When you suffer an injury on the job or develop an occupational disease and are unable to return to work for a period of time, you will likely be entitled to disability income benefits under your employer’s workers’ compensation. This disability pay can be a lifesaver when you are facing temporary or permanent disabilities due to a work injury and cannot provide for your family. The weekly benefits can help you stay afloat financially until you recuperate.
Note: You may also be entitled to medical treatment benefits to cover the costs of your medical care.
What types of workers’ compensation income benefits are available?
You are not entitled to income benefits unless you are out of work for seven or more days. If you miss more than 21 days of work, the first seven days will also be compensable.
The nature and extent of your (or your loved one’s) injury determines which benefit applies to you.
- Temporary Total Disability Benefits (TTD) – You can receive TTD when your injury totally prevents you from going back to work in any capacity for a certain period of time. If you injured your back and your doctor says you cannot work for at least six weeks, then you would receive TTD payments during that time. The maximum amount of time you can receive TTD payments is 400 weeks, unless your injury is catastrophic, in which case you can receive lifetime disability benefits.
- Temporary Partial Disability (TPD) – If your injury limits your capacity to work in some degree, but your doctor still okays you to return to work, albeit at a lesser capacity, you can receive TPD income benefits until you have fully recovered. The maximum amount of time you can receive TPD is 350 weeks.
- Permanent Partial Disability (PPD) – If you suffer a permanent disability, but are still able to work in some capacity (e.g., an appendage amputation), then you can receive PPD benefits. Your work injury doctor will assign you with a “disability rating,” a percentage which will be the guiding factor for your PPD benefits
- Death Benefits – If your loved one died because of a work injury or occupational disease, you are entitled to income benefits, as well. Beneficiaries that qualify include the surviving spouse and dependent children. Death benefits will include not only a weekly income check, but they will also pay for funeral expenses and any medical expenses your loved one accrued prior to death.
How much will my weekly income benefit amount to?
TTD income benefits are calculated at two-thirds of the average wages you were receiving prior to your accident. When calculating your benefit, the insurer will begin by taking an average of your weekly wages for the last 13 weeks prior to your accident. This includes overtime. Your benefit will be two-thirds of that figure. So, if your average weekly wages were $750/week, your TTD income benefits will be $500. This formula applies to death benefits, as well. TTD and death benefits have a maximum of $550/week.
If a doctor clears you to go back to work, but you need to take on lesser paying job as a result of your disability, you will qualify for TPD. The amount of TPD you receive will amount to two-thirds of the difference between your pre-injury wages and your current wages. So, if your average pre-injury wages were $750/week and you are now only receiving $450 week because of your disability, your TPD benefit will be $200/week. [($750 – $450) * 2/3] TPD benefits are capped at $367/week.
PPD income benefits are a little more complicated. O.C.G.A 34-9-263 identifies the maximum weeks of disability benefits corresponding to each body part. The maximum weeks for an arm or leg is 225, for a hand is 160, for a foot is 135, etc.
Once your doctor provides you with a disability rating in accordance with American Medical Association Guidelines, an insurer will multiply that percentage of bodily loss by the number of maximum weeks corresponding to the injured body part in O.C.G.A 34-9-263.
For example, if a doctor rates your injured arm at 20 percent disabled, the insurer will calculate PPD benefits by multiplying 225 weeks by 20 percent, and then multiply the result by your TTD benefits. If your TTD benefits are $500, then your PPD benefits would be [225 weeks x 20 percent x $500] = $22,500.
If you sustained a permanent disability at work and qualify for PPD, have an attorney review your case as soon as possible. It is not uncommon for injured workers to be assigned a disability rating that is too low, which ultimately reduces their weekly income benefit amount. Your attorney can determine if your rating and your benefit are fair and advise you accordingly.
What do I do if the insurer made mistakes with my income benefits?
Insurers handle many workers’ compensation claims quickly and fairly, causing claimants relatively few issues. However, a good number of people run into big problems with their claims – and specifically with their income benefits.
Some of the income benefit-related problems people commonly experience include the following.
- Insurers disputing the severity of your condition or overstating your abilities.
- Doctors or employers pushing employees to return to work before their condition safely allows.
- Insurers making mistakes when calculating average weekly wages.
- Doctors providing too low of a disability rating.
If you are having problems with your income benefits or have questions about what you are entitled to, we can help. Contact a workers’ compensation attorney in Savannah at the Bader Law Firm. Call us at 678-562-5595 and schedule a free consultation at your convenience.