The Four Types of Workers’ Compensation Benefits

Workplace accidents can severely limit your ability to work and acquire income. In those cases, you may qualify for workers’ compensation benefits to mitigate your losses. Your award is categorized into four types of workers’ compensation benefits, depending on the severity and extent of your injury.

The four types of workers’ comp benefits you may qualify for are:

• Temporary total disability (TTD)
• Temporary partial disability (TPD)
• Permanent partial disability (PPD)
• Total permanent disability (TPD)

Know the difference between these claims, because adjusters calculate compensation differently depending on what disability benefits you qualify for.

Workers’ compensation only covers medical fees, lost wages, potential job replacement, or death benefits on-the-job. Unlike a personal injury claim, workers’ comp does not cover non-economic damages like pain and suffering.

If you believe your case goes beyond work injuries, consider hiring a personal injury attorney instead.

Even if you’re certain you qualify for workers’ comp, there’s always a chance for rejection, and you’ll have to file an appeal.

To increase your chances of approval or filing an appeal when rejected, it’s best to hire a workers’ comp attorney on your corner. Only with an attorney can you receive specific legal advice for your accident. 

What are Workers’ Compensation Benefits?

Workers’ compensation is a government-authorized program that provides paid benefits or medical care for injured workers. Employers pay for this insurance and cannot threaten adverse action against employees who receive workers’ comp.

In the U.S, each state manages workers’ compensation through separate workers’ compensation officials. Unlike the rest of the states, Texas doesn’t require an employer to hold workers’ compensation coverage, although most do.

To understand your workers’ compensation benefits within your state, find a workers’ comp attorney to assist you with your claim.

Temporary Total Disability

Workers can receive temporary total disability if a work-related injury prevents them from working completely for over three days. Employees can acquire temporary disability benefits to help substitute lost wages from work-related injuries or illnesses.

Temporary total disability are payments you’d receive if you cannot work at all and have lost wages because:

• Your doctor states you can’t perform your job for over three days, or you’ve been hospitalized overnight.
• Also, your employer doesn’t offer other tasks that pay your wages while recovering.

Temporary disability is defined as a work injury that can be reasonably treated within a period of time under proper treatment.

TTD is often calculated using two-thirds of your gross pre-tax wages including overtime. If you were scheduled for a pay raise before the injury, your TTD may raise according to your updated wage.

Temporary Partial Disability

You may qualify for temporary partial disability benefits when you’re able to perform limited work and your employer can provide such opportunities while you’re injured.

TPD workers’ comp benefits are calculated by the difference between your part-time wages and the amount you earned before injury.

Different states follow separate reporting requirements for the four types of workers’ compensation benefits in their area. In California, if your temporary disability benefits are delayed, your employer must send a delay letter within 14 days of your request.

If your injury persists with no indication of getting better or worse, your condition moves into Maximum Medical Improvement (MMI). If your injury progresses to this stage, you may qualify for permanent disability benefits.

Permanent Partial Disability

Permanent partial disability workers’ comp benefits are provided when an injury is deemed to never recover after maximum medical improvement. The injury may permanently reduce work capacity, but they can still work other roles while disabled.

The amount of permanent partial disability benefits depends on a variety of factors:

• The degree of injury
• How long one was injured
• Date of the accident
• Where the accident took place

An example of PPD potentially taking place is if a guitarist lost a finger during an accident on-stage. They may not be able to play guitar like their previous job, but they can take part-time jobs to supplement lost income.

The duration of PPD payouts depends on what body part was permanently damaged and how it affects future work. If the victim’s injuries prevent them from working completely, then total permanent disability benefits may be provided.

Total Permanent Disability

Sometimes, workers can’t fully recover due to work-related injuries or illnesses, and employees may qualify for total permanent disability benefits. TPD benefits only occur if the victim cannot meaningfully work any job role due to their condition.

These benefits may be awarded after maximum medical improvement and your doctor deems your injury cannot improve enough to return to work. The duration of TPD depends on a variety of factors, but if the injury is severe, you may qualify for lifetime benefits.

How to Qualify for Workers’ Compensation Benefits

Typically, you may qualify for workers’ compensation benefits under these four basic requirements:

• You must be an employee.
• Your employer must carry workers’ comp insurance.
• Your injury or illness must be work-related.
• You must meet your state’s deadline for reporting the injury to your employer and filing a workers’ comp claim.

State laws may vary, but most employers are mandated to possess workers’ comp coverage. An employer’s workers’ comp coverage depends on how many employees they have, the type of business they conduct, and the job role each employee performs.

Most employers already have workers’ comp insurance even if they aren’t legally required to have one. This is because state laws allow employers to opt into the workers’ comp system and protect the employers from filing a lawsuit against them.

Employers often buy workers’ comp insurance through a private market or, in some states, through a state fund.

Some rules are different for employees working in unique environments like migrant workers and contractors. The federal government even has its own workers’ comp system for federal employees separate from state laws.

How Workers’ Compensation Death Benefits Work

For workers’ compensation death benefits, the deceased individual has to have died from a work-related injury or illness. Additionally, occupational illnesses caused during unsafe work environments can be diagnosed by a primary care physician, and be eligible for workers’ comp.

Workers’ comp adjusters must determine if the cause of death occurred within the course and scope of employment. In most states, immediate family like spouses and children under 18 (including adopted and step-children) are dependents eligible for compensation.

Each state varies on who is eligible to receive workers’ comp death benefits, and this could extend to dependents over 18 enrolled in college. Also, parents and siblings may be eligible if they prove themselves dependents to the deceased.

However, in some states, workers’ comp benefits may be unavailable for spouses if they make over a certain income level.

It’s possible to receive workers’ comp death benefits if the work-related injury or illness has worsened the worker’s pre-existing health condition.

Which Benefits are Not Covered Under Workers’ Compensation?

In most states, benefits not covered under workers’ compensation are non-economic damages which are emotional and mental effects of an injury.

Also, you cannot receive punitive damages under workers’ comp. This is because workers’ comp protects companies from lawsuits caused by work-related injuries. Punitive damages often show up in cases that punish particularly reckless or malicious behavior.

If you believe your lawsuit extends beyond workers’ comp, always consult an expert before signing forms. You may need to call a personal injury attorney if there are extra variables that may constitute a tort claim.

How are Your Workers’ Comp Benefits Calculated?

The available amounts for the four types of workers’ compensation benefits depends on an impairment rating given by the doctor.

• The impairment measures your loss of use or function such as strength loss, amputation, sensory loss, etc.
• Work disability is awarded if you cannot return to work regularly and is based on your age, education, and professional factors including your skills and the nature of your job.

If you cannot work and your injury is not improving, your condition is permanent and stationary (P&S). This is when you reach maximum medical improvement (MMI) and receive a partial disability rating.

Your partial disability rating is calculated as a percentage of how much your disability limits your ability to make a living. Ratings are based on a few factors:

• Your doctor’s P&S report or a medical-legal report showing your medical condition.
• Date of injury and your age.
• Your job role.
• Your job’s liability for your accident, also called apportionment.
• Rating schedule for permanent disabilities.

Monetary Limits to Workers’ Compensation

Workers’ comp policy differs from other types of insurance as it has no ceiling or limit on the policy amount. The insurance company may accept a transfer of the employer’s entire statutory obligation which is whatever the employer is legally responsible for as a result of the injury.

What Happens When Your Workers’ Comp Benefits Are Denied?

For denied workers’ compensation claims, your injury may not have been work-related or you were late in reporting your injury.

In some states, you can appeal through a state-law process, specifically the Workers’ Compensation Appeals Board.

Protect Yourself With a Workers’ Comp Attorney

If you have questions about whether you qualify for these four workers’ comp claims, you should have legal help by your side. You may wonder how long you’ll receive benefits and whether you qualify. That’s when you hire a workers’ comp attorney to analyze your case.

Find an experienced workers’ comp attorney to determine if you are eligible for workers’ comp benefits for you and your loved ones. LegalASAP can help you find an attorney suited to your case while local to your location.