Work-related injuries that keep you from working can be a real bummer, but salary help is often available when you are unable to work. Be prepared to wait, though, because workers' comp benefits, except for medical treatment, aren't issued the minute you have a workplace injury. The claims examiner must complete an investigation before she can accept or deny your workers' comp claim. Individual state laws define the waiting period before you are eligible to receive temporary disability payments when you can't work.
When you get injured at work, immediately tell your supervisor or employer. If the injury requires emergency treatment, have someone call 911 so you get immediate care. Your employer must provide you with a claim form for you to officially report your injury, typically within at least 24 hours after receiving notification of your injury, which may vary depending on the state in which you work. After you report your injury, the claims examiner must interview your employer, you and any witnesses to the injury. In California, for example, the examiner can take up to 90 days to accept or reject your claim, but usually begin the claim investigation within the first 24 hours. If you fail to file your claim within the period set by state law, usually within a year of the injury, you will not be entitled to receive benefits.
Unless you live and work in Texas, your employer must carry no-fault workers' compensation coverage for all employees. State regulations establish the qualifications for receiving disability payments when you are unable to work because of your injury. If your injury does not require you to miss any work, you won't receive any salary compensation, but the insurance does pay for doctor visits for medical-only injuries. For these injuries, follow the directions your employer gave you for filing a claim. Medical-only injury benefits don't have a waiting period, like when you need stitches for cuts that occurred at work.
Temporary Disability Payments
The waiting period to receive temporary disability (TD) payments differs from state to state. In California, for example, TD payments can begin within three days of when your doctor says you are unable to work. In Ohio, TD payments begin on the eighth day if you are off work for up to 14 days. If you've been off work for 15 days, payments are calculated from the first day of your injury but begin after the eighth day. In New York, TD benefits are not allowed for the first seven days of missed work unless you miss work for more than 14 days. To determine your state's exact waiting period for workers' compensation benefits, talk to your employer, the claim examiner handling your claim or visit your state's workers' compensation website.
Permanent Disability Payments
When you receive an injury that permanently affects your ability to work, you will receive permanent temporary disability payments until your doctor determines your physical condition is permanent and stable. These payments follow the same guidelines as TD payments and waiting periods in your state. When your condition becomes permanent and stable, the workers' compensation carrier typically offers a settlement that includes money for future medical treatment and lost salary due to the injury. The negotiation might include vocational rehabilitation or training for a job that you can do even with your injury. The amount of money you receive is based on insurance charts for the type of injury, your salary at the time of the injury, and the calculation set by state law.
Individual states use its average weekly wage in calculating your benefits based on a maximum and minimum it also sets. TD payment calculations are typically figured on a percentage of your wage, which typically starts at two-thirds of your wage or more comparative to the state's weekly wage. These figures change when the state's average weekly wage changes, usually on an annual basis. In New Jersey, for example, you can receive up to 70 percent of your weekly average wage, but not to exceed 75 percent of the state's average weekly wage.
- California Department of Industrial Relations: Division of Workers' Compensation Fact Sheet.
- Texas Department of Insurance: Workers' Compensation
- Ohio Department of Administrative Services: Workers' Compensation Lost Time Claims
- New York State Workers' Compensation Board: Glossary – Waiting Period
- State of New Jersey Department of Labor and Workforce Development: WC Benefits – Temporary Total Disability Benefits