According to the Revised Statutes of Missouri, Section 287.170, when a worker sustains an injury rendering them temporarily incapable of work, they are entitled to Temporary Total Disability (TTD) benefits. How do these and other work-related benefits work?
Understanding Temporary Total Disability Benefits
The TTD benefits are calculated as follows:
- For injuries sustained on or after August 28, 1991, the weekly compensation is 66 2/3% of the injured worker's average weekly earnings at the time of the injury. This amount cannot exceed 105% of the state average weekly wage.
Temporary Disability vs. Permanent Disability
In the realm of workers' compensation in Missouri, it's crucial to distinguish between Temporary and Permanent disabilities.
1. Temporary Disabilities:
- Temporary Partial Disability (TPD): This compensation is paid during the rehabilitative process, capped at 100 weeks. It covers the difference between your pre-injury earnings and your earnings during the disability.
- Temporary Total Disability (TTD): TTD benefits, capped at 400 weeks, are paid when you're unable to work during rehabilitation. They constitute 2/3 of your average weekly wage.
2. Permanent Disabilities:
- Permanent Partial Disability (PPD): This is for life-long injuries to a body part but where you can still work. The payment is a product of various factors, including your average weekly wage and the severity of your injury.
- Permanent Total Disability (PTD): This applies when you're unable to return to any form of employment. If eligible, you'll receive compensation equivalent to your TTD for the rest of your life.
Breaking Down the Numbers. Here are Examples of TTD Benefits:
The TTD benefits calculation might seem complex, but let's consider a real-world scenario.
- Example: John, a construction worker, earns an average weekly wage of $800. After a fall on the worksite, John is temporarily unable to work.
According to the law, John should receive TTD benefits equal to 66 2/3% of his average weekly earnings. That equates to $533.33 per week.
Temporary Disability vs. Permanent Disability: Injury Scenarios
In Missouri's workers' compensation realm, differentiating Temporary and Permanent disabilities is crucial. Here are some scenarios to illustrate these:
1. Temporary Disabilities:
- Example: Emily, a warehouse worker, sprains her ankle at work and is temporarily unable to perform her duties. After rehabilitation, she returns to her job. In this case, Emily can claim TTD benefits while she's unable to work.
2. Permanent Disabilities:
- Example: Mike, a factory worker, loses a finger due to a machinery accident at work. He can continue to work, but his ability is permanently reduced. Mike can claim PPD benefits for this life-long injury.
Understanding the Role of Medical Care in Workers' Compensation
One primary advantage of workers' compensation is that the employer provides the necessary medical treatment resulting from the injury. This includes "medical, surgical, chiropractic, and hospital treatment" necessary to alleviate the effects of the injury. However, since the employer pays, they choose the provider.
Navigating Hardship Hearings and Medical Care Challenges
In cases where the workers' compensation carrier denies necessary medical care, you have the right to a Hardship Hearing.
Example: Jane, a teacher, develops chronic wrist pain due to continuous typing at work. Her workers' compensation carrier denies her claim for physical therapy. Jane can request a Hardship Hearing to argue her case and potentially secure the necessary treatment.
The Second Injury Fund Claim
For workers with a pre-existing severe injury or disability, they may be eligible for benefits from the Second Injury Fund. To receive these benefits, an employee must file a claim against the Second Injury Fund. However, there is a complex statute of limitations governing when a claim must be filed, and prematurely settling your workers’ compensation case might jeopardize your Second Injury Fund claim.
Workers with a pre-existing severe injury or disability might be eligible for benefits from the Second Injury Fund.
Example: Mark, a truck driver with a pre-existing knee injury, gets into a work-related accident resulting in a back injury. He can file a claim against the Second Injury Fund, which can provide additional benefits due to the compounded effect of his injuries.
Protecting Your Rights
Navigating workers' compensation claims can be daunting, particularly when facing uncooperative insurance carriers or hardship hearings. Therefore, if you're dealing with these challenging situations, don't hesitate to seek legal help.
Our team at Aaron Sachs & Associates is experienced in workers' compensation claims and is ready to help you maximize your benefits and protect your rights. We aim to provide valuable assistance and strategic advice throughout your claim process.
Contact us today for a free consultation and let us help you navigate your workers' compensation journey.