How and When Workers’ Compensation Benefits Are Paid

The workers’ compensation system is designed to help employees when they get injured at work.  Employees will be entitled to receive a variety of different type of payments, including temporary disability, permanent disability, and medical costs.  Understanding when and how these payments are made can be immensely helpful to getting a better grasp to how the workers’ compensation system works.

Temporary disability is either temporary total disability, i.e. when the employee is not able to work at all during recovery, or temporary partial disability, meaning the employee can work, but not work a full schedule while recovering.  Temporary disability payments are two thirds of the gross wages the employee receives, although there is a cap set by state law.  The temporary disability payments begin after the employee’s medical provider determines that the employee is unable to work for at least three days.  Payments are made directly to the employee, and are made every two weeks.

Permanent disability means that the employee has a lasting disability that permanently reduces the employee’s earning capacity.  The employee may be entitled to permanent disability payments even if he or she is able to return to work.  After a doctor determines that an employee’s injury has become “permanent and stationary,” meaning the employee’s injury has reached the maximum level of recovery, the amount of permanent disability must be determined according to very particular formulas.  The percentage of permanent disability will be converted to a specific dollar amount, based on average weekly rages at the time of the injury.  The permanent disability payments are made directly to the employee, and must be paid within fourteen days after temporary disability payments end.

Medical payments are typically handled directly between the health care provider and the workers’ compensation insurance company.  The medical provider will bill the workers’ compensation insurance company directly for the cost of medical services and devices.  If the worker’s claim is accepted, the medical provider is not permitted to bill the injured worker for the balance of services rendered if the workers’ compensation insurance company does not provide as much payment as they usually receive.  The employee will only receive copies of the bills from the medical provider if he or she specifically requests to receive them.

The timing and method of workers’ compensation payments can seem overwhelming.  Call us today at (714) 516-8188 and let us help you understand the system.

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