When a person experiences a work place injury they are often confused as to what types of benefits they may be entitled to. Quite often I get phone calls and walk-ins wanting some guidance on what an accepted workers’ compensation claim entitles the injured worker to. This article will focus on temporary total disability benefits and the commons ways the workers’ compensation insurer can discontinue them.
Temporary Total Disability Benefits (TTD): This may be the workers’ compensation benefit most injured workers are familiar with. That said, they often do not understand all the nuances of TTD. In a nutshell when someone experiences an admitted work place injury that brings about work restrictions prescribed by a doctor that precludes the injured worker from returning to work, then they are entitled to this benefit. The amount of the benefit is 2/3’s of your average weekly wage. If the employee is salaried, then figuring out this amount is rather easy. If the injured worker is hourly and works different hours each week, then determining the average weekly wage requires going back 26 weeks of pay and averaging that amount out.
Refusal of Accommodating Work
One important caveat to this benefit is that when a work place injury does occur, the employer is entitled to provide the injured worker with accommodating work. What this means is that if your position for the employer is a more physical job and you get injured resulting in work restrictions that preclude you from performing those tasks for a period of time, the employer has the right to offer you a position that is consistent with your work restrictions. The example I often use is a construction worker getting hurt on a job site that precludes him from lifting heavy objects so the employer gives the injured worker a desk job at the office for a period of time. In this circumstance, if the construction worker refuses accommodating work (i.e. the desk job) then they are precluded from receiving Temporary Total Disability Benefits.
Failure to Conduct a Diligent Job Search
Other common factors that will affect your TTD benefits include being released to work without restrictions, retiring from your job, and failing to search diligently for work. It may come to a surprise to many that the workers’ compensation insurer can discontinue your TTD benefits for inadequate job searches. That’s why it is important to understand that if your employer lets you go because they are unable to accommodate your restrictions then it is the employee’s responsibility to search for work that is within their work restrictions. Failing to do so may result in a discontinuance of TTD benefits.
Maximum Medical Improvement (MMI)
It’s also important to understand that in the world of workers’ compensation, TTD benefits are also affected by what is termed “Maximum Medical Improvement (MMI)”. MMI is a complex concept, but is defined as “the date after which no further significant recovery from or significant lasting improvement to a personal injury can reasonably be anticipated.” This is the long way of saying the moment when the doctor tells you that there isn’t anything additional they can do to help you improve from your work injury and issues permanent work restrictions. After this date, the workers compensation insurer is entitled to discontinue your TTD benefits 90 days following the date of MMI.
Termination for Cause or Misconduct
Injured employees that have been terminated from there date of injury employer for misconduct suspends them from receiving TTD benefits. Unlike the other types of ways the insurer can discontinue, benefits can be reinstated if they conduct a diligent job search following the termination.
This last one is pretty self-explanatory, but when the employee decides they are going to retire, any ongoing TTD benefits will cease. The presumed age of retirement in workers’ compensation is 67. The good thing is that this presumption can be rebutted if the employee has no interest in retiring (ie. by showing diligent job search, by getting a job or by expressing interest in returning to the date of injury employer when they recover from the injury).
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