One workers’ compensation benefit is temporary total disability or TTD benefits. These are benefits for lost wages. The insurance company pays these benefits when you are unable to work because of your injury.
Also, if you return to work but are making less money because of your injury, you receive benefits for your reduced earnings. These benefits are called temporary partial disability or TPD benefits and are discussed in this other article.
What if I have to Miss Work because of an Injury?
You should receive temporary total disability benefits when your injury keeps you out of work. This could happen in some of the following situations:
- When you initially suffer an injury at work, you may find that the injury prevents you from going back and doing your regular job.
- You may have a surgery or other medical treatment that takes you totally out of work
- Your doctor may give you light duty restrictions. If your employer does not have light duty work available, these restrictions may keep you out of work.
When Do Temporary Total Disability Benefits Start?
Temporary total disability benefits do not start immediately in Georgia. You may not receive any benefits for the first few days that you are out of work.
The Georgia Workers’ Compensation law has a seven day waiting period. So, you will not receive benefits for the first week you miss from work.
There is a tricky part to this rule. If you miss three weeks consecutively at some point in your case, the insurance company should come back and pay you for this initial one week waiting period.
Do I start getting TTD benefits after 7 days?
No. The 7 day waiting period just makes you eligible for benefits. The insurance company has twenty-one days from the first date you missed work to start paying you. So, be prepared to go three weeks without a check when an injury disables you from work.
When the workers’ compensation insurance company starts paying you temporary total disability benefits, they should pay you all benefits due up to that point. Also, they will start paying you on a weekly basis as long as you are eligible to receive temporary total disability benefits.
Determining the amount of your TTD benefits
The amount of your temporary total disability benefit check is based on the amount you were earning from your employer on average at the time of your injury. Your earnings can include wages, tips, per diems, and other benefits.
Making sure all of your earnings are included is extremely important. Workers compensation already pays you a reduced amount even when your check is calculated correctly. If your check amount does not take into account all your earnings, it can be very hard to survive off of what workers compensation pays. This article has a more complete discussion of tips, bonuses, and other items that count as earnings for workers compensation.
Also, many people work more than one job. This is called “concurrent employment” in workers compensation. Sometimes, the earnings from additional jobs are included when calculating your average weekly wage amount.
How do I determine my Average Weekly Wage?
In most situations, your employer or their insurance company should take your gross earnings from the thirteen weeks before your injury. The average of the thirteen weeks of earnings is your “average weekly wage”.
If you are receiving less than the maximum workers compensation check amount, you should receive a document called a Form WC-6 that explains how the insurance company calculated your average weekly wage. Be sure and save this document so you can refer to it later. You will also want to reference this document to make sure that it actually has accurate numbers showing the earnings you had in the thirteen week before your injury.
What about my Workers Compensation Check Amount?
When you are paid temporary total disability or permanent partial disability benefits, your check should be two-thirds of that average weekly wage, subject to a maximum benefit amount. If your date of injury was before July 1, 2023, your maximum benefit amount would be $725 per week (or even less if your date of injury was prior to July 1, 2022). If you were injured after July 1, 2023, the maximum weekly amount you could potentially receive would be higher.
It is important to understand that you will not receive the maximum amount of temporary total or permanent partial disability benefits unless your average weekly wage is high enough to require it. For example, if you were injured on June 1, 2023 and had an average weekly wage of $1,200, then your temporary total disability benefit amount would be $725 per week.
This is because two-thirds of your average weekly wage would be $800 which is more than the maximum weekly temporary total disability benefit amount for that date of injury. Since you cannot receive more than the maximum temporary total disability benefit amount, you receive the maximum amount in that situation.
If two-thirds of your average weekly wage was less than the maximum amount, then you would receive two-thirds of your average weekly wage as your temporary total disability benefit amount. Let’s take an example where your average weekly wage was $600 and your date of injury was June 1, 2023.
In that situation, two-thirds of your average weekly wage is $400 per week. The maximum temporary total disability benefit for that date of injury is $725 per week. Your temporary total disability benefit amount would be $400 since two-thirds of your average weekly wage is less than the maximum temporary total disability benefit.
What if I did not work all of the three months before my injury?
If you did not work most of the thirteen weeks before your injury, the insurance company may use the wages of a similar employee. It can be difficult to determine who qualifies as a similar employee.
The insurance company may try to use someone who has lower wages than you. This could result in you getting paid less by workers compensation than you should.
If there is no similar employee, the insurance company should use your “full time weekly wage”. In either one of these situations, the insurance company should pay a temporary total disability amount equal to two-thirds of the average weekly wage (subject to the maximum amount rule discussed above).
What about temporary partial disability benefits?
Georgia law entitles you to temporary partial disability benefits when you are working but making less per week because of the injury at work. The amount of benefits depend on your average weekly wage at the time of your injury. Read this article for more information about payment of temporary partial disability benefits. It is important to know that insurance companies often fail to voluntarily pay temporary partial disability benefits even when they should be paying them.
Time limits on temporary total disability benefits
Generally, you receive temporary total disability benefits while you are out of work because of your work injury. However, Georgia law does limit how long you can receive temporary total disability benefits in most claims that are not designated catastrophic.
400 weeks may seem like more than enough time. It is for most injuries. But, serious injuries often make it very difficult to return to work.
If your injury will keep you out of work for a long time, you need to consider requesting a catastrophic designation. A catastrophic designation provides an exception to the 400 week limit on temporary total disability benefits. Also, certain types of serious injuries may automatically qualify for a catastrophic designation.
Other events that can cause temporary total or temporary partial disability benefits to stop
Probably the most common reason that TTD benefits stop is a return to work. When you return to work, you are earning wages again. The insurance company does not have to pay you temporary total disability benefits. They may have to pay you temporary partial disability benefits if you are making less money because of your injury.
Another event that can stop your benefits is your doctor releasing you to return to full duty work without restrictions. If your authorized treating physician releases you to full duty work without restrictions, the insurance company will probably suspend your temporary total disability benefits. All they have to do is file the proper paperwork.
There are other events, such as the failure to cooperate with medical treatment, that can potentially cause the insurance company to suspend your benefits. Regardless of the reason that the workers’ compensation insurance company stops paying you benefits, you will want to make sure that they have the right to do it under the law. You can almost always contest a suspension of benefits.
