Return-to-Work Supplement Program
Employees injured on or after January 1, 2013, who have received a supplemental job displacement benefit voucher (SJDB), may also qualify for an additonal one-time $5,000 payment.
The Return-to-Work Supplement Program (RTWSP) will mail approved applicants a $5,000 check that can be used to supplement the earnings lost from being injured.
Instructions for completing online application:
Eligibility for RTWSP payment:
- Date of injury must be on or after January 1, 2013.
- Applicant must have received a SJDB voucher for that injury.
- Apply by the deadline. RTWSP must receive your application within one year from the date you were mailed the SJDB voucher
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.
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 search function to find your case and ADJ number. If you do not have an ADJ number, please contact the Information and Assistance Office nearest you.
- Workers’ Compensation claim number
- Claim numbers are issued by the claims administrator when an injury claim form is filed.
Frequently asked questions:
Please e-mail questions or comments regarding Return-to-Work Supplement Program at: RTWSP@dir.ca.gov.