What Is a Benefit Notice in a California Workers’ Compensation Case?

In a California workers’ compensation case, a benefit notice is a written communication sent by the insurance company to an injured worker. This notice explains the status of benefits, including what benefits are approved, denied, delayed, or modified.

Benefit notices are required by law and are meant to ensure that injured workers understand what to expect in terms of medical care, temporary disability, permanent disability, and other compensation.

Why Are Benefit Notices Important?

Benefit notices help workers keep track of what the insurance company is doing and give them a chance to take action if something is incorrect or missing. These notices are critical because they:

• Inform the injured worker of decisions about their benefits
• Explain reasons for delays, denials, or changes in benefits
• Provide timelines for when payments will be made
• Offer information on the right to dispute or appeal the decisions

Failing to provide timely and accurate benefit notices can result in penalties for the insurance company.

Common Types of Benefit Notices

Some of the most common notices include:

• Notice of Delay (NOA) – Informs the worker that the insurance company needs more time to investigate the claim (usually up to 90 days).
• Notice of Denial – States that the claim or a specific benefit has been denied, including the reasons and legal basis.
• Notice of Temporary Disability Payments – Outlines the amount and schedule of temporary wage replacement payments.
• Notice of Permanent Disability Benefits – Explains the worker’s permanent disability rating and how compensation will be paid.
• Notice of Supplemental Job Displacement Benefits (SJDB) – Informs the worker whether they qualify for a retraining voucher.

Each notice must include information about the worker’s rights, how to dispute the decision, and where to get help.

What Should You Do If You Receive a Benefit Notice?

• Read it carefully to understand what benefits are being paid, delayed, or denied.
• Check for errors, such as incorrect dates, benefit amounts, or missing information.
• Consult your doctor or attorney if you do not understand the medical basis for the decision.
• Take action quickly—many disputes must be filed within specific deadlines.

Need Help Understanding a Benefit Notice?

If you received a benefit notice that is confusing, inaccurate, or unjustified, legal guidance can help you respond appropriately. The Law Offices of Norman J. Homen assists injured workers with reviewing benefit notices and pursuing the benefits they are entitled to under California law. Contact us today for a free consultation.