On-The-Job Injury Claims: How To Get Your Lost Wages Benefit
When a worker misses time at work due to an injury, they are eligible to receive wage replacement or time-loss benefits. These benefits are also called “temporary disability” benefits and are meant to replace the wages the worker would have earned had they not been injured. When the attending physician restricts the injured worker from work for a period of time, that worker is then authorized to receive payment of time-loss.
Time-loss benefits are calculated by the insurer and paid according to your average weekly wage (AWW). The insurer will request payroll information from your employer for the 52 weeks prior to the date of your injury. Your earnings during that 52 week period are averaged to determine the AWW value. You are entitled to 66.667% of your AWW for time-loss. Part of the reason you can only earn 66.667% of your AWW is because these earnings are not taxable. If you think your AWW has been calculated incorrectly you should tell your Workers Compensation attorney and provide him or her documentation to show the incorrect calculation.
It is important to know who your attending physician is, and to meet with him or her every 30 days to get a work restriction. You are not entitled to time-loss benefits if you do not have a work restriction from your attending physician. If you need to miss work because of your work related injury, you must have a work restriction from your attending physician to be eligible for time-loss benefits.
As your injury improves and you begin to recover your doctor might release you to light or modified duty. Generally, your employer will give you enough hours at a rate that will completely offset your temporary disability amount. If your employer does not have light duty assignments available then you will stay off work and receive time-loss until you have a full release. Even though you are released to light duty, often times you will still earn 66.667% of your AWW. Make sure to keep your employer informed immediately when you receive new or updated work restrictions. Inform your employer any time that you will miss work to attend a doctor’s appointment.
Three important things to do to ensure you receive time-loss:
1. Meet with your attending physician every 30 days and get an updated work restriction. Your doctor should have work restriction forms in the office, and will give you two copies; keep one for yourself and give the other to your employer. Your physician will send one to the insurer.
2. Inform your employer as soon as possible after you receive new work restrictions from your doctor.
3. Make sure to make prior arrangements if a doctor’s appointment conflicts with your work schedule.
Taking these steps will help to prevent obstacles to receiving your time-loss.