Hip Injury Workers' Comp in California — Fractures, Labral Tears, and Hip Replacement Claims

How Do You Get Hip Surgery Approved?

Your doctor requests the surgery. A reviewer checks it against state medical rules. If they say no, you can appeal through Independent Medical Review.

Hip fractures often come from falls, ladders, or crashes at work. Most hip claims start with an X-ray or an MRI. Your doctor uses those scans to find the damage. Many workers first try rest, shots, or physical therapy. When those steps fail, surgery may be the answer. That could mean repairing a torn labrum. The labrum is the ring of cartilage around your hip socket. Severe damage may call for a full hip replacement.

First, get medical help right away. Tell your employer about the injury as soon as you can. Ask for the claim form, called a DWC-1. Once you report it, the insurer must authorize up to $10,000 in care while they investigate. So treatment can begin before your claim is even approved. Do not let hip pain go unchecked while you wait.

Before surgery happens, the insurer reviews the request. This step is called Utilization Review under Labor Code 4610. A reviewer compares your case to the state medical guidelines. Strong scans and clear doctor notes help win approval. Most needed hip surgeries do get the green light.

Sometimes the reviewer denies the surgery. You do not have to give up. You can appeal through Independent Medical Review. You must file that appeal within 30 days under Labor Code 4610.5. A good appeal includes your scans, your records, and your doctor's reasons. Many denials get reversed when the file is strong.

How Much Does Workers' Comp Pay While Your Hip Heals?

You get temporary disability pay while your hip keeps you off work. It equals about two-thirds of your average weekly wage, within state limits.

When your hip stops you from working, you lose income. Workers' comp fills part of that gap. This benefit is called temporary disability, or TD. It pays about two-thirds of what you normally earn. The state sets a floor and a ceiling on the weekly amount.

Your first TD check should come quickly. Under Labor Code 4650, it is due within 14 days. That clock starts when your employer learns of your injury and lost time. A late check adds a 10 percent penalty on top. Here is how the 2026 numbers break down.

TD pay is not your full paycheck, so budget with care. It also does not replace your medical care. That care stays separate and is fully paid. If your doctor puts you on light duty, the rules can shift. Partial pay may apply when you work reduced hours. Always report any change in your work status to keep your checks correct.

What Is the Permanent Disability Rating for a Hip Injury?

If your hip never fully recovers, a doctor rates your lasting loss from 0 to 100 percent. That rating sets your final payout.

Some hips heal well, and some never feel the same. Once your hip stops improving, a doctor measures what stayed wrong. This is your permanent disability, or PD. For a hip, the doctor looks at lost motion and pain. They also weigh trouble with standing, walking, and climbing. A worker who needed a hip replacement usually rates higher.

Your rating is not just about the hip alone. Under Labor Code 4660.1, your age and your job adjust the number. The rating can move up or down because of those factors. A higher rating means more weeks of pay. PD checks run from $160 to $290 per week in 2026. Your lawyer can challenge a lowball rating with a second medical opinion.

The chart below shows how ratings turn into weeks and dollars. It uses the top 2026 weekly rate. A rating of 70 percent or higher also adds a lifetime life pension. That pension brings smaller checks for the rest of your life.

What If Your Hip Pain Built Up Over Years?

Slow wear from years of lifting or standing also counts. This is called cumulative trauma, and comp covers it like a sudden injury.

Not every hip injury comes from one bad fall. Years of heavy lifting can grind the joint down. So can constant standing, climbing, or twisting on the job. This slow harm is called cumulative trauma. It is just as valid as a single accident. Labor Code 5412 sets your injury date for these claims. It is the day the pain disables you and you learn work caused it.

Older hips often show some arthritis already. The insurer may blame part of your damage on that wear. This split is called apportionment. Your employer pays only for the share that work caused. A neutral doctor may examine you to settle the dispute. A strong medical report can protect the benefits you are owed. Do not accept a reduced offer without that report.

You may also qualify for help getting back to work. Say your hip keeps you from your old job. You can then receive a job-retraining voucher worth $6,000. It pays for schooling, tools, or training in a new field. This helps you build a future your hip can handle.