What Benefits Are Available to Someone Who is Hurt On the Job ? Wage Loss Benefits

This section discusses Compensation for Wage Loss (called “Temporary Disability”)

Are you going to miss time from work?

If you miss time from work due to your injury, in almost all cases you are entitled to payment for Wage Loss – sometimes called “Time Loss” or Temporary Disability (“TD”) – as long as your medical provider authorizes your absence from work.

You don’t get paid for the first three calendar days for your time off work, unless you are off work for 14 days in a row (or hospitalized overnight as an inpatient within the first 14 days).

If the Work Comp Insurer denies your claim within the first 14 days from the date you reported it to the employer, you will not get paid for time loss (unless your claim is later accepted).

NOTE: If your claim is denied you only have a certain time period to appeal the Denial. Therefore, timely action is critical and important.

The law imposes certain deadlines and timelines for taking action. That action usually requires that a written document (often in the form of an Appeal and Objection to an Insurer’s decision to act, or failure to act) be properly completed and filed with the Workers’ Compensation Board, with a State Agency, or with a Court.

Failure to take timely and appropriate action can lead to serious consequences including a loss of some – or all – past, present or future benefits.

If you have concerns and/or questions about time limits and deadlines you should consider obtaining advice from a Lawyer.

Temporary disability (TD) is a not taxable. It is paid to replace your wage loss while you are off work and under the care of a doctor for your Work Injury while you are temporarily disabled because of your work-related injury or illness.

If you are able to work, but for reduced hours or wages, you may be able to receive Temporary Partial Disability (TPD) to make up for some of the money lost due to your injury or illness.

If you are not able to work at all because of your injury or illness, you may be entitled to Temporary Total Disability (TTD).

If you are unable to work, tell your doctor each time you see him/her to send a written authorization for TIME LOSS to the insurer.

How Is Temporary Disability Calculated?

Temporary total disability is paid at two-thirds (66.6%) of your Average Weekly Wage (“AWW”) at the time of injury. There are also maximum and minimum rates for payment of TEMPORARY DISABILITY.

Your AWW is based on, not only your wages, but also other considerations, such as overtime and bonuses, tips, commissions, per diem compensation, etc.

When Does Temporary Disability Start and End?

Temporary disability is not payable for the first three days of disability – unless you are hospitalized or you are disabled for more than fourteen days.

Once your claim has been accepted, payments should begin within fourteen days and continue to be paid every fourteen days until you are released to return to work, or until your treating doctor reports that your condition has stabilized (sometimes called “MEDICALLY STATIONARY” or “PERMANENT AND STATIONARY”).

Medically Stationary means that your medical condition (or conditions if you sustained injuries to multiple body parts) has stabilized or plateaued, and is not expected to get much better or worse with further medical treatment and/or the passage of time.

For California Claims Only:

If your injury occurred after April 19, 2004, your TD payments only last for a maximum of 104 weeks from the first payment for most injuries. Payments for a few long-term injuries such as severe burns or chronic lung disease can go longer than 104 weeks. TD payments for these injuries can continue for up to 240 weeks of payment within a five year period.

You can also file a state disability insurance (SDI) claim with the Employment Development Department.