Temporary disability (TD) benefits are payments you get if you lose wages because your injury prevents you from doing your usual job while recovering.
Do I need to fill out the claim form?
Yes, if you want to make sure you qualify for all benefits. If you do not file the claim form within a year of your injury you may not be able get benefits. Your employer must give you a claim form within one day of knowing you were injured. Filling out the claim form opens your workers’ comp case. State law also lays out benefits beyond the basics you may qualify for once you file the claim form with your employer. Those benefits include, but are not limited to:
• A presumption that your injury or illness was caused by work if your claim is not accepted or denied within 90 days of giving the completed claim form to your employer
• Up to $10,000 in treatment under medical treatment guidelines while the claims administrator considers your claim
• An increase in your disability payments if they’re late
• A way to resolve any disagreements that might come up between you and the claims administrator over whether your injury or illness happened on the job, the medical treatment you receive and whether you will receive permanent disability benefits.
What if my employer didn’t give me the claim form?
Ask your employer for the form or call our office for help to get it.
What are TD benefits?
TD benefits are payments you get from the insurance company providing Workers’ Compensation coverage to your employer if you can’t do your usual job while recovering from your injury or illness. TD benefits are not taxable. If you can do some work while recovering but earn less than before the injury, you will receive temporary partial disability benefits. If you can’t work at all while recovering you will receive temporary total disability benefits.
How is TD calculated?
As a general rule, you are paid two-thirds of your gross (pre-tax) wages at the time of injury, with minimum and maximum rates set by law. Your wages are figured out by using all forms of income you receive from work: wages, food, lodging, tips, commissions, overtime and bonuses. Wages can also include earnings from work you did at other jobs at the time you were injured. You must have proof of these earnings.
When does TD start and stop?
TD payments begin when your doctor says you can’t do your usual work for more than three days or you get hospitalized overnight. Payments must be made every two weeks. Generally, TD stops when you return to work, or when the doctor releases you for work, or says your injury has improved as much as it’s going to. If you were injured on or after Jan. 1, 2008 you are eligible to receive 104 weeks of disability payments within a five-year period. The five-year period is counted from the date of injury. 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.
State disability insurance
You can also file a state disability insurance (SDI) claim with the Employment Development Department. You should file this claim even if your workers’ comp case is accepted. This will allow you to get SDI payments after the 104 weeks of TD payments if you are still too sick or hurt to go back to work.
Do I get other benefits while receiving TD?
You have the right to receive medical treatment right away. Your employer’s workers’ compensation insurance may investigate your claim before deciding whether or not to accept it. Even if it investigates, it must approve medical treatment for your injury within one working day after you submit a claim form. You should also be reimbursed for transportation costs including mileage, parking and tolls for trips to and from the doctor’s office. Workers’ compensation insurance also pays for prescriptions, physical therapy visits and other medical costs.
What if there is a problem with my benefits?
Consult Statewide Law attorneys. We help injured workers with their workers’ compensation claims . Our job is to plan a strategy for your case, gather information to support your claim, keep track of deadlines and represent you in hearings before a workers’ compensation judge at your local Workers’ Compensation Appeals Board office. If you hire one of our attorneys, the attorney’s fees will be taken out of benefits you receive. A judge must approve the fees.
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