Temporary total disability (TTD) is a form of benefits through California’s workers’ compensation program that injured workers may qualify for. If you qualify to get TTD benefits, you’re likely experiencing the financial burden of being out of work for an extended time period, and collecting workers’ comp payments may be vital for the financial stability of your family.
California’s workers’ compensation program is full of laws and rules that you must follow closely. If you don’t adhere to the rules, your claim can be denied. This is where an experienced California workers’ compensation attorney like KCNS Law Group may be able to help.
If a job-related illness or injury keeps you from working for a lengthy time period while you’re recovering, you could qualify to receive compensation to help replace the income you lose.
To be eligible for these payments, you must first qualify for workers’ compensation benefits, file a claim for workers’ comp, and seek medical care under California rules. If the doctor who treats you says that you’re not to go back to work immediately after your injury or when you developed your illness, you should be able to start collecting TTD payments through your employer’s insurance company.
The doctor must state that you can’t work or that you’re limited to the amount or type of work that you’re able to do. Your employer will then decide if they have modified work that you can perform that will comply with the work restrictions put forth by your doctor. Your doctor will then see you every 45 days and put forth recommendations regarding your ability to work and any work restrictions.
In California, TTD benefits are limited to 104 weeks within a five-year time period from the day you were injured. This doesn’t impact permanent disability benefits. TTD benefits will end when:
However, you may be able to receive up to 240 weeks of TTD benefits if you have any one of the following conditions:
It’s essential that you speak with a reliable California workers’ compensation lawyer who may be able to get you the maximum compensation you’re qualified for in the maximum amount of time based on your personal situation.
If you expect your disability to render you unable to work for a year or longer, you might qualify for Social Security Disability Insurance (SSDI) payments along with TTD benefits. But, it’s important for you to know that how much compensation you get in TTD payments can decrease how much you get in SSDI payments.
SSDI rules limit the total disability benefits amount you may receive to 80% of your normal pre-injury wages. If the value of your SSDI benefits and TTD benefits go beyond 80% of your normal earnings, your SSDI payments will be “offset” by the Social Security Administration to bring your overall amount of monthly benefits to the 80% threshold.
There are ways to reduce or eliminate the impact of the SSA offset. Some things you can do are:
If you qualify for both TTD benefits and SSDI benefits, it’s best to speak with an experienced lawyer for guidance.
There may be a situation where you feel like you qualify for temporary disability, but you’re not getting it. Depending on your personal situation, you have some options that you can pursue, including appealing any negative decision the workers’ compensation board makes.
You may feel that you’re unable to work or that the restrictions your doctor places on you are incorrect. If that occurs, you’ll be able to ask that a different doctor assess you and determine your TTD status. This doctor is referred to as an Agreed Medical Evaluator (AME) or a Qualified Medical Evaluator (QME). They’ll examine you and provide you with an opinion on your TTD status.
The insurance provider may also disagree with the treating doctor’s opinion regarding your TTD status and may also ask for a second opinion. This is a process known as utilization review.
In some cases, even if you have a medical report that states you’re temporarily disabled or it has an opposite opinion, an insurance provider won’t pay TTD benefits.
At this point, you may ask for a judge that will make the decision on whether or not you qualify for these benefits. This will require you to file an Application for Adjudication Claim if one hasn’t been filed already. After that, a Declaration of Readiness to Proceed to an Expedited Hearing must be filed.
Obtaining TTD benefits is a combination of learning the way your doctor decides on the work restrictions based on the injury you sustained and if your employer can accommodate the restrictions. You may need to consult with a knowledgeable workers’ comp attorney who can put these factors together in order to help you obtain the benefits you require to recover from your injury and pay your bills.
If you’ve been injured or developed an illness because of your job in California, our reliable workers’ compensation lawyers here at KCNS Law Group may be able to help you take the next steps to recover the compensation you deserve. Call us today at (818) 937-9255 or fill out our contact form to schedule a free consultation.