For Eligible Individuals with Date of Injury ON or AFTER January 1, 2013

Rules and Regulations:

The Return-to-Work Supplement Program (RTWSP) is one of the components of Senate Bill 863. Labor Code section 139.48 requires the Director to administer a $120 million fund for the purpose of making supplemental payments to workers whose permanent disability benefits are disproportionately low in comparison to their earnings losses. The program is based on studies conducted by RAND regarding permanent disability; specifically “Identifying Permanently Disabled Workers with Disproportionate Earnings Losses for Supplemental Payments.” (February 2014)

Eligibility for RTWSP:

An applicant must have a date of injury (DOI) on or after Jan. 1, 2013 and have received a Supplemental Job displacement Benefit (SJDB) voucher for said injury.

What is the deadline for applying:

The application for the Return-to-Work supplement benefit must be received by the RTWSP within one year from the date the Supplemental Job Displacement Benefit (SJDB) voucher (DWC-AD Form 10133.32 Rev: 10/1/15, or later version) was served on the applicant or one year from the effective date of the amended 8 CCR 17304 (March 20, 2017) for SJDB vouchers issued prior to December 1, 2015.

How to apply:

The application for this one-time supplemental payment is available online and can be completed from any computer which has access to the internet. If you do not have access to a computer, every DWC district office has a kiosk near the Information and Assistance office equipped with a computer, scanner, and printer for your use.

If you were previously denied because of the eligibility cutoff date, you do not have to resubmit a second RTWSP application. Your case will be reopened, reviewed, and a new determination made within 60 days.

You will need the following information to complete the application:

• The entire SJDB voucher including proof of service (page 6) 
  • SJDB voucher in .pdf or .tiff format for uploading and attaching to online application
• Adjudication (ADJ) number 
  • Use the public information search function to find your case and ADJ number. If you do not have an ADJ number, please contact the I&A office nearest you.
• Workers’ Compensation claim number 
  • Claim numbers are issued by the claims administrator upon filing an injury claim form
• Instructions for completing online application 
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