Dec
18
2009
1

Permanent Total Disability Benefits – deja vu all over again

Double dip done right

Double dip done right

Some commentators have suggested that the recent Duncan v. WCAB (X.S.) case creates a “double dip” for injured workers entitled to permanent total disability benefits. [1]  While I would take issue with much of that commentary, I would agree that permanent total disability benefits are affected by changes in the state average weekly wage twice under Duncan v. WCAB (X.S.).  Of the four benefits in California workers’ compensation system that are affected by changes in the SAWW, only permanent total disability benefits are affected twice.

It took the patient guidance of a very smart friend to help me to understand how this works:

  • When determining the proper starting rate for a permanent total disability case, you must first turn to Cal. Labor Code § 4453(a)(10).  This statute dictates that the limits (as in the statutory minimum and statutory maximum limits) are to be increased by the increase in the state average weekly wage (or SAWW).
  • However, according to Cal. Labor Code § 4659(c) as interpreted by Duncan v. WCAB (X.S.), the benefit rates themselves are then increased by the increase in the state average weekly wage (or SAWW).

Is it “double dipping” to have both the upper/lower limits and benefit rates increased by the SAWW?

Perhaps, but that’s what the two statutes say and what the Court of Appeals has decided.

  1. Photo courtey of alex012 []
Dec
17
2009
0

What benefits are affected by the SAWW?

Getting a handle on the SAWW

Getting a handle on the SAWW

Four benefits in California workers’ compensation are affected by changes in the state average weekly wage (or SAWW).[1]

  1. Temporary total disability benefits
    • The maximum and minimum benefit rates can be affected by the SAWW.
    • “Commencing on January 1, 2007, and each January 1 thereafter, the limits specified in this paragraph shall be increased by an amount equal to the percentage increase in the state average weekly wage as compared to the prior year.”  Cal. Labor Code § 4453(a)(10).
  2. Life pension benefits
    • The statutory life pension rates are now increased by the SAWW as directed by the recent Duncan v. WCAB (X.S.) case.
    • “For injuries occurring on or after January 1, 2003, an employee who becomes entitled to receive a life pension or total permanent disability indemnity as set forth in subdivisions (a) and (b) shall have that payment increased annually commencing on January 1, 2004, and each January 1 thereafter, by an amount equal to the percentage increase in the “state average weekly wage” as compared to the prior year.”  Cal. Labor Code § 4659(c).
  3. Permanent total disability benefits
    • First, the minimum and maximum limits for permanent total disability benefits are increased, then the benefit rates themselves are increased.
    • “Commencing on January 1, 2007, and each January 1 thereafter, the limits specified in this paragraph shall be increased by an amount equal to the percentage increase in the state average weekly wage as compared to the prior year.”  Cal. Labor Code § 4453(a)(10).
    • “For injuries occurring on or after January 1, 2003, an employee who becomes entitled to receive a life pension or total permanent disability indemnity as set forth in subdivisions (a) and (b) shall have that payment increased annually commencing on January 1, 2004, and each January 1 thereafter, by an amount equal to the percentage increase in the “state average weekly wage” as compared to the prior year.”  Cal. Labor Code § 4659(c).
  4. Death benefits
    • “A death benefit in all cases shall be paid in installments in the same manner and amounts as temporary total disability indemnity would have to be made to the employee, unless the appeals board otherwise orders.” Cal. Labor Code § 4702(b).

Did I just describe two increases to the permanent total disability benefit rate?  Huh, so I did.

Tune in tomorrow for more on Duncan v. WCAB, COLA’s, and SAWW increases!

  1. Photo courtesy of Sean Venn []
Mar
06
2009
1

Ready for testing: Future Life Pension Rate with SAWW/COLA

XYZZXSJO2 - The motion picture!

XYZZXSJO2 - The sequel!

Last week I posted about a recent case from the San Jose WCAB that indicated a life pension SAWW[1] increase is applied on the first January 1 after the date of injury.  You can find a download of the XYZZXSJO2 case here.

I’ve just finished the COLA / SAWW future life pension rate calculator to determine what the future life pension rates are assuming a COLA / SAWW increase of 4.7% per year.  If you’re interested in becoming a beta tester for this COLA / SAWW calculator for life pension increases, please drop me a line and ask for access. [2]

Please keep in mind that this is not a life pension with SAWW / COLA increase commutation calculator.  The actuarial math involved in performing that calculation is … intense.

As an interesting side note, this week I saw my very first DEU commutation of a life pension with COLA increase.  Unlike the typical commutations everyone receives from the DEU, this commutation calculation was devoid of the actual methodology used.  I was pretty disappointed to find this out.

No matter!  Help beta test the new calculator by dropping me a line.  After you’ve given it a whirl, let me know what you think.

  1. SAWW means State Average Weekly Wage []
  2. If you have already helped me out as a beta tester, you already have access to this calculator. []
Feb
25
2009
2

XYZZXSJO2 – COLA and SAWW Increase Starts After the Date of Injury

XYZZXSJO2 - The motion picture!

XYZZXSJO2 - The motion picture!

Last week while Steve was at the Sacramento WCAB he heard about a recent case that held the COLA / SAWW adjustments and increases are calculated based upon the first January 1 following the date of injury. [1][2]

This case involving SIF (the subsequent injuries fund) is from the San Jose WCAB.  The name of the case is “XYZZXSJO2 v. Subsequent Injuries Benefits Trust Fund, ADJ 1510738, SJO 0251902”.  The name of the Applicant was anonymized to protect their identity.  [3][4]

Download a copy of XYZZXSJO2 now!

Thus far the conventional wisdom has been that the COLA/SAWW increases are calculated starting with the first January 1 after life pension gets paid out.  This is a tremendous change in the COLA/SAWW calculation of life pension.

Assuming a 1/1/2003 injury at exactly 70% permanent partial disability, there would be 426.5 weeks of permanent disability paid after the permanent and stationary date before the life pension gets paid out.  This equates to 8.2 years from the permanent and stationary date that has, thus far, not been taken into account with life pension calculations to date.  To put this in perspective, if someone had an injury on 1/1/2003 and became P&S on that same date[5] , the traditional method of calculating the life pension with COLA / SAWW increase would be too low by approximately 44%.

At the moment I’m finalizing a COLA / SAWW life pension calculator to determine what the future life pension rates are assuming a COLA / SAWW increase of 4.7% per year.  If you’re interested in becoming a beta tester for this COLA / SAWW calculator for life pension increases, please drop me a line and ask for access.

Unfortunately, I don’t have a citation for the 4.7% COLA / SAWW increase, but I believe it to be the offiical average used by the DEU[6] to calculate commutations of COLA / SAWW increases and adjustments.  If you have an official citation or document from the DEU, please drop me a line so I can include that citation here!

  1. COLA = cost of living adjustment. []
  2. SAWW = state average weekly wage. []
  3. I hope to have a scan of this decision for you soon! []
  4. David DePaolo of WorkCompCentral.com has graciously allowed me permission to offer you a copy of XYZZXSJO2 for download!  Thanks David! []
  5. Not likely. []
  6. Disaiblity Evaluation Unit. []

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