How long can you collect temporary total disability payments in a Maryland workers compensation case?
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The short answer is there are a lot of factors that play into this. The payments are for a temporary basis so not to last permanently. Depending on the severity of the injury, amount of treatment, what doctors are recommending, and other factors, an injured worker could conceivably be on temporary total disability (TTD) for years. The reality is that most workers comp insurers will not let this happen without a fight.
If you have not obtain legal counsel it may be a good time to consider doing so. Good personal and family health are perhaps the most important thing in an individuals life. Obviously when one is hurt on the job their health is called into question which increases worry among family members and the individual. While health may be the single most important concern in a persons life, financial security and well being likely makes the top five concerns. When health and financial security face changes at the same time the injured worker is placed in one of the most stressful situations of their lifetime. This scenario often leads to a number of question: How long can the injured worker expect the temporary total disability payments to be paid? Is there a way to increase the chances that the workers comp lost wages continue throughout the duration of the claim? What will trigger the temporary total disability payments to stop? What happens when the payments stop?
Currently receiving lost wage payments from workmans comp but how long will temporary total disability payments continue?
Under Maryland law the workers compensation insurer is obligated to pay temporary total disability payments as long as the injured workers treating physician is holding that person out of work. The physician must essentially saying the injured worker is totally disabled and unable to work, but only for a temporary basis. Conceivably a person could be disabled completely for many years and then obtain treatment that would give them the ability to work in some capacity. Practically speaking this does not ordinarily happen and most workers comp claims follow a pattern regarding TTD payments.
The typical scenario starts with the injured worker seeking medical attention. He or she is then told to take off of work for a particular period of time, perhaps a few days or a few weeks. Upon follow up with the physician the injured worker will be reassessed and either provided an out of work note and continue to receive temporary total payments or the injured worker will be placed on light duty with restrictions.
In the more severe injury cases it is predicted by the treating physician that the injured worker will be unable to work for an extended period of time. For instance when a bone is fractured, or a shoulder ligament or knee ligament is torn doctors often indicated the injured worker will be out of work for x months.
When a workers comp case arises in the typical fashion and does not involve any major injuries, and temporary total disability payments have begun, it is likely the injured worker would receive a month or two of lost wage checks before the payments are interrupted.
In the more severe injury cases the TTD payments are less predictable and a number of factors come into play. Is the adjuster being aggressive from the beginning of the case? If so this could be a sign of continued aggression regarding temporary total payments. Did the adjuster willing start paying temporary total disability without much inquiry and requests? If so then the payments may continue for the duration of the required medical treatment. There are a multitude of factors that may affect the frequency and duration of the temporary total disability payments including but not limited to:
- Is there a defense attorney involved in the case or does it seem like just the adjuster is working on it?
- Is the employer self insured or do they have a policy with an insurance provider?
- Does the injured worker have prior workers comp cases? How many and of what nature were those injuries?
- Are there prior injuries to the same body part?
- Prior auto accident cases?
- How long has the employee worked for the employer?
- Any prior surgeries to the injured body part?
- Has the insurance company scheduled an Independent Medical Evaluation?
- What workers compensation insurance company is involved?
- Who is the treating physician placing the injured worker on temporary total disability status?
Is there a way to increase the chances that workers comp lost wages continue throughout the duration of the claim?
Updated out of work notes are vital to the continuation of temporary total disability payments. If there is no doctor indicating the injured worker is unable to work than there is very little chance temporary total disability payments will continue for very long. Work notes are the first step in obtaining lost wages, however some adjusters require more than just a work note before they willingly pay lost wages. A work note that indicates the injured worker will be out of work for an extended period of time is not acceptable to some. The need for an updated slip on a monthly basis is regularly required. Some workers compensation adjusters want particular restrictions written out on the notes. To them it is not good enough to say out of work and they may want the doctor to indicate if the injured worker is able to stand, sit, lay, squat, bend, twist,… for any length of time each day. The adjuster requests these itemized work notes so he or she can attempt to find a light duty position which physically accommodates the injured worker and allows them to return to work.
The injured worker should not miss appointments as they relate to the case. This is especially true concerning doctor or medical appointments. If the injured worker misses medical appointments then it is argued he or she is not accepting reasonable medical treatment and therefore delaying the case. This could lead to a justified termination of temporary total benefits. Other appointments that should not be missed are meetings with nurse case managers, vocational rehabilitation counselors, IME appointments, Functional Capacity Evaluation appointments, and hearings at the Commission.
Make sure to do what the adjuster asks. This is difficult to hear, I am sure. It is equally painful for me to say. But the workers comp adjuster has the power to make life difficult, very difficult. There are some instances where doing what the adjuster is requesting is not practical or possible, however when the request is fairly reasonable it is best to simply do it and move on. This will ensure that the temporary total disability checks continue to be issued. Always keep in mind that the adjuster may terminate the temporary total disability checks at anytime for any reason, even if not legally justified. Sometimes it is best just to do what is asked rather than run the risk of having no income at all while waiting for a workers compensation hearing.
Along with not missing any medical appointments it is important to comply with treatment recommendations. If an injured worker does not accept reasonable medical treatment then temporary total disability benefits will likely be terminated. The question of whether the treatment is reasonable will vary on a case by case basis. Ordinarily physical therapy is reasonable and if the therapy is necessary to get the injured worker back to work than he or she can be expected to get that treatment or not receive TTD payments.
What will trigger the temporary total disability payments to stop?
Workers compensation adjusters do not want to continue to pay temporary total disability indefinitely so as time goes bye there may be extra scrutiny directed at injured workers. On occasion adjusters or defense attorneys will order a private investigator to perpetuate surveillance in hopes to catch the injured worker doing something they otherwise are not physically allowed to do per doctors orders. If a doctor places a patient off of work because they are to do no lifting then the injured worker should not be doing any lifting at home either. Surveillance footage to the contrary will prove detrimental to any continuation of TTD.
In the event a subsequent accident occurs the temporary total disability payments may stop.
Unfortunately some injured workers are involved in an accident after their work accident. If the accident involves the same body part that was injured in the work accident the case could potentially fall apart. For anyone involved in a subsequent accident, work related or otherwise, it is best to contact an attorney immediately.
If an Independent Medical Evaluation (IME) is scheduled there is a good chance that the lost wage benefits will soon be terminated. IME doctors often disagree with treating physicians regarding the work capacity of the injured employee and will therefore find that they are capable of working despite what the treating physician opines. Needless to say the workmans comp adjuster will agree with the IME doctor and terminate the lost wage payments.
What happens after the temporary total disability payments stop?
There are a few choices the injured worker will be faced with if temporary total disability payments are stopped. The first option depends on the injured worker having an updated out of work note. If so they have the option to file for a hearing before the Maryland Workers Compensation Commission and seek reinstatement of the wages. A qualified and experienced workmans comp attorney can advise the injured worker on the likelihood of winning at a hearing. Hearings are scheduled anywhere from 1 month to 6 months after the request for hearing is obtained by the commission. Ordinarily hearings are scheduled within 3 months from the time the attorney filed for the hearing. That is at least 3 months without income, and potentially longer if the injured worker is not successful at the hearing.
Rather than go to the hearing the injured worker may decide to give the return to work a try. While this may be putting their physical health on the line it may prevent financial devastation. If there is no intention of returning to the same occupation the injured worker may choose to look for a different job. A new job search can usually be conducted while the injured worker is receiving temporary total disability benefits but this should be discussed with an attorney first as there are some legal ramifications that may go along with the decision to look for a different employer.
While the length of time temporary total disability payments in part depends on the extent of the injury and treatment, very often the injured worker can continue to receive treatment regardless of their work status. TTD and medical treatment is largely a separate and apart component of workers comp benefits.
In the event temporary total disability payments stop and medical treatment stops the injured worker may choose to move their case towards a permanency award or settlement. A permanency award would come after the injured worker has been rated by a physician chosen by their attorney, and a physician chosen by workers comp. Once the rating is performed a hearing can be requested which will lead to an award of permanency, or a stipulation (agreement between the parties) as to the permanency. The injured worker would have the option to try and settle their case completely rather than go to permanency. Settlement and permanency are often confused. Click the following link further reading on the distinction between Settlement and Permanency.