It is important injured Maryland workers know how long they can expect workers comp to pay!
The short answer is that an injured worker should not expect lifetime payments by workers comp. Only in very rare circumstances is the injured worker paid for a lifetime.
Understanding how long workers comp payments will be made can have a huge impact on the injured workers plans and intentions. It is also important to know that there are multiple forms of workers compensation payments and not just payments for lost wages while held out of work. For many the unexpected termination of payments has a devastating affect on their financial well being. Creating this expectation is the, in my opinion, inaccurate nomenclature called “permanency” payments. In a great majority of cases lifetime payments should not be expected.
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When might workers comp stop issuing payments
Perhaps the scariest reality to the injured worker is that the insurance company could potentially stop issuing payments at anytime without notice. Maryland law requires they provide notice to the injured worker before terminating these benefits. In practice this is not always done. Payments may be stopped unexpectedly and at anytime during the course of the case however this does not mean the injured worker does not have an opportunity to get these wages reinstated. If workers comp payments are stopped it is recommended to contact a workers compensation attorney for a free consultation and to discuss the chances of getting the wages reinstated. In some cases it may be quite simple to have the payments reinstated. In other circumstances going to an administrative hearing may be mandated.
There are certain times the injured worker should expect workers comp payments to stop
In order to qualify for lost wage payments an injured employee needs a physician to indicate they are unable to work. If the doctor is no longer indicating the injured worker must be off of work then it should be expected that the lost wages will no longer be issued by workers comp.
Another common time workers comp payments are terminated is when an Independent Medical Evaluation (IME) is pending. IME’s are scheduled by the insurance company to obtain a second opinion regarding the workers ability to perform their job duties. It often makes no difference that the treating doctor is stating “no work.” Unfortunately workers comp has the legal right to schedule an IME and argue that lost wages are not indicated based on the IME doctors opinion. See Independent Medical Evaluations.
If an injured worker returns to their job then they will no longer be entitled to one form of workers comp payments refereed to as temporary total disability. The good news is that additional compensation benefits are likely available. Also, the injured worker may begin to enjoy the benefit of having a full check rather than a reduced lost wage check.
Payments will also be terminated if the injured worker finds a different job rather than returning to their pre-injury occupation.
What are the different forms of payment issued by Maryland workers comp?
Contrary to popular beleif there are numerous forms of payments that any individual hurt at work may receive from workers comp. Temporary Total Disability (TTD), Temporary Partial Disability (TPD), Permanent Partial Disability (PPD), and vocational rehabilitation benefits (VP) are the forms of payment an injured worker may recover. Most injured workers only receive Temporary Total Disability (TTD) and Permanent Partial Disability (PPD).
See how to calculate the payments.
What are workers comp payments &
How long those payments can be expected
Temporary Total Disability Payments, and Temporary Partial Disability payments are paid on a Temporary basis. These payments will eventually stop at some point in the case. It is possible that these temporary payments are stopped and restarted at anytime in the future. In some circumstances injured workers will require further medical treatment in the future which may require the temporary benefits to restart. An experienced workers compensation attorney should be immediately consulted if you feel temporary payments have wrongfully been terminated.
Permanent Partial Disability Payments, and Permanent Total Disability payments are issued when an injured worker has secured an award of permanency by the Maryland Workers Compensation Commission (MWCC). Permanency does not reflect the status of a persons disability, rather it reflects the nature of a disability. ie The worker is not permanently disabled and unable to function, but they do have a permanent disability that will limit them in some nature. Permanent Partial workers comp payments will stop and a qualified attorney can explain to their clients an exact date of termination. Permanent total disability payments will likely be issued for life.
Lost wages/ Temporary Total Disability payments (TTD) will eventually stop
These payments are issued on a temporary basis while the hurt worker is found to be totally disabled by his or her treating physician. As long as the treating physician finds the injured worker is unable to perform the duties of their job entitlement to temporary total disability exists. Entitlement does not mean guarantee to benefits! Given the entitlement, many workers comp recipients are quite disturbed and confused when payments are stopped regardless of what their doctor is indicating.
The employees entitlement is countered with the insurance companies right to schedule an IME. The purpose of the IME is to question whether the treating doctors opinion. IME’s give the workers comp insurer a defense to paying lost wages.
Temporary Total disability payments will be paid for any length of time and it is difficult to indicate exactly how long one can expect these payments. In many cases the insurance adjuster is willing to issue lost wage payments for few weeks after the injury in minor cases. In more sever cases the adjuster is often willing to issue payments until a reasonable time of recovery after any invasive or surgical procedure. However, ttd payments can be stopped at anytime in the process by the adjuster.
Temporary Partial Disability Payments (TPD) will eventually stop
Temporary Partial Disability payments are issued to an employee while they are working light duty and not receiving their pre-injury pay amount. If the injured worker is told by his treating doctor that he can work but it must be reduced hours then the employee is entitled to TPD benefits.
Temporary Partial Disability payments may be terminated at anytime by the adjuster. Ordinarily TPD status does not exist very long so these workers comp payments are not as likely to be prematurely terminated by the adjuster. TPD status is a stepping stone to a full work status. In the event full work duty status is not met then the injured worker should be moved quickly into a vocational rehabilitation program, or a full time occupation should be established with the current employer. On occasion IMEs are used to fight the payment of TPD benefits.
Permanency Payments most often stop at a certain time
Permanent Partial Disability payments are issued after the Workers Compensation Commission finds that the injured worker has a permanent impairment. This is determined by a number of factors including testimony, a rating, and legal argument. These workers comp payments are issued based on the percentage of impairment the Commission awards. The percentage is then calculated into weeks of payment. The number of weeks awarded will indicate, roughly, how long the employee can expect payments. There are other factors that complicate the calculations such as expenses that come out of the award, attorney fees, and occasional credits to workers comp.
Permanent Total Disability payments are paid only in very rare circumstances to the injured worker who is unable to work in almost any capacity. This is a benefit that is awarded to, I would guess, less than 1% of workers comp recipients. It is awarded to those that sustained such a serious injury that expectation for them to return to the work force in any meaningful capacity is non-existent.
PTD workers comp payments are issued for the life of the injured worker. On occasion the injured worker is able to find an occupation in which case the PTD payments would stop. Again these payments can be questioned by the workers compensation insurer by the use of an IME. On occasion the workers compensation adjuster will schedule an IME while the injured worker is receiving PTD payments in hopes to argue that the injured worker has become better and is able to work again. While permanent total disability payments are by law mandated to be paid for life, the insurance company continues to have rights. They are able to file for hearings to argue a “betterment” and are also able to use surveillance in hopes to catch the injured worker performing something that is inconsistent with legal testimony or medical findings.
Vocational Rehabilitation payments will stop eventually
Vocational Rehabilitation payments are issued to the injured worker while he undergoes the vocational rehabilitation process. VR payments are paid at the same rate as temporary total disability payments and are issued to the injured worker while he searches for a job with the assistance of a vocational rehabilitation counselor.
These payments can theoretically be stopped at any point in time, however if the injured worker is compliant and does exactly as recommended by the vocational counselor benefits are not ordinarily stopped unexpectedly. Vocational Rehabilitation payments will be terminated if the injured worker is not compliant with the counselors recommendations. VR payments will also be terminated if the injured worker is able to find a job.
Injured workers will only be entitled to VR payments for as long as the job search continues. At a certain point the Vocational counselor may recommend that the job search be terminated, or the adjuster may refuse to continue the benefits at a certain threshold. Typically VR payments are issued for a three month period and may be renewed if the injured worker continues to be compliant.
Workers Comp Payments will not be issued forever
Unfortunately there is no guarantee an injured worker will receive their workers compensation payments. A workers compensation attorney can help maximize the time frame and amount of workers comp benefits an injured worker receives. Ensuring accurate payment amount, timely payments, and the various forms of payments are all considerations for the injured worker. Failure to obtain TPD benefits can lead to missed out money. Inaccurate TTD or Voc Rehab payments can lead to thousands of dollars over the life of a claim.
Maryland Workers Compensation attorneys work on a contingency basis and are only paid if money is recovered for the injured worker.
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