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Return-to-Work Supplement Program

The Return to Work Supplement Program is a fund that will pay injured workers $5,000.00 if they are issued a Supplemental Job Displacement Benefit.  Unfortunately, many injured workers do not know they can apply for this extra money.

The application for this one-time supplemental payment is available online (  An injured worker must have a Date of Injury on or after Jan. 1, 2013 and have received a Supplemental Job Displacement Benefit Voucher for said injury. The application for the supplemental benefit must be received by the Return To Work Supplement Program within one year from the date the Supplemental Job Displacement Benefit voucher was served on the injured worker or one year from the effective date of the amended 8 CCR 17304 (March 20, 2017) for Supplemental Job Displacement Benefit vouchers issued prior to December 1, 2015.  You will need the following information to complete the application: 1) the entire Supplemental Job Displacement Benefit voucher including page 6, 2) Adjudication (ADJ) number and 3) Workers’ Compensation claim number.

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