When you leave your home and go to work every day, a work injury is probably the last thing on your mind. The reality is work injuries do happen. There are more than 4,000,000 job related injuries and illnesses annually in the United States. Tens of thousands of these Americans become permanently disabled each year.
Types of Disability
Disability is categorized as being temporary or permanent. The obvious meaning is that a "temporary" disability will eventually go away but a "permanent" disability is one that is forever. Most disabilities are classified as temporary. These workers recover from their injuries and return to work with no lasting effects of their injuries. Permanently disabled workers are those who never completely recover from their injuries and will require medical treatment on an ongoing basis.
Permanent Disability Benefits
Within one day of knowing you were injured, your employer must give you a claim form (DWC 1). Completing this form opens your worker's compensation case. If you do not file a form within one year of your injury, you may not be eligible to receive benefits. A physician will determine if your injury is classified as a permanent disability, (PD). The doctor issues a PD rating based on how your injury will affect your ability to perform job duties. Other factors calculated include your age, time of injury and future earnings potential. The PD rating determines the benefit amount you will receive.
If you disagree with the doctor's findings, you can request a qualified medical evaluator (QME) to consider your case. The employer must pay for the QME examination. You have 10 days from the time your claims administrator gives you the application to submit your request. If you do not complete the form within 10 days, the claims administrator can choose the doctor you will see. If you have legal representation, your attorney can help you find a QME or you can be evaluated by an agreed medical evaluator (AME).
How Permanent Disability is Paid
If you are determined by your doctor to be permanently disabled, the claims administrator will start making estimated payments to you even before a final disability percentage has been calculated. PD benefits are in addition to any temporary disability (TD) benefits you receive. Permanent disability payments must begin 14 days after temporary disability benefits end. PD benefits are paid every two weeks.
How Disability Claims are Resolved
After your PD amount is determined, a workers' compensation judge determines a settlement or award of benefits. If your doctor determined ongoing medical care is needed, the worker's compensation judge will consider this in your award settlement. There are two types of settlements: compromise and release (C & R) settlements pay a lump sum for your permanent disability. This usually means that the claims administrator will not be liable for any further payments to you or for your future medical care. Stipulations with request for award (stip) settlements include a lump sum payment for your permanent disability and pay for future medical treatments. These payments are usually distributed over time.
Claiming Both Worker's Compensation Benefits and Disability Benfits
If you are a permanently disabled worker, you may be eligible to receive both worker's compensation benefits and disability benefits. Social security benefits must be filed for as soon as possible after the injury. Worker's compensation permanent disability benefits and social security disability benefits are separate. If you receive both benefits, your social security disability benefit will be reduced. The combined amount of worker's compensation benefits and social security disability benefits you receive may not exceed 80 percent of your current earnings.