Workers injured on the job receive temporary total disability payments if they lose time from work. This equates to a percentage of salary based upon the state in which the injury occurred. Each state sets the limits for workers' compensation payments for lost time at work. When the worker incurs a permanent injury, a lump sum award occurs only after the treating physician classifies the injury as permanent and stationary or P&S, as referred to in the industry.
Injured workers that do not experience any lost time from work do not receive disability payments or settlements, but they do receive medical treatment for their injury. As long as the injury continues, the injured worker receives medical treatment. The treating physician is the one who declares the status of the injury and determines whether treatment is to continue. Claims examiners also have the ability to review the medical reports and meet with the doctor to question the status of continued treatment.
Temporary Total Disability
Temporary total disability occurs when an injured worker experiences an injury that keeps him from returning to work for a temporary period. The injured worker receives TTD payments to replace a portion of his salary while he cannot work. Payments occur on a regular basis and must start within a specific amount of time from the date of injury under most state laws, if the insuring agency accepted the claim. Payments calculate based upon the wage at the time of the injury and the state’s set amounts for payments. Employees with this type of injury do not receive a settlement.
Employees that receive a permanent disability due to an on-the-job injury will receive a lump sum payment settlement only after the treating physician considers the injury permanent and stationary. In California, for example, as the injured worker undergoes treatment, the injury may be in flux and he receives PD payments in addition to the TTD payments. If the employee loses an eye, a limb, a digit or experiences a loss of vision or hearing because of a work injury, the doctor waits until all the healing that can occur reaches a stable state before declaring the injured worker permanent and stationary. Injured workers can receive a settlement for a permanent disability, even if they are able to return to work.
When the treating physician submits his permanent and stationary report to the claims examiner, a copy goes to the injured employee. At this time, or shortly thereafter, the claims examiner will call for a settlement meeting with the injured worker. Advice to injured workers includes seeking counsel at this time from an attorney familiar with the workers' compensation laws in his particular state, as the laws vary state-to-state, to ensure he receives the maximum award available. Insurance companies have tables that rate a permanent disability based on the claimant's age, the injury type and the potential he could have earned if the injury did not occur. Individual states establish the rating table for permanent disability injuries. Future medical treatments receive an award that can occur in a lump sum payment in certain circumstances.
If the injured worker cannot return to the job he previously held due to an injury, he is entitled to vocational rehabilitation. Vocational rehabilitation can occur for any employee that can no longer do the job he held, regardless of whether he has received a permanent disability rating. If the injury prevents him from doing the job, but he is not permanently disabled, he will not receive a settlement, but will receive training in another line of work. Claims examiners handle employee injuries on a case-by-case basis and outcomes rely heavily on doctor's reports.