Disability payments may just be one of the most difficult workers’ compensation claims to understand. You have to know what kind of injury you have, when it occurred, and how it’s affected your life and your ability to work. Since it’s so difficult to figure out, it can be hard to know if you’re receiving just payments for your injury or work-related disability. So, we’ve written this blog to help you figure out how much you’re entitled to, and for how long. If you still have questions, however, just call The Epstein Law Firm! As always, your first consultation is free.
What payment am I eligible for?
If you’ve been injured at work and have lost income as a result, you may be entitled to disability compensation. But what you may not know is that disability compensation comes in many forms. It’s important to understand the differences when filing your claim, because the amount of money you receive after an accident can be dramatically different.
Temporary Total Disability
The most common form of workers’ compensation, TTD, or temporary total disability, is when you are completely unable to work for a given period of time. This time could vary from a few weeks to a few years, but is ultimately due to an injury or illness that can be recovered from. For example, with a back injury, a worker might be unable to walk for a period of time due to pain. But with physical therapy and rest, they can recover and go back to work. But the criteria for total disability are strict, and one must be unable to complete even light tasks to qualify.
TTD payments extend only through the period of time an individual is unable to work due to the injury. Generally, TTD payments are around 2/3 of an employee’s average gross weekly wage (excluding overtime and bonuses) for the year prior to the injury. If an injured employee was working multiple jobs at the time of the accident, the different salaries will all be considered, assuming the employer in charge during the time the accident occurred was aware of the individual’s second occupation.
Unfortunately, you may not be eligible to begin receiving TTD payments until the 4th working day after the accident. But payment must be received within two weeks of the employee notifying their boss of the accident. If you have not received payment, and have not received an explanation why, this might be the time to contact an experienced workers’ compensation attorney.
Regarding the amount you are entitled to, minimums exist depending on your family situation to ensure you receive enough money to keep your household afloat. The chart below shows the minimum rates and the average weekly wages a worker must earn in order to exceed this minimum:
Maximum TTD rates however, exist at a cap of 2/3 of weekly gross wages or the maximum TDD rate indicated in the chart below (note: workers are entitled to the lower of the two numbers).
While an estimate is useful to make sure you’re not being cheated, TTD payments can be complex and there are many variables which may change what you’re entitled to. TTD does not account for medical expenses or vocational retraining, so it is an incomplete estimate of what you’re entitled to. For more information, feel free to contact our office for a free consultation.
Temporary Partial Disability
Employees are entitled to temporary partial disability, or TPD, when they are able to return to work but must complete lighter tasks and lose wages as a result. A worker may still be able to work full-time and receive payments, as long as wages have been cut after an accident at work. Examples may include individuals who have strained muscles and are forced to carry lighter loads or limit the stress they put on their backs, and thus have to work easier jobs at lower pay.
Basically, as long as you are working at less than full capacity and are subsequently losing wages, this is your payment plan.
For TPD, your payment plan depends on when your injury occurred. If it occurred before June 28, 2011, you are entitled to 2/3 the difference of your average net wages (take-home pay) before injury, and your current reduced wages. To calculate what you are entitled to, you may follow the following equation:
((net wages pre injury)-(post injury reduced wages)) x 2/3
If your injury occurred after June 28, 2011, you are entitled to a similar sum of money, but that sum is calculated using your gross wages instead of net wages and can be calculated the following way:
((gross wages pre injury)-(post injury reduced wages)) x 2/3
In order to understand the difference, net wages are what an employee takes home after tax. Gross wages on the other hand, includes the taxes which are taken out of your weekly salary before you take your paycheck home. Therefore, payments for injuries occurring after June 28, 2011 are likely to be larger.
Permanent Total Disability
Unlike TTD or TPD, Permanent Total Disability (PTD) is intended to assist workers who are permanently unable to work due to a critical workplace accident. Injuries where PTD payments apply are generally:
- The permanent and complete loss of use of both hands, both arms, both feet, both legs, both eyes, or any two such parts, e.g., one leg and one arm;
- A complete disability so the employee is permanently unable to do any kind of work for which there is a reasonably stable employment market. This could mean quadriplegia, severe brain damage rendering a vegetative state, or other severe physical disabilities that make employment impossible.
Like TTD, permanent total disability is based on receiving 2/3 of your average gross wages (subject to minimums and maximums). The minimums and maximums for PTD are set based on the statewide average weekly wage (SAWW) at the time of the injury. In effect, this means the minimum PTD payments must exceed 50% of SAWW, but must remain below 133%. Unlike TTD, these payments are delivered out for the duration of an injured worker’s life. As such, employment while receiving PTD benefits may result in a termination or modification of the benefits. Further, PTD can be paired with the receipt of social security disability payments, but the Social Security Administration will adjust their payments accordingly, potentially resulting in a deduction of social security.
Assuming the maintenance of PTD benefits, however, PTD weekly amounts are adjusted yearly to reflect the increase in statewide average weekly wages for the past year. As such, PTD “wages” are constantly adjusted to ensure a standard of living can be maintained. When paired with social security, injured workers are generally provided sufficient coverage to live without worrying about the lost wages, and instead are able to focus on rebuilding their lives after the accident.
Permanent Partial Disability
Permanent Partial Disability, or PPD, is possibly the most complex of the types of disability payments. If a worker qualifies for PPD, this means part of the workers’ ability to earn a living has been permanently lost, however unlike PTD, this is not all encompassing. Like TPD, an individual may be able to do a lesser task at work at lower wages, and likely can find some level of employment, however PPD is likely more severe and could include permanent loss of a hand, eye, or leg, limiting mobility and subsequently making work more challenging on a permanent basis. Severity of the injured is determined on the basis of how an individual is able to function after experiencing maximum medical improvement (MMI), and MMI is assumed to occur within two years of the injury.
There are two types of PPD: Schedule Loss of Use (SLU) and Non-Schedule. SLU payments are provided assuming the lost use of an upper extremity (shoulder, arm, hand, wrist, finger), lower extremity (hip, leg, knee, ankle, foot, toe), eyesight or hearing. SLU benefits have a maximum number of weeks during which the compensation can be received, however the exact number depends on which appendage has been damaged. For more details on SLU payments, visit our amputation page or our hearing and eyesight page.
Comparatively, non-scheduled payments act as the catch-all for injuries not covered by SLU payments. These could include injuries to the spine, torso, heart, lung, pelvis, brain, etc., and payments are based on an employee’s permanent lost capacity to receive wages. For injuries occurring after March 13, 2007, the number of weeks to receive non-scheduled payments is determined as follows:
450 weeks for loss of wage earning capacity of greater than 80% thru 85%
425 weeks for loss of wage earning capacity of greater than 75% thru 80%
400 weeks for loss of wage earning capacity of greater than 70% thru 75%
375 weeks for loss of wage earning capacity of greater than 60% thru 70%
350 weeks for loss of wage earning capacity of greater than 50% thru 60%
300 weeks for loss of wage earning capacity of greater than 40% thru 50%
275 weeks for loss of wage earning capacity of greater than 30% thru 40%
250 weeks for loss of wage earning capacity of greater than 15% thru 30%
225 weeks for loss of wage earning capacity of 15% or less
Disability payments are one of the most confusing aspects of a workers’ compensation case. If you have questions about what type of disability you have, or what type of payment you qualify for, don’t hesitate to call the Epstein Law Firm. We’ll sit down with you and help you figure out exactly what you’re entitled to, for how long, and we’ll help you get the compensation you deserve. As always, your first consultation is free!