Disability Benefits In-Depth
There are a few different types of disability-related benefits that workers' compensation insurance pays. The most common is Temporary Total Disability (TTD) benefits. These benefits partially pay you for lost wages when your work-related injury prevents you from working.
How much will I be paid?
Weekly wage replacement benefits are tax-free and amount to two-thirds of your average weekly wage. Your average weekly wage is usually determined by averaging your pay from the last four full weeks of work immediately before your injury. Overtime, commissions and other taxable pay are also included in the calculation, subject to limitations. This is the most common method of determining your average weekly wage but there are other ways depending upon how you are paid. Note: We will obtain your wage information from your employer; however, you may tell your claims rep of any and all forms of compensation you receive so you are paid correctly.
The amount of your weekly TTD benefit is subject to a minimum of $121 and a maximum of $454 as of Sept. 1, 2005.
When will I receive my first check?
According to the law, if your injury prevents you from returning to work for more than seven (7) calendar days, benefits begin on the eighth calendar day you miss work. (If your injury causes you to miss as many as 42 days from work, you will be paid for those first seven days of missed work.)
You should receive your first TTD check no later than the 14th day of missed work. If you do not, please contact us immediately. After your first check, you will receive this wage replacement check weekly from us for as long as you are eligible. LWCC mails those checks on Wednesdays.
Can I receive social security or unemployment while collecting workers' compensation benefits?
You may receive social security benefits, but they may be offset by your workers' compensation wage replacement benefits or vice-versa, so you would not necessarily be getting any additional money. In fact, if you receive social security, the government requires that you report any workers' compensation benefits and we require that you report to us any social security benefits.
It is illegal to collect unemployment compensation while you are collecting worker's compensation TTD benefits.
When will wage replacement benefits stop?
Under most circumstances, weekly TTD payments will stop when your doctor believes you are able to return to work, whether that means returning to a light duty position or to your regular occupation.
There are other circumstances, which may cause wage benefits to terminate or be temporarily suspended. These include:
What if I can work, but it doesn't pay as much?
If you are able to return to a job or begin earning any income that is less than 90 percent of your pre-injury wages, you may be entitled to two-thirds of the difference to supplement your earnings. This type of payment is called Supplemental Earnings Benefit (SEB).
You can receive SEBs until you are released to full-duty, are earning pre-injury wages or hit the maximum of 520 weeks, whichever occurs first. (TTD wage replacement benefits are included in the 520-week maximum)
SEB checks are mailed monthly.
What if after my wage replacement benefits stop, my injury again prevents me from working?
If the same work-related injury causes a second period of disability, you may be eligible for additional benefits, provided it has been less than one year since you received your last benefit check.
If the same work-related injury causes you later to earn less income, you may be eligible for additional SEB benefits, provided it has been less than two years since you last received an SEB payment.
What if there isn't any work I'm qualified for that can accommodate my injury?
LWCC has found that it is rare that your injury will prevent you from ever returning to your previous occupation or something related to your skills that will pay comparatively.
Permanent Partial Disability (PPD)
In some extreme cases, an injury may cause a permanent disability to a part of the body. In these cases, an additional PPD benefit may be owed after TTD or SEBs are paid if the doctor determines that a permanent disability exists to any of the following:
- Other fingers or big toe
Any other toe
The amount of any PPD benefit depends upon the body part injured and the percentage of disability determined by the physician. The amount of other wage replacement benefits already paid (TTD & SEB) is subtracted from the PPD. Since most injuries that involve permanent disability to the above body parts usually require significant time away from work, it is rare any additional PPD benefits are owed.
Permanent Total Disability (P&T)
When an injury renders an employee completely unable to earn any wages, even with job retraining, he may receive P&T benefits. Examples of such injuries are those involving loss of both hands, or both arms, or both feet, or both legs, or both eyes, or any two thereof, or paraplegia, or quadriplegia. Because some type of employment can be found for nearly all physical restrictions, P&T claims are very rare and are determined only once the injury has reached Maximum Medical Improvement. Note: Receiving social security disability benefits does NOT automatically classify the injured workers as P&T under the workers' compensation statute.