Workers’ Compensation Temporary Disability Benefits

If you’ve been injured on the job, you may be asking yourself, “What do I do now?” Of course, your first priority is to try and obtain the needed medical treatment to heal from your injuries so that you can get back to work.  Medical care is paramount to your recovery and should be the first thing on your list. Your medical providers can help you heal faster by providing the treatments, prescription medications, or therapies that you need. All injuries take time to heal, and your ability to recover and the time it takes for recovery will depend on many factors, including the nature and extent of the injuries you’ve sustained and whether the recommended treatment is authorized by the Employer, the Workers Compensation Carrier or their administrator.

Your medical team may advise that you stay home from work to give your body the time it needs to rest and recover.  It’s also possible that you may be able to go back to work, but in a reduced or light duty capacity. Either way, when you can’t work or the hours you can work are limited due to a workplace injury, it places you in a position of enormous stress, wondering where the money to pay your bills is going to come from.

What you may not know is that if you’ve been injured in a workplace accident while performing duties in the course and scope of your employment, California’s workers’ compensation laws are there to protect you.  These laws may allow you to get paid while you’re recovering if you qualify for temporary disability benefits. Attorney Todd Tatro is a certified specialist with extensive knowledge and experience in dealing with the complicated workers’ compensation laws and related benefits, including temporary disability.  Once retained, he will fight to make sure that you receive the temporary disability benefits that you’re entitled to, and this in turn will help take the burden of finances off your shoulders so that you can focus on healing.

About Temporary Disability

From a historical standpoint, prior to the Workers’ Compensation System coming into existence, it used to be that those who were injured at work really had no options. If they couldn’t work because of the injuries they sustained, they simply didn’t get paid. The employer was not responsible for paying their salary if they weren’t there. And of course, if someone is injured and isn’t able to produce income, the bills pile up very quickly. Even if they did recover fully from their injuries and could eventually go back to work, it was often too late because many times the financial damage was already done, and these people and their families could not financially recover.

Today, there are a wide array of workers’ compensation laws that have been put in effect that are specifically designed to try and eliminate or reduce the potential financial devastation that had previously occurred in the above scenario.  Anyone injured on the job today while an employee of another and performing work in the course and scope of their employment is usually entitled to some form of workers’ compensation benefits.  If they qualify, temporary disability benefits/payments are one of those benefits.  Temporary disability payments are designed to be short-term benefits that are designed to help you to stay financially stable during a transitory incapacity to work while you recover from your workplace injuries.  Generally, temporary disability benefits are based on a percentage of your average weekly earnings prior to the date of injury, subject to minimum and maximum rates that are fixed by statute.  However, when your treating physician or an evaluating physician gives you the go-ahead to go back to work and/or finds that your injuries have plateaued or stabilized thereby  reaching either a Permanent and Stationary (P&S) or Maximum Medical Improvement (the term currently used and known as MMI) status, your potential rights to temporary disability payments will end.

Who Is Eligible for Temporary Disability Benefits?

There are two different types of temporary disability benefits that are available under the California workers’ compensation laws. If you are considered totally disabled and unable to work by your doctors and have been taken off work while you recover,  then you are entitled to what is known as temporary total disability benefits.  However, if your doctor indicates you can work in a reduced capacity while you recover from your injuries, then you may be eligible to receive what is known as temporary partial disability or wage loss benefits.

To become eligible for any workers’ compensation benefits, it is important to keep in mind that your claim for benefits must first be approved or accepted by either your claim administrator.  On the other hand, if your case has been denied any benefits you might be entitled too would in most situations would need to be Awarded by the Administrative Law Judge assigned to your case based on a finding of a compensable injury and entitlement to such benefits, unless an agreement can be reached with defendants to pick up your case and provide such benefits.  For this reason, it is imperative that you have an experienced workers’ compensation attorney such as Todd R. Tatro on your side. After you’ve received your initial treatment for your on the job injuries, you should immediately contact Mr. Tatro for a consultation to discuss your case and potential rights to workers’ compensation benefits.

Temporary Disability Benefit Payments

If you have been taken off work by your doctor due to an industrial injury to heal and your claim has been accepted, you’re probably wondering how much money you’ll receive in weekly temporary disability benefits. The amount you receive in temporary disability benefits per week will usually depend on the average amount of money you were making prior to your date of injury.  Generally speaking, you should receive two-thirds of your average weekly total gross income (average weekly earnings) that you’ve lost due to your injuries up to the maximum amount fixed by statute based on your date of injury. For example, if you were earning an average of $1,200 gross each week in pay before your workplace accident, you would receive $800 per week in temporary disability benefits (two-thirds of $1200 equals $800), should you qualify for such benefits.

As to your temporary disability rate, you will need to be able to prove the income that you are “missing” or have “lost” due to your industrial injuries based on your earnings or in some instances earning capacity.  In determining your proper temporary disability rate, even part time jobs with other employers that are now affected because of your industrial accident/injuries can be taken into consideration. Remember that the more income or earnings you can prove, the more your temporary disability payments will usually be, up to the statutory maximum.

At the Law Offices of Todd R. Tatro, we know how confusing all of this can be, and that you may be overwhelmed with the information provided. Attorney Tatro will help you make sense of it all, and if retained to represent you, he and his experienced staff will help  guide you each step of the way through the workers’ compensation process, thereby leveling the playing field so that you can potentially maximize the benefits to which you are entitled out of the workers’ compensation system, including temporary disability benefits.

Time Period for Temporary Disability Benefit

Generally,  any temporary disability benefits to which you are initially entitled will start following a brief three (3) day waiting period once your treating physician decides that you are unable to work as a result of the injuries you’ve sustained.  If your disability extends beyond 21 days or if you are hospitalized as a result of your industrial injuries, then the waiting period is eliminated and compensation for the first three days is payable retroactively.

Thereafter, these benefits will normally continue to be paid to you at 2 week (14 day) intervals, until you have either fully recover and/or the treating physician has released you to return to work, or the treating or evaluating physician finds that your industrial injuries have reached a Permanent & Stationary/Maximum Medical Improvement status.   However, by law, for injuries occurring after April 19, 2004, you generally can’t receive temporary disability benefits for more than 104 weeks total (during the 5 year period following the date of your industrial injury), unless you sustained an industrial injury that meets one of the very limited exceptions under Labor Code, Section 4656(c)(3).

As indicated, under Labor Code Section 4656(c)(3) the very limited exceptions to the 104 week rule by statute for temporary disability benefits would include if you are suffering from industrial acute and chronic hepatitis B or C, HIV, sustained an injury resulting in an amputation or severe burns, had a high-velocity eye injury or your injury resulted in chemical burns to the eyes, pulmonary fibrosis or chronic lung disease.  In these limited situations where an individual has sustained one of the above outlined industrial injuries or conditions covered under Labor Code Section 4656(c)(3) and meets the required criteria for such, they would be potentially entitled to receive up to a total of 240 weeks of temporary disability benefits within the 5 year period following the date of the industrial injury.  Again, for cases that do not involve work related injuries that meet one of these very limited exceptions, the maximum period for temporary disability benefits would still be a total of up to 104 weeks within the 5 year period following the date of the industrial accident/injury.

The theory behind the above time limits on temporary disability is that, during that time you should have recovered fully from your industrial injuries, or if you haven’t, your injuries are probably severe enough so that you will likely not recover further. If you will not fully recover, once your right to temporary disability ends, you may become eligible for permanent disability benefits.

Bear in mind that when you are receiving temporary disability benefits, any employment that you agree to during this time will reduce the amount of your disability payments, and any amounts earned will need to be reported to the workers’ compensation insurance carrier or administrator. If for example, you find a paying job that your doctor approves of while you’re recovering, any temporary disability benefits to which would might otherwise be entitled too, would be reduced or offset by the amount you are receiving from that new job.

If you’ve suffered injuries while at work, and think you’re entitled to workers’ compensation benefits, call the office of Todd R. Tatro to discuss your case and how the process of filing and pursuing a workers’ compensation claim can help you. We offer a free, no-commitment consultation, and you can reach us by phone at (559) 431-0123 or online here.