If you have been injured at work, the extent of your disability determines how much you receive in cash benefits. Your doctor will give an opinion on how much your injury disables you and the insurer will agree or disagree. If they disagree, the insurer can require you to see a doctor of its choosing for an independent medical exam. Once that is complete, the Workers’ Compensation Board will decide on your degree of disability. If you feel what the insurance company’s doctor recommends isn’t fair, an experienced attorney can review your case and help you get what you’re entitled to. Learn what the classes of disability are and what you may be entitled to depending on which class you fall into. Please note that all injuries, even if they are later found permanent, are considered temporary first.
Average Weekly Wage
Your average weekly wage is used to calculate your disability benefits. It reflects your average pay for the 52 weeks prior to your injury. The Workers’ Compensation Law entitles a disabled worker to receive a maximum of 2/3 of his/her average weekly wage or the statutory maximum—that is, the legal limit—based on the date of accident.
Temporary Total Disability
If you are deemed to have a temporary total disability, you are completely disabled from any and all work, but on a temporary basis. While this is the case, you are entitled to the full allowable wage benefit, which is 2/3 of your average weekly wage or the statutory maximum, whichever is less.
Temporary Partial Disability
If you have a temporary partial disability, you have temporarily lost some (but not all) of your ability to work and earn wages. Your benefit during this time will be a percentage of your total disability rate. For example, if you are 50% disabled, you may receive 50% of your total disability rate or the statutory maximum, whichever is less.
Permanent Total Disability
Having a permanent total disability means that you have completely lost your ability to work and earn wages. When you are deemed to have a permanent total disability, you will receive 2/3 of your average weekly wage or the statutory maximum, whichever is less. There is no limit on the number of weeks you can continue to receive benefits in this case.
Permanent Partial Disability
A permanent partial disability means that you have permanently lost some of your ability to work. There are two categories of permanent partial disability, and both are dealt with slightly differently.
If you have a nonschedule loss and were injured before March 13, 2007, you receive the percentage of your total disability rate or the statutory maximum, whichever is less, possibly for the rest of your life. However, if you were injured after March 13, 2007, your benefits are capped based on your percentage of permanent wage loss. You may receive the percentage of your total disability rate or the statutory maximum, whichever is less, for a period of time ranging from 225 to 525 weeks, depending on your percentage of loss of earning capacity. The cap on permanent partial disability benefits does not apply to medical benefits.
If your permanent partial disability resulted in the loss of eyesight, hearing, or the use of your arm, hand, leg, or foot, this is known as a schedule loss. In this case, the law will specify the number of weeks of benefits you will receive, dependent on your percentage loss of use of the body part. For example, if you have a 20% loss of use of your arm, you will receive 62.4 weeks (20% of 312 weeks) of your total disability rate or the statutory maximum, whichever is less. Any previously paid temporary benefits are deducted from the award. As with nonschedule losses, medical benefits remain open.
Who to call
If you have been disabled because of a work injury, your life has been forever changed. Figuring out the compensation you should receive based on your disability is confusing and is not something you should have to focus on during this difficult time. Let Lipsitz Green Scime Cambria help you through the process. Our experienced team of attorneys and licensed representatives is committed to staying with you every step of the way and getting you the compensation you deserve. We have the resources to stand up to insurance companies and get you the best possible results, and we will be with you every step of the way.
This article does not purport to give legal advice and is for informational purposes only.