When a worker is injured in the course and scope of his/her employment, workers’ compensation benefits fall into two broad areas: medical benefits and indemnity benefits (money benefits) paid to an injured worker. Indemnity benefits can only fall into one of five categories:
Temporary Partial Disability Benefits
Temporary Total Disability Benefits
Impairment Income Benefits
Rehabilitative Temporary Total Disability Benefits (AKA Retraining Benefits)
Permanent Total Disability Benefits
These payments are paid in two week installments, based on the injured worker’s average weekly wage, and are largely determined by the physician’s opinion regarding work status. Exceptions do exist and the payment of benefits or entitlement to benefits can be very fact-specific and vary from person to person and situation to situation.
Indemnity Benefits – What To Expect before Reaching Maximum Medical Improvement
When an injured worker is in active treatment (treatment designed to improve the condition), he/she will likely have work restrictions (ie light duty), or will be in an off work status. If the injured worker is still employed with the employer, it is important to always keep an open line of communication with the employer and accept light duty work that is offered within the limitations assigned by the doctor. During this period of time, i.e. prior to maximum medical improvement, the only categories noted above available to an injured worker are temporary partial and temporary total disability benefits.
Eventually, whether surgery is required or not, the injured worker will reach a level of maximum medical improvement. Maximum medical improvement is the point at which no additional medical treatment is likely to bring about improvement in the individual’s condition. This does not mean the individual is necessarily 100%, or as good as they were before the accident. It simply means that no additional treatment is likely to bring about improvement in the condition. At that point, the injury changes from being temporary in nature to permanent in nature. The treating physician will assign a permanent impairment rating, if applicable, by consulting the Florida Impairment Rating Guides. The Florida Impairment Rating Guides cover a multitude of injuries that could be expected to be sustained in the course of employment.
Additionally, once maximum medical improvement has been assigned, the physician is required to determine whether any permanent restrictions are appropriate for the injury. A restriction is a limitation assigned by the doctor, such as no lifting greater than 10 pounds, no bending, no kneeling, etc. The purpose of assigning restrictions in general, and permanent restrictions in particular, is to give the claimant some understanding as to the nature of the injury, and the risks associated with exceeding certain physical demands. The goal, of course, would be to make certain the claimant is working and living in a safe manner, and thereby reduce the likelihood of re-injury.
Once an individual reaches maximum medical improvement, very little changes in terms of their right to ongoing medical treatment (keeping in mind the statute of limitations; the obligation to never allow a year or more to pass without receiving authorized treatment). An individual is entitled to medical treatment after maximum medical improvement has been assigned, as long as the treatment remains reasonable, necessary and related to the injuries sustained in the accident. The only difference is that once MMI has been assigned, the individual is required to make a $10 co-payment to their physician for office visits.
Indemnity Benefits – What To Expect after Reaching Maximum Medical Improvement
Once the physician assigned maximum medical improvement, he/she may assign a permanent impairment rating, if applicable, by consulting the Florida Impairment Rating Guides. If an impairment rating is assigned, then impairment income benefits will be paid pursuant to that rating.
Other than the impairment benefits, the only other categories of benefits available to an injured worker are Rehabilitative Temporary Total Disability Benefits (AKA Retraining Benefits) or Permanent Total Disability Benefits.
Workers’ Compensation Attorney
Our workers’ compensation attorney in Tampa has extensive experience dealing with injured workers – and the various issues that arise in workers’ compensation cases. We help ensure your claim is filed correctly and you receive the help you need to get back on your feet and back to work. Schedule a consult today at our website here.
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