If you become injured on the job, you may be eligible for temporary disability benefits. Temporary disability replaces the injured employee’s missed income if the workplace accident has not happened. Benefits are only paid to the injured employee if the insurance company admits that the injury occurred in the course and scope of employment and did not occur elsewhere. Temporary disability is given for a limited time, paid on a set schedule, and calculated based on your weekly earnings. It also considers the restrictions set by your doctor for the type of work you can do while recovering.
What are the two types of temporary disability benefits?
There are two types of temporary disability benefits that you can receive if you are injured on the job in California:
- Temporary total disability payments (TTD) – If you cannot work while recovering.
- Temporary partial disability payments (TPD) – If you can do some work while recovering and your employer offers you this type of work if your wages are below a maximum limit set by law.
How much temporary total disability will I receive?
Typically, temporary total disability pays two-thirds of your gross (pre-tax) wages you lost while recovering from your on-the-job injury. If you receive temporary disability benefits, you don’t pay any federal, state, or local income taxes on those benefits. You also don’t pay any Social Security taxes, union dues, or retirement fund contributions on those temporary disability benefits.
By law, you can receive up to the maximum weekly or less than the minimum weekly amount. You cannot receive less than the minimum weekly amount, so if two-thirds of the wages you were earning before your injury was less than the minimum payment, you would receive more. As of 2021, the minimum temporary total disability that you can receive is $203.44 a week. However, you can receive less than two-thirds of your wages if you earned more than a certain amount before your injury, with the maximum temporary total disability being $1,356.31 per week as of 2021.
When will I start to get temporary disability benefits?
If you are eligible for temporary disability, you will receive payments every two weeks. These payments typically begin within 14 days of your employer learning of your injury and your treating physician stating that you cannot do your job. Typically, temporary disability ends once you return to work, when your doctor releases you for work or your condition has stabilized and is unlikely to improve. However, your temporary disability payments do not last more than 104 weeks within five years from the date of your on-the-job injury.
If there are any questions about whether or not workers’ compensation covers your injury, then the claims administrator may delay your first temporary disability payment while they investigate. The delay is usually 90 days at maximum, and the claims adjuster must notify you of the delay. The notification must detail why you are not receiving payments, what the claims adjuster may need in additional information, and when to expect a decision. Your claim is typically accepted unless you receive a denial letter within 90 days of filing a claim.
What determines your exact temporary disability amount?
It can be complicated to determine your exact temporary disability amount. It is incredibly complicated for workers who:
- Had a second job or seasonal job
- Had wages that increased or decreased
- Earned additional income (tips, overtime, bonuses, etc.)
- We’re scheduled for a wage increase after the date of the injury
- Received temporary disability benefits more than two years after the date of injury
What can I do if I disagree about temporary disability?
Suppose you believe that your doctor’s assessment of your limitations is wrong. In that case, you can have a different doctor examine your injury to determine what temporary disability you are entitled to receive. You will be evaluated by a Qualified Medical Evaluator (QME) or an Agreed Medical Evaluator who will assess your injury to determine your temporary disability status.
If the insurance company disagrees with your physician’s assessment of your temporary disability, you will complete a process known as a utilization review. If the insurance company still refuses to pay temporary disability for your injuries, you can have a judge decide whether you are entitled to temporary disability. You must file an Application for Adjudication of the Claim and a Declaration of Readiness to Proceed to Expedite Hearing. You will then receive the notice of your hearing date. Your Stockton workers’ compensation attorney can help you through this process and help you submit the appropriate medical records that show you should receive temporary disability benefits.
What can a Stockton Workers’ Compensation Attorney do?
If you are having trouble obtaining the temporary disability benefits you are entitled to, contact a Stockton workers’ compensation attorney today. Do not hesitate to contact us for a FREE consultation or any questions about temporary disability benefits.