Workers' Comp Benefits FAQs

Q: When does payment of workers' comp benefits begin following an injury?

  • Benefit payments should start a short time after the workers' comp insurer receives notice of your claim, investigates and determines you're eligible.

Q: Are injured employees always entitled to vocational rehabilitation?

  • A: It depends on the law in your state. "Rehab" isn't required in all cases. It's where you receive training or education to help you perform your former job or prepare for a new one. Vocational rehab takes your medical restrictions into account.

Q: Is there an appeal process if I'm not satisfied with the decision in my case?

  • Generally, both the employee and the employer and its insurer can seek an appeal, which is usually heard by the state's high court. Rules for appeals vary by state, and help from a workers' comp attorney will be needed.

Q: Are any non-medical expenses related to my injury covered, such as travel to and from the doctor?

  • Yes, such expenses are generally covered. You may have expenses for travel, prescriptions and supplies, which may be covered under your state's laws.

Q: Does workers' comp law or the Family Medical Leave Act (FMLA) cover my time off from work due to my injury?

  • A: The Family Medical Leave Act may apply to leave for your work-related injury if you had in-patient or continuing medical treatment. The FMLA provides up to 12 weeks of leave; note it may not be paid time off. Your employer can tell you if your workers' comp leave is deducted from your FMLA allotment of leave time, and whether you'll be paid.

Q: Am I required to go to vocational rehab?

  • You might be required to attend a vocational rehab program. You may lose your temporary total disability benefits (TTD) if you don't go, and it may be needed if your employer doesn't have a job geared to your medical restrictions.

Q: Are workers' comp benefits taxed?

  • Benefit payments aren't taxed because they aren't considered earned income under tax laws.

Q: Is there interest or a penalty added to my benefits if the workers' comp carrier doesn't have a good reason for a delay in my payment?

  • A: It's possible penalties will apply, but the delay has to be on purpose or for no reason at all, and not just a simple error. Your state industrial commission can help you determine if there's been a wrongful denial of benefits and provide information on filing a complaint.

Q: What if the insurance carrier tries to reduce my benefits and there's been no change in my condition?

  • This does happen, and it's best to contact your workers' comp attorney as soon as you can.

Q: What is the process for death benefit claims?

  • Death benefits vary by state, and are paid to the spouses and children of workers who died due to work-related injuries. It's important to seek help from a workers' comp attorney to make sure the benefits are calculated correctly.

Q: What is the expected amount of my benefit check?

  • If you're receiving TTD benefits, you'll get a percentage of your average weekly wages, and payment for your medical expenses.

Q: How are weekly wages calculated and is overtime a factor?

  • To calculate your average weekly wages, divide the amount of your earnings for the 52-week period before your accident happened by 52. Treatment of overtime varies by state, but when counted is included at a straight-time rate.

Q: If I have a second job, do workers' comp benefits apply to that loss of my income?

  • Payment of benefits for lost income can be a complicated issue, so you may want to seek help from your attorney. This issue depends on the facts of your case, and generally your first employer had to know about your other job. You'll need to provide proof of your lost wages.

Q: What is temporary total disability (TTD)?

  • You receive TTD benefits if you have a work-related injury, but you expect to be able to go back to work. TTD is intended to replace part of your lost wages, with benefits based on a percentage of your usual wages.

Q: How long can I receive Temporary Total Disability (TTD) payments?

  • You can receive TTD payments while recovering from your injury until you can return to either your regular work or light duty work.

Q: What is permanent partial disability (PPD)?

  • This is when a job-related accident causes a lasting disability, preventing you from going back to work at your full physical capacity. Loss or loss of use of a limb is a good example.

Q: Does workers' comp cover my attorney fees?

  • Your attorney usually receives a percentage of the settlement of your claim. The attorney is paid at the end of your case. Ask your attorney to explain how fees will be handled in your case.

Q: What should I do if my benefits aren't what I expected?

  • Be sure your employer properly reported your injury to its workers' comp insurer, and you've given all medical documentation to back up your claim. Contact the insurer for an explanation why your aren't receiving expected benefits. You can seek help from an attorney if you don't get an answer.

Q: Can I qualify for both workers' comp benefits and Social Security disability benefits?

  • You can receive both types of benefit payments, but total payments are limited to 80 percent of the income you earned before you became disabled.

Q: What accommodations must my employer make so I can work?

  • If there's work your employer can offer and it's within the limits of your medical restrictions, you must attempt to do the work. You're entitled to temporary total disabilty (TTD) payments if there's no such work available.

Q: Do I have to use my vacation time if I'm out because of a work-related injury?

  • If you can't work due to a work-related injury, your state's TTD benefits should be used, and not your vacation time.

Q: If I have a work-related injury, should I apply for Social Security Disability Insurance (SSDI)?

Q: How long does it take for my claim to reach final settlement?

  • Once your claim is settled, there's no further payment for your medical expenses by the workers' comp carrier. So, your claims shouldn't settle until you've completed medical treatment for your injury. Also, the insurer isn't required to offer a settlement. If an offer is made, review the offer with your attorney before accepting it.

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