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WORKERS' COMPENSATION BENIFITS - Related Questions
Who decides if I qualify?
In most cases, the insurance provider will evaluate your initial claim and decide if you qualify. Some states review initial workers' compensation claims through their respective workers' compensation review boards and make a determination. Not all states review initial workers' compensation claims. Many only require the workers' compensation review board to engage in disputed claims. If a claim has been denied by an insurance company, and the injured worker disputes this decision or files an appeal, it is usually the workers' compensation review board that mediates and ultimately makes a determination regarding the case.
What benefits will I receive?
The benefits that you receive as a result of your workplace injury depend entirely upon the nature and extent of your injury. If your injury has totally disabled you in such a way that you are immobile and/or incapable of performing your job, but you will eventually heal, you will receive temporary total disability (TTD) until you have achieved total medical recovery. If you are unable to recover from your injury and you will remain permanently disabled as a result of your injury you might be eligible for permanent total disability (PTD). If you partially recover from your injury, but a portion of your injury is permanent, you may be eligible for permanent partial impairment (PPI).
Sometimes, the injury you sustain, such as a sprain or mild fracture, disables you from performing only certain tasks, or certain portions of your job. Should you only be able to perform your job on a part-time basis as a result of your injury you may be eligible for temporary partial disability (TPD). You will receive this payment until you reach a full medical recovery. If you are unable to make a full medical recovery you may be eligible for a PPI payment. If your claim is approved, the insurer will cover all medical expenses incurred as a result of a workplace injury. Travel expenses also related to medical treatment are also covered under this provision.
If you are unable to perform to your previous occupation, you may be eligible to receive reemployment benefits that retrain you for a new job. This benefit can also be in the form of a one time "job dislocation" payment should you wish to forgo retraining. Lastly, if you are the dependent of a loved one who has suffered a work related death you are eligible for death benefits through the workers' compensation program.
How long do benefits last?
The length of time that a benefit lasts depends on the type of benefit you are receiving. Typically, most temporary benefits end once you have reached a complete medical recovery and have returned to work on a full-time basis. Medical benefits will cover medical and travel expenses incurred as a result of your injury and most insurance companies will cover all expenses related to the injury until a complete medical recovery is achieved.
Permanent disability benefits are usually paid until death or until a full medical recovery is achieved. If the injured worker is able to find a new full-time occupation that he or she is able to perform, this may also result in the termination of permanent disability benefits. Similarly, permanent partial impairment payments may also be terminated should the worker make a complete medical recovery or obtain a new full-time occupation. The period of time that death benefits are paid to eligible dependents largely depends on the laws governing the state in which the deceased worker was employed.
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