My workers’ comp checks stopped

Payments stopping without explanation is one of the most common things that happens in a California claim, and it is almost always one of six things.

Before anything else: you should have received a written notice. California requires the claims administratorClaims administrator / adjuster The person handling your claim for the insurer or self-insured employer. to send a benefit notice explaining any change in your payments. If your checks stopped and nothing arrived in the mail, that is itself a violation — and it is worth pointing out in writing, because it tends to produce a fast answer.

The six reasons

1. The doctor said you’re permanent and stationaryP&S / MMI Permanent and Stationary / Maximum Medical Improvement. Your condition has plateaued — not that you are healed. Temporary disability ends here.. Temporary disabilityTD / TTD / TPD Temporary Disability, Total or Partial. Wage replacement while recovering. Two-thirds of average weekly earnings; 2026 maximum $1,764.11/week. ends when you reach maximum medical improvement. This is the most common reason, and it is not necessarily bad news — it means the case moves to the permanent disabilityPD Permanent Disability. Compensation for lasting impairment. A different and much lower weekly rate — 2026 maximum $290/week. phase. But it should have been explained to you.

2. You hit the 104-week cap. California generally limits temporary disability to 104 weeks within five years of the date of injuryDate of injury For a cumulative or occupational disease claim, the law sets it as when you first suffered disability and knew or should have known it was work-related — not when the wear began. Almost every deadline runs off this.. Nine conditions listed in § 4656(c)(3) — including severe burns, amputations, and chronic lung disease — get 240 weeks instead. And § 4656(d), added by SB 1127, gives 240 weeks for a cancer covered by the § 3212.1 presumption with no five-year window at all. If you are near two years of payments, check this first.

3. The doctor released you to modified work and your employer offered it. If modified duty is available and you can do it, temporary disability generally stops or converts to a partial payment based on the wage difference.

4. The claim was denied or delayed. Sometimes the checks stop because liability was rejected and the letter has not reached you yet, or crossed in the mail. If that is what happened, start here.

5. A medical report changed the picture. A QMEQME Qualified Medical Evaluator. A state-certified physician who resolves disputes. Unrepresented workers get a panel of three by random draw. or treating physician report finding you able to work will stop payments — often before you have seen the report yourself. Ask for it.

6. An administrative problem. A new adjuster, a file transfer, a returned check, an address change, a bank issue. Genuinely common, and genuinely fixable in a phone call — which is why it is worth calling before assuming the worst.

What to do this week

1. Check your mail, including anything you set aside. Benefit notices look like junk.
2. Call the adjuster and ask one question in writing: under what authority did temporary disability terminate, and on what date? Put it in an email. A written question creates a written answer.
3. Ask your treating physician whether you have been declared permanent and stationary, or released to modified duty.
4. Count the weeks you were paid. If you are near 104, that is likely the answer.
5. Apply for EDD State Disability Insurance if the gap is going to last. There is a lien later, but you need income now.

If the payment was simply late

The law adds an automatic 10% to any late temporary or permanent disability payment. There is no requirement to prove the delay was unreasonable — it is strict liability for lateness, and it is supposed to be added without you asking for it.

It very often is not. In 2024 alone, the DWCDWC Division of Workers’ Compensation, part of the Department of Industrial Relations. Administers the system. Information Services Center: 1-800-736-7401. Audit Unit cited 588 violations for late first temporary disability payments and 452 for late subsequent indemnity payments in the files it audited.

Pull your payment ledger and check the dates. This is money that is already owed and frequently unpaid.

Frequently asked questions