Workers’ Compensation, (WC) is designed to compensate the injured employee for an injury, death, or occupational disease occurring while the employee is on the job.  The payments include all authorized medicine, and medical, doctor and hospital bills.  If the employee is unable to work for more than three days, he is paid compensation based on his average weekly wage.  The average weekly wage is calculated based on earnings before the date of injury. 

If you were injured on the job, you should know that papers need to be filed correctly within the appropriate number of days. You must follow all the rules and procedures or you might not get all the benefits you have a legal right to receive.

There is no compensation for pain and suffering.

Temporary Total Disability (TTD)

An employee is entitled to TTD when the employee is unable to work due to medical restrictions. The amount of the TTD payment is 2/3 of the weekly wage, including overtime and insurance benefits, up to a maximum determined by the year of injury.  It is payable at least every two weeks. It is payable until the employee is capable of going back to work. 

Temporary Partial Disability (TPD)

TPD is payable to those persons who are unable to return to work full-time but are able to resume work in a different capacity or on a part-time basis.  The amount that the person is compensated is 2/3 of the difference between his present earnings and his pre-injury earnings up to a maximum determined by the year of injury.  It is payable at least every two weeks until the person reaches maximum medical improvement.

Permanent Partial Disability (PPD)

PPD occurs when full recovery from the injury is not possible; for example, a loss of arm, fingers, or  restricted mobility in the back.  The amount of disability depends on the severity of the injury.  Certain types of injuries or losses are “scheduled awards” meaning that the law has   defined the amount of compensation to be granted to them.  Claimants who have extremity (legs, feet, arms, hands, fingers, eyes, shoulder) injuries are limited to scheduled awards.  For the “non-scheduled award” the disability is rated as a percent of the body as a working unit.  The following factors are taken into consideration: a doctor’s determination of medical impairment,  life expectancy, the weekly temporary disability rate. 

For accidents before January 1, 2006 the law limits claimants with impairment of 25% or less to $60,000.00 for temporary and permanent benefits combined.  Claimants with more than 25% impairment may receive up to $120,000.00 in combined benefits. 

For accidents after January 1, 2006 the law limits claimants with impairment of 25% or less to $75,000.00 for temporary and permanent benefits combined.  Claimants with more than 25% impairment may receive up to $150,000.00 in combined benefits. 

Permanent Total Disability (PTD)

PTD occurs when a person loses both hands, both eyes, both legs, or a disability determination by an administrative law judge stating that the employee is totally disabled after considering the medical impairment, educational background, work history, etc.  PTD is payable at the rate of 66 2/3 % of the employee’s salary for life.  In order to qualify, the person must be unable to earn any wages.

You may change physicians by making a written request to the employer or insurance carrier.  If the permission is neither granted nor refused within 20 days, the employer’s insurance carrier is deemed to have waived any objection.  (Frequently, the employer and insurance company   object to any change in physician and the issue needs to be brought before a judge for determination). You may also change a doctor once in the first 90 days if you have not been placed at MMI. If you change doctors without requesting permission in writing, the insurance company may refuse to pay these bills.

If you disagree with the doctor’s impairment rating or the date of maximum medical improvement, your attorney may request an Independent Medical Examination (IME). If you are objecting to a Final Admission of Liability, you must send in your objection and propose the name or names of a level II accredited physician within 30 days of the date of the final admission.

A Level II accredited physician has received special training through the Division of Workers’ Compensation to evaluate permanent impairment under the law. The cost of this examination is usually $675.00 and is paid by the party requesting the IME.

An employee may obtain a lump sum payment on almost all permanent disability awards.  For certain types of awards lump sum payments are not granted until six months have passed from the date of injury. Further, the lump sum payment must be justified and such action must be shown to be in the worker’s best interest.              

If you receive a permanent partial disability award, you may request the automatic payment of up to $10,000 in a lump sum without waiving your right to prosecute the claim for additional permanent disability benefits. Or, you may request a maximum lump sum payment of up to $60,000 (in combined lump sum payments) on your claim.