1. DWC

Return-to-Work Supplement Program

Employees injured on or after January 1, 2013, who have received a supplemental job displacement benefit voucher (SJDB) furnished by a claims administrator (insurance company) to an injured worker pursuant to section 10133.31, may also qualify for an additional one-time $5,000 payment by completing the online application.    

All completed and timely filed applications will be reviewed and a decision will be made on whether the individual is entitled to the supplement within 60 days of the receipt of the completed application. The $5,000 payment will be made within 25 days of the eligibility decision.

Eligibility for RTWSP payment:

• Date of injury must be on or after January 1, 2013.
• Applicant must have received a SJDB voucher furnished by a claims administrator.
• Apply by the deadline. RTWSP must receive application within one year from the date the SJDB voucher was served to the injured worker.

How to apply:

The application for the one-time $5,000 payment is available online. If you do not have access to the internet, every DWC district office has a kiosk equipped with a computer, scanner, and printer for your use. Information and Assistance Officers are available in person and over the phone at 1-800-736-7401.

You will need the following information to complete the application:

• The entire SJDB voucher including proof of service (page 6) furnished by a claims administrator (insurance company).
  • SJDB voucher in .pdf or .tiff format for uploading and attaching to online application
• Adjudication (ADJ) number
  • Use the public search function to find your case and ADJ number. If you do not have an ADJ number, please email RTWSP@dir.ca.gov
• Workers’ Compensation claim number
  • Claim numbers are issued by the claims administrator when an injury claim form is filed.
• Supplemental Job Displacement Benefit (SJDB) Proof of Service Date
  • Date SJDB voucher served to injured worker (page 6 of 6)

Frequently asked questions:

• Frequently asked questions about RTWSP
• Frequently asked questions about SJDB voucher

Contact Us:

Please e-mail questions or comments regarding Return-to-Work Supplement Program at: RTWSP@dir.ca.gov or (510) 286-0787.

What's

New

• DWC Posts Draft Regulations Updating SJDB/RTW Rules to Online Forum for Public Comment

December 2024