00$ 1,066.72$ Death Benefit 800.00$ 153 17,485.71$

2014 161.19$ 1,074.64$ 800.00$ 365 41,714.29$

2015 165.49$ 1,103.29$ *6/1/2015* $ 800.00 365 $ 41,714.29

2016 169.26$ 1,128.43$ 800.00$ 365.24 41,741.71$

2017 174.34$ 1,162.28$ 800.00$ 365.24 41,741.71$

2018 179.57$ 1,197.15$ 800.00$ 365.24 41,741.71$

2019 184.96$ 1,233.06$ 800.00$ 365.24 41,741.71$

2020 190.51$ 1,270.05$ *3/2/2020* 800.00$ 365.24 41,741.71$

2021 196.23$ 1,308.15$ *4/1/2021* 800.00$ 90.80015 10,377.16$

2022 202.12$ 1,347.39$

2023 208.18$ 1,387.81$

2024 214.43$ 1,429.44$

2025 220.86$ 1,472.32$

2026 227.49$ 1,516.49$

2027 234.31$ 1,561.98$

2028 241.34$ 1,608.84$

2029 248.58$ 1,657.11$

2030 256.04$ 1,706.82$

2031 263.72$ 1,758.02$

2032 271.63$ 1,810.76$

2033 279.78$ 1,865.08$

2034 288.17$ 1,921.03$

Concluded 4/1/2021 320,000.00$

Commutation of Death Benefits

� Commutations � https://www.dir.ca.gov/t8/10169.html

� §10169. Commutation Tables and Instructions.� Table 1 (“Present Value of Permanent Disability at 3%

Interest”), Table 2 (“Present Value of Life Pension at 3% Interest for a Male”), Table 3 (“Present Value of Life Pension at 3% Interest for a Female”), and “Commutation Instructions”, as issued in January 2001, are hereby incorporated by reference in their entirety as though they were set forth below. The tables and instructions are available from any office of the Division of Workers' Compensation and may be accessed and printed from the Division's homepage at www.dir.ca.gov.


Commutations – DEU

� https://www.dir.ca.gov/dwc/deu.html

◦ Commutation templates and instructions .zip file

◦ Templates and instructions to facilitate the calculation of life pension and permanent disability benefit commutations. When properly used, the templates assure that calculations are done in accordance with commutation calculation methods and tables that went into effect Jan. 17, 2001. The regulations and tables can be found in section 10169 and 10169.1 of Title 8, California Code of Regulations.


Commutations - DEU

� section 10169 and 10169.1 of Title 8, California Code of Regulations.

◦ https://www.dir.ca.gov/t8/10169.html

� Commutation Instructions

� Table 1Table 2Table 3

Table 1 (“Present Value of Permanent Disability at 3% Interest”) as issued in January 2001,

Table 2 (“Present Value of Life Pension at 3% Interest for a Male”) as issued in July 2001,

Table 3 (“Present Value of Life Pension at 3% Interest for a Female”) as issued in July 2001, and “Commutation Instructions” as issued in January 2001, are hereby incorporated by reference in their entirety as though they were set forth below. The tables and instructions are available from any office of the Division of Workers' Compensation and may be accessed and printed from the Division's homepage at www.dir.ca.gov.


Commutations - DEU

◦ Commutation templates

◦ Ex A, B, C, D, E, F, G

� Life Expectancy Tables (needed for lifetime benefit projections - PTD and Life Pension

◦ http://www.dir.ca.gov/osip/LifeExpectancyTables2010.pdf

◦ http://www.dir.ca.gov/osip/LifeExpectancyTables2011.pdf


COMMUTATIONS

� A – COMMUTATION OF ALL REMAINING PD

� B – COMMUTATION OF PD “OFF THE FAR END”

� C – COMMUTATION OF PD BY UNIFORM REDUCTION OF PAYMENTS

� D – COMMUTATION OF ALL REMAINING LIFE PENSION AFTER COMMENCEMENT OF LIFE PENSION

� E – COMMUTATION OF ALL REMAINING LIFE PENSION BEFORE COMMENCEMENT OF LIFE PENSION

� F – COMMUTATION OF PORTION OF REMAINING LIFE PENSION BY UNIFORM REDUCTION

� G – COMMUTATION OF PORTION OF DEFERRED LIFE PENSION BY UNIFORM REDUCTION


Commutations

� Ex A, B, C – fixed benefit end – PV Table 1

� DOC = date of commutation = 1/13/2016

� We are commuting death benefits, not PD.

� Death Benefit Calculation example # 3

◦ DOI 6/1/2013

◦ Date of Death 8/1/2013 (date that Death Benefits start)

◦ AWE $1200; Death benefit rate $800

◦ 3 dependents = $320,000 total benefit

◦ $320,000 paid at $800/ week = 400 weeks.

◦ Assume 15% attorney fees = $48,000


Commutations – Ex A – Commutation of all remaining PD (Death Benefit)

� Weeks elapsed through DOC (8/1/2013 – 1/13/2016) = 128.000 ◦ Accrued = 128 weeks @ $800 = $102,400.00◦ Commutation is for what remains beyond the accrued

amount

Total weeks of benefits = 400PV – use Table 1 – Present Value – line 2a – 273 weeks

line 2b – 272 weeksCommuted Value of all Benefits due after DOC = $201,549.76

this is the remaining benefit due, and includes any attorney fees (In this case, $48,000 to

applicant attorney; $153,549.76 to dependents)Interest Savings = $16,050.24


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IW:WCAB#Date:

A) COMMUTATION OF ALL REMAINING PD

DOI: PD Rating: %PD starts: 08/01/13 # of weeks: 400.0000DOC: 01/13/16 PD weekly rate: $800.00

1 Determine weeks of PD remaining after date of comm utation (DOC).1a # of days from PD starts through DOC incl………………………………………………… 8961b Divide by 7 days per week………………………………………………………………………………...…………� 71c Weeks elapsed through DOC………………………………………………………………………128.0000

1d Total weeks of PD………………………………………………………………………………. 400.00001e Subtract weeks elapsed through DOC (1c from above)………………………………………………...………….- 1281f Weeks of PD remaining after DOC ………….……………………………………………………………………..272.0000

2 Determine PV of weeks of PD remaining after DOC.Weeks PV

2a Enter corresponding PV for #weeks just above 1f* ………………………………….273 252.79352b Enter corresponding PV for #weeks just below 1f* ………………………………..272 251.93722c Difference of 2a & 2b…………………………………………………………………………....………….- 0.85632d Multiply by fractional portion of 1f………...……………………………………………………....………….x 0.00002e PV of fractional week…………………………………………………………………………. 0.00002f Add 2b………………...……………………….………………………………………………...……..…..+ 251.93722g PV of weeks remaining after DOC……………………………………………………………….251.9372

3 Determine commuted value of all PD due for period after DOC.3a PV of weeks remaining after DOC (2g from above)………………………………………………………………….. 251.93723b Multiply by PD rate………………………………………………………………………………...………….x $800.003c Commuted value of all PD due for period after DOC…………………………………………..$201,549.76

4 Additional interest due for payment after date of commutation:Additional interest due for each day late:……………………………………………………. $55.22

* Take values from Table 1 - Present Value of Permanent Disability

Commutations – Ex B – Commutation “Off the Far End” (death benefit)

� Weeks elapsed through DOC (8/1/2013 – 1/13/2016) = 128.000

Accrued = 128 weeks @ $800 = $102,400.00

Total weeks of benefits = 400

Amount to be commuted from remaining benefit = $48,000

PV – use Table 1 – Present Value – line 2a – 273 weeks

line 2b – 272 weeks

line 6a – 192 weeks


Benefit still due after commutation = 203.2762 weeks @ $800/ week = $162,620.96 (1/14/2016 – 12/6/2019)

68.7238 weeks eliminated from the far end (projected end date for Example 3 was 4/2/2021)

Interest Savings = $6,979.04 www.bradfordbarthel.com 50

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IW:WCAB#Date:

B) COMMUTATION OF PD "OFF THE FAR END"

DOI: 06/01/13 PD Rating:PD starts: 08/01/13 # of weeks: 400.0000DOC 01/13/16 PD weekly rate: $800.00

Amount to commute: $48,000.00

1 Determine weeks of PD remaining after date of comm utation (DOC).1a # of days from PD starts through DOC incl.…………………………………………………………..8961b Divide by 7 days per week………………………………………………………………...…………� 71c Weeks elapsed through DOC………………………………………………………………………128.0000

1d Total weeks of PD……………………………………………………………………………. 400.00001e Subtract weeks elapsed through DOC (1c from above)………………………………………………...………….- 1281f Weeks of PD remaining after DOC …………………………………………………………………………….272.0000

2 Determine PV of weeks of PD remaining after DOC.weeks PV

2a Enter corresponding PV for #weeks just above 1f* ………………………………273 252.79352b Enter corresponding PV for #weeks just below 1f *………………………………..272 251.93722c Difference of 2a & 2b……………………………………………………………………………. 0.85632d Multiply by fractional portion of 1f……………………………………………………………………………………….…………………………………………………………………...………….x 0.00002e PV of fractional week……………………………………………………………………………. 0.00002f Add 2b………………...……………………………………………………………………………………………….…….……………………………..……..…..+ 251.93722g PV of weeks remaining after DOC……………………………………………………………….251.9372

3 Determine commuted value of all PD due for period after DOC.3a PV of weeks remaining after DOC (2g from above)………………………………………………………………….. 251.93723b Multiply by PD rate………………………………………………………………………………...………….x $800.003c Commuted value of all PD due for period after DOC…………………………………………..$201,549.76

4 Determine PV (at $1/week) of amount to be commuted .4a Amout to be commuted…………………………………………………………………………….$48,000.004b Divide by weekly PD rate………………………………………………………………....…………� $800.004c PV of amount to be commuted…………………………………………………………………………….60.0000

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5 Determine PV of weeks remaining after commutation off far end.5a PV of weeks remaining after DOC (2g from above)…………………………………………………………………………….251.93725b Subtract PV of amount to be commuted (4c from above)…………………………....………….- 60.00005c PV of weeks remaining after commutation off far end……………………………………………………………………………….191.9372

* Take values from Table 1 - Present Value of Permanent Disability6 Determine number of weeks of PD remaining after co mmutation off far end.

Weeks PV6a Enter PV and corresponding #weeks for PV just above 5c* ……….. 192 181.82366b Enter PV and corresponding #weeks for PV just below 5c* ……….. 191 180.92676c Difference of 6a and 6b…………………………………………………………………………………0.8969

6d PV of weeks remaining after commutation off far end (5c from above)…………………………………………………………………………….191.93726e Subtract 6b……………………………………………………………………….…………….……....………….- 180.92676f Difference of 6d and 6e……………………………………………………………………………….11.01056g Divide by 6c…………………………………………………………………………….....…………� 0.89696h Proportional amount of last week of PD…………………………………………………………………………….12.27626i Add to weeks component of 6b……………………………………………………………………………...……..…..+ 191.00006j #weeks remaining after commutation off far end……………………………………………………………………………….203.2762

7 Determine amount of PD due after commutation off f ar end.7a #weeks remaining after commutation off far end (6j from above)…………………………………….203.27627b Multiply by PD rate……………………………………………………………………....………….x $800.007c PD still owed for period after DOC…………………………………………………………………………….$162,620.96

8 Determine number of weeks eliminated from far end.8a #weeks PD before commutation off far end (1f from above)……………………………………………………………………………….……………………272.00008b Subtract #weeks PD remaining after commutation (6j from above)………………...………….- 203.27628c #weeks eliminated from far end……………………………………………………………………………….…………………………………………………….68.7238

9 Additional interest due for payment after date of commutation:Additional interest due for each day late:……………………………………………………………….$13.15


Commutation – Ex C – Commutation by Uniform Reduction of (Future) Payments

� Weeks elapsed through DOC (8/1/2013 – 1/13/2016) = 128.000

Accrued = 128 weeks @ $800 = $102,400.00

Total weeks of benefits = 400

Amount to be commuted from remaining benefit = $48,000

PV – use Table 1 – Present Value – line 2a – 273 weeks


Benefit still due after commutation = 272 weeks @ $609.48 week = $165,778.56 (1/14/2016 – 4/2/2021)

$190.52 per week deducted from future benefit payments

Interest Savings = $3,821.44 www.bradfordbarthel.com 53

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IW:WCAB#Date:

C) COMMUTATION OF PD BY UNIFORM REDUCTION OF PAYMENT S

DOI: 06/01/13 PD Rating:PD starts: 08/01/13 # of weeks: 400.0000DOC 01/13/16 PD weekly rate: $800.00

Amount to commute: $48,000.00

1 Determine weeks of PD remaining after date of comm utation (DOC).1a # of days from PD starts through DOC incl…………………………………………………………….8961b Divide by 7 days per week……………………………………………………………………………...…� 71c Weeks elapsed through DOC………………………………………………………………………128.0000

1d Total weeks of PD…………………………………………………………………………………………..400.00001e Subtract weeks elapsed through DOC (1c from above)………………………………………………...………….- 1281f Weeks of PD remaining after DOC ………….……………………………………………………….272.0000

2 Determine PV of weeks of PD remaining after DOC.weeks PV

2a Enter PV for #weeks just above 1f* ………………………………………………….…..273 252.79352b Enter PV for #weeks just below 1f* ……………………………………………….…..272 251.93722c Difference of 2a & 2b……………………………………………………………………….. 0.85632d Multiply by fractional portion of 1f………...……………………………………………………………...………….x 0.00002e PV of fractional week………………………………………………………………………….. 0.00002f Add 2b………………...……………………….………………………………………....……..…..+ 251.93722g PV of weeks remaining after DOC……………………………………………………………….251.9372

3 Determine amount of reduction required to produce lump sum.3a Amount to be commuted………………………………………………………………………………$48,000.003b Divide by PV of remaining weeks (2g from above)………………………………………………...…� 251.93723c Amount of reduction after rounding to nearest whole cent………………………………………..$190.52

4 Determine new PD rate after reduction.4a Weekly PD rate………………………………………………………………………………….. $800.004b Subtract amount of reduction (3c from above)………………………………………………....………….- $190.524c New PD rate after reduction…………………………………………………………………….. $609.48

5 Determine amount of PD still owed for period after DOC.5a #weeks of PD remaining after DOC (1f from above)…………………………………………. 272.00005b Multiply by new PD rate after reduction (4c from above)……………………………....………….x $609.485c Amount of PD still owed for period after DOC………………………………………………….$165,778.56

6 Additional interest due for payment after date of commutation:Additional interest due for each day late:……………………………………………………….$13.15


Commutations

� Limitations

� Issued in 2001

� Table 1 – PV for commutation of current benefit payment – ends at 950 weeks (18.27 years)

� Table 2 and 3 – PV for commutation of future benefit payment (Life Pension) will project only up through 88% PD

� COLA is not included

� You can request Commutations from the DEU◦ https://www.dir.ca.gov/dwc/forms/DEU_CommutationRequ

est.xls


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COMMUTATION REQUEST

All cases:IW: Requested by:EAMS Case#: Contact number:

DOI:P&S date:

Attorney fee% (if applicable): ___________Annual SAWW increase (if appl.):_______ Judge to fill in Annual SAWW increase and

provide approval signature. If judge leaves Permanent Disability: Annual SAWW Increase blank, DEU will use 3%.

PD Rating: JudgePD duration (in weeks): Signature:____________________________Initial PD weekly rate:

Is PD subject to +15% adjustment under LC 4658(d)? (Y/N)Is PD subject to -15% adjustment under LC 4658(d)? (Y/N)

Life Pension: Death Benefit:

Date of birth: Average Weekly Earnings:PD start date ( typically the Start date of benefits:P&S date or the day after TD ends): Initial benefit rate:PD duration (in weeks): Death benefit am't (LC 4702): ____________Initial rate of LP benefits: DOB of youngest child:Gender:

100% Permanent Total Disability: All commutations will follow Baker vs. WCABin determining effective date of first SAWW

Date of birth: increase.PTD start date (typically the P&S date or the day after TD ends): Commutations involving 104 week TD capInitial rate of PTD benefits: will follow Brower vs. Jones (ADJ802221) inGender: determining start date of PD or PTD.

Additional Comments:

FAX Number

Directions: Fill in the section under All Cases as completely as possible. Remaining sections only need to be filled in if you are requesting a commutation of those benefits.

If DOI is o/a 1/1/03, then any LP or PTD benefits would be subject to annual SAWW-based increases.

If DOI is 1/1/05-12/31/12, then PD may be subject to adjustment under LC 4658(d). If applicable, enter the effective date of adjustment and rate after adjustment in Additional Comments section below.

Request Date:

Leave blank for Judge

DEATH CLAIMS CALCULATING BENEFITS

� They are uncommon

� They are expensive

� Benefit amount can vary

� Check your Labor Code

� Obtain assistance as needed


Tim Mussack

AMA Analysis & Ratings

B&B Sacramento

(916) 569-0790 – Office

[email protected]


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