You get hurt at work and have to miss time… what are you entitled to while receiving treatment?

Frist, the basics on temporary total disability benefits “TTD.”

If you get hurt at work and report your injury to the employer, your employer has the right to direct your medical care. This means they can pick your treating physician. That treating physician then can make referrals to other doctors as part of your treatment program. The insurance company will pay for your medical bills related to the work injury.

If the treating physician says that you are temporarily unable to return to work due to your work-related injury, then you are entitled to be paid 2/3 of your average weekly wage, up to the state maximum of $737.  This is known as temporary total disability benefits or “TTD”.

Your first week of compensation is not paid unless you unless your TTD continues for 3 consecutive weeks (you miss 3 weeks of work), at which they are then required to pay the first week. You may also receive TTD if you’re a released for light duty restrictions and the employer is unable or chooses not to accommodate those restrictions. TTD payments will stop when the doctor says you have reached maximum medical improvement and can return to your work. Unfortunately, maximum medical improvement doesn’t mean you are as good as you were before the injury, but that essentially your condition has stabilized. TTD will stop even if you are deemed to be at MMI and do not have a job to return to.

So, if 2/3 of your average weekly wage is $500 you will receive TTD for each week missed, until you’re at MMI or return to light duty.

Medical Mileage

Your employer is required to reimburse you for your medical mileage, pursuant to the State mileage rate, currently $0.56, if you have to travel to an appointment that is greater than 5 miles round-trip. We cannot request mileage reimbursement for appointments with our doctors, only for appointments you attend for the insurance company.  

For very long trips or overnight stays, you may be entitled reimbursement for a hotel.

Second Opinions/Unauthorized medical

You have the right to obtain a second opinion with regard to treatment, or obtain treatment through a doctor of your own choice, up to a limit of $500. This is called unauthorized medical. Typically, we will use the unauthorized medical to determine if you need additional or different medical care than what the insurance company doctor is providing for you. We may also use unauthorized medical to obtain opinions on causation.  However, we cannot use unauthorized medical to obtain a rating.

More questions? Call us for free at 785-233-9988