“The surgery is approved but it’s three months out. Who pays me until then?”

The rule

Temporary disability is owed while you are unable to work because of the industrial injury. Not while you are receiving treatment — while you are unable to work. Waiting for an authorized surgery, with a physician taking you off work, is squarely within that.

What has to be in the record is the work status. A physician’s report saying you are temporarily totally disabled, or setting restrictions your employer cannot accommodate. If nobody has written the work status down, that is the actual problem — not the waiting.

Get it in writing at every visit. A verbal “stay off work” that never reaches the file is the most common reason payments stop.

If the checks stopped anyway

Ask why, in writing. California requires 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 pointing it out tends to produce a fast answer.

Then check whether it is one of the six usual reasons. The six reasons checks stop.

And count the penalty. The law requires payment every two weeks. A late payment carries a self-executing 10% — no hearing, no motion, no showing of unreasonableness. § 5814 can add up to 25% or up to $10,000, whichever is less where the delay was unreasonable. What that comes to.

If the delay is the carrier’s doing

A surgery that is authorized but not being scheduled, or an authorization that keeps expiring, is a treatment-delay problem with its own remedies.

An expedited hearing exists for exactly this. The law requires expedited handling where the issue is entitlement to temporary disability, or to treatment outside utilization reviewUR Utilization Review. The process that approves, modifies, or denies each treatment request. A modification is a denial of what it left out., once some injury has been accepted. It is available to unrepresented workers. How to ask.

And check the utilization review timeline on the original decision. A UR decision issued late is invalid, and an invalid UR moves the medical necessity question to a judge. The date on the letter matters. What to check.

While you wait

Keep the treating relationship active. A gap in the record during a wait reads as improvement and gets used that way.

Do not take on work that contradicts your restrictions, even briefly, even for a friend. This is when surveillance happens. What that looks like.

And if you truly cannot make it to the surgery date financially, say so — to the adjusterClaims administrator / adjuster The person handling your claim for the insurer or self-insured employer. in writing, and to a lawyer. There are faster paths than waiting quietly. I can’t afford to wait.