Application for Return-To-Work Supplement Program - California

Application for Return-To-Work Supplement Program - California

Application for Return-To-Work Supplement Program is a legal document that was released by the California Department of Industrial Relations - Division of Workers' Compensation - a government authority operating within California.

FAQ

Q: What is the Return-To-Work Supplement Program?A: The Return-To-Work Supplement Program is a program in California that provides financial assistance to eligible workers who have a work-related injury or illness and have a permanent disability that prevents them from returning to their previous job.

Q: Who is eligible for the Return-To-Work Supplement Program?A: To be eligible for the program, you must meet certain requirements, including being injured on or after January 1, 2013, having a disability rating of 15% or more as determined by the Workers' Compensation system, and not being able to return to your previous job due to your disability.

Q: How much financial assistance does the program provide?A: The Return-To-Work Supplement Program provides a one-time payment of up to $5,000 to eligible workers. The amount of assistance you receive depends on your disability rating and other factors.

Q: Is there a deadline for applying to the program?A: Yes, there is a deadline for applying to the Return-To-Work Supplement Program. You must submit your application within one year from the date you received the Supplemental Job Displacement Benefit voucher or within one year from when the program was enacted, whichever is later.

Q: Are there any other benefits available for injured workers in California?A: Yes, besides the Return-To-Work Supplement Program, California also provides other benefits for injured workers, including medical treatment, temporary disability payments, permanent disability payments, and vocational rehabilitation services. It is advisable to contact the California Department of Industrial Relations for more information on these benefits.

Q: Can I receive other disability benefits while participating in the Return-To-Work Supplement Program?A: Yes, you can still receive other disability benefits while participating in the Return-To-Work Supplement Program. The program is designed to provide additional financial assistance on top of any other benefits you may be eligible for.

Q: What if I am denied eligibility for the Return-To-Work Supplement Program?A: If you are denied eligibility for the program, you have the right to appeal the decision. You should follow the instructions provided in the denial letter and submit a request for a hearing within the specified timeframe.

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Form Details:

  • Released on August 1, 2020;
  • The latest edition currently provided by the California Department of Industrial Relations - Division of Workers' Compensation;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the California Department of Industrial Relations - Division of Workers' Compensation.

Download Application for Return-To-Work Supplement Program - California

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