When will workers' comp cut off my temporary disability (TD)?
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- Опубликовано: 9 сен 2024
- This video reviews the most common ways workers' comp will stop TD. If you are an injured worker with a California injury, and don’t have an attorney, this video is intended to help provide an overview of workers’ compensation topics so you can better represent yourself.
Jeremy Lusk is a certified specialist in workers’ compensation with about two decades of experience, and previously served as a Judge at the Fresno District Office of the WCAB. He has worked out of Fresno, but appeared at numerous Boards to represent both injured workers and employers/carriers.
No attorney/client relationship is created or implied by this video. This video is not offering legal advice as to what you should, or should not, do in your workers’ compensation case, but rather offers education/information as to the California workers’ compensation system for unrepresented workers so they can better represent themselves and make more informed decisions.
If you have any questions, let us know at questions@mywcguide.com
Ins. cut off after 2years, even primary Dr. state that I am still permanently temporary disability, then what will happen? Thank you.
There is no "permanent temporary disability." It's either one or the other. Insurance can cut off temporary disability after two years of payments. If the injured worker is still temporarily disabled, then he or she may be able to get EDD benefits. Plus, workers' comp may start permanent disability advances if there is an expectation of PD.
Great videos and rare to see someone say it out loud the way it is.
How Temporary Disability weakly rate is calculated?
Lets say the worker has a 20$ per hours salary and works 40 hours = 800 $ per week. But the worker is working more than 40 hous a week and adds overtime and double time. And her whole paycheck is 1400 per week.(600 in overtime/ doubletime)
Is the temporary disability calculated based only on the base pay of 800 per week=40 hours , or its calculated keeping in mind the overtime also 1400 = 60 hours( overtime and doubletime included) ?
And how is the calculation based? Last 30 days of work before she is taken off work by the doctor? The last 3 months? The last 6 months average salary? Usually workers especially in medical field end up with 50 to 60 h per week instead of 40. The Average weekly wage (AWW), is calculated for the last 30 days or 3 months, 6 months or last 12 months of work.
Second question is. How AWW is calculated if you get a subtantial raise 6 months before being put of work by PTP.
If the Insurance ignores the weakly wage and uses the hourly rate? How that can be disputed
Please make me understand how it works and on what Labour code article its based?
Thank you
Temporary disability is generally based on earning capacity, and the most common way of doing that is to look at the injured worker's total earnings over the last year, divide by 52, and you have an average weekly wage. The TD rate is then 2/3 of that AWW, within the statutory limits. See generally Labor Code section 4654, 4656, etc.
What if your employer offers you a position but cut your hours and give you a work with less pay ?
It depends on when that happens. If the injured worker is getting temporary disability, and the employer offers light duty work but it is fewer hours and/or less pay, then the insurance company will pay temporary partial disability - essentially paying 2/3 of the loss of average weekly wages. If the injured worker is P&S and the employer can only offer work with fewer hours or less pay, then workers' comp benefits won't change (probably still pay PDA's) and then the worker would get a voucher for retraining.
What about not permanent and stationary mean on QME report I still have another procedure to do? I've had rotator cuff surgery and cervical spine fusion C5-C6-C7 surgery but need to go back in to remove possible scar tissue in arm my neck its been only 4 months since surgery. What do I do now?
It sounds like the QME agrees that you need further treatment, and therefore you are not P&S. If that's the case, then TD should continue if you are still off work, the PTP has you off work, and it hasn't been two years since TD started. Then after further treatment you'll end up going back to the QME for a re-exam.
Dr. Released me as of 12-28-23 , MMI . With restrictions. Employer can not accommodate me, can I apply for state disability?(CA)
Generally when a PTP or QME says the injured worker is P&S, and the employer cannot accommodate, then if there is a reasonable expectation of PD the insurance carrier will start PDA's. If workers' comp starts PDA's, and no other doctors say the injured worker is completely off work, then the worker can apply for EDD disability benefits. However, it is likely that EDD may not pay since workers' comp is paying PDA's and that is what the injured worker is entitled to after the P&S date. Every case is unique. You may want to reach out to a local attorney for a consultation or call the I&A Officer at your local WCAB office.
If the qme says not permanent stationary, but require further medical treatment.... does TTD resume?? If way under the 2yr ttd mark...
It would often depend on whether the employer can accommodate any temporary light duty work restrictions. If yes, then no TD. If not, then TD would likely resume. But each case is unique.
@myworkerscompguide
So bck in may.. I was laid-off and or terminated... but the Workmans Compensation Claim is still Active... I received ttd at home for several months, as at the time, the employer could not accommodate.. then, recently..they stopped ttd.. it's been nearly 2months without ttd.. I'm suffering..
I saw the second qme for the primary injury recently, he has declared not permanent stationary, but will need further medical treatment..
Will ttd resume during this time??.. of further medical treatment??
@@7clovers007 Generally if an injured worker is not yet P&S, and is either completely off work or on light duty temporary restrictions that the employer cannot accommodate, and two years of TD have not been paid out, and it is within five years of the date of injury, and there are not other disputes such as treatment outside the MPN, then TD would be paid. You may want to reach out to the I&A Officer at your local WCAB office to discuss your options, or talk to a local attorney for a consultation.
@@myworkerscompguide
Thank you for this information.. I appreciate it.
@@7clovers007 Best of luck to you.
They just cut off my temper disability benefits after 2 years am I going to receive permanent disability
workers' comp will generally start PDA's when TD ends, assuming there is a reasonable expectation of some level of PD. The adjuster needs to make an estimate of what the PD will be based on the medical reporting, and will then start advances on PD. Note, they are generally much lower than the TD rate. Also, even though the injured worker has been off for two years it does not mean there necessarily is going to be PD. In those instances, if the adjuster does not start PDA's but the injured worker is still off, then he or she may be able to get EDD benefits for a period of time.