Workers' compensation benefits are typically paid on a weekly basis only to those with workplace injuries that are severe enough to prevent them from returning to work, either temporarily (for at least seven days) or permanently.
How much you'll receive depends on the state where you live, your average weekly wage, whether you can return to work in the short or long term, and the severity of your workplace injuries. In general, you can receive as much as two-thirds of your average weekly wage in workers' comp benefits, not to exceed a cap set by state law.
Workers' comp eligibility rules vary from one state to the next, but most of them have the same general rules when it comes to weekly workers' comp benefits. Here's what you need to know.
The types of workers' compensation benefits you'll receive depends on whether you are able to return to work in some capacity, including light duty positions offered by your employer.
Depending on the laws in your state, you are likely eligible for regular time loss compensation benefits if you are unable to work as a result of your industrial injuries. The amount you will receive is a percentage of your wages at the date of injury. In many states, the percentage is 66 2/3%.
Some states include in your "wages" the amount your employer contributes to your employee benefits. For example, in Washington, if your employer is no longer paying for your health insurance, your wages will include the amount your employer contributed for your health care benefits.
Time loss compensation benefits are paid on a periodic basis, usually twice per month. However, the rules in your state may allow your employer to pay you once per month, or once per week. The important thing to remember is that temporary disability benefits will likely be less than the amount you earned while working.
How many weeks can you receive TTD workers' comp benefits? The answer depends on your state's rules. In Massachusetts, you can receive benefits for up to 156 weeks; in California, it's 104 weeks. Other states are less generous: Idaho, for example, allows 52 weeks.
Loss of earning power benefits are not available in all states. These benefits are available to workers that are able to return to work temporarily following a work-related injury, but in a different, lower paying job. This is often the case in light-duty positions or part-time positions. Your employer, through the workers' compensation system, will pay you a portion of the difference between the amount you are earning now as compared to your wages at the time of the work-related injury.
Your medical bills will be paid as they are incurred. Your doctors will bill your employer or your employer's workers' compensation insurance company directly. If the bills are for treatment related to your industrial injury, and are a covered treatment in your state, you should not be required to pay for the treatment. The amount of your medical bills does not impact the amount of time loss benefits or loss of earning power benefits you are eligible to receive.
You will likely only receive continuous, regular workers' compensation benefits when your claim is closed in one of three situations:
A workers' compensation pension, or life pension, as it is sometimes called, is typically given to a worker who is totally and permanently disabled as a result of their industrial injury. This means a worker is unable to return to work in any continuous employment due to their work-related injury, illness, or disease.
If you receive a workers' compensation pension, you will receive regular benefits, usually a percentage of your wages at the time of your industrial injury. Note that in many states, the amount of your pension benefits will be less than the amount of temporary disability benefits (time loss compensation) that you received while your claim was open. The pension benefits are paid periodically, such as once per month, twice per month, or once per week, depending on your state.
Pension benefits last for your lifetime; in some states, your surviving spouse will continue to receive the benefits after your death.
If you have a permanent impairment that is less than total disability, you can get regular weekly permanent disability benefits, if you don't agree to settle for a lump sum. These weekly payments will be based on the percentage of your disability (how disabled you are) and/or your wages before you were injured.
In some states, another way in which you can receive continual, regular payments as part of your workers' compensation claim after claim closure is by entering a structured settlement agreement.
Rather than providing a lump sum settlement for permanent disability, these agreements require the employer to pay out the settlement amount to you in small portions, over a period of time. That period may be one-year, five-years, or more. How much you are paid, and when you are paid, are determined by the terms of the agreement.
If you think you are eligible for one of these types of benefits and are not currently receiving the benefits (or the amount you think you should receive), talk to a workers' compensation attorney in your area.
An attorney can help advocate on your behalf to ensure you receive the maximum amount of benefits you are eligible for. You may even be able to receive money for benefits you should have received in the past under your current workers' compensation claim.