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Injured workers may be entitled to
indemnity (wage compensation), reimbursement for
medical expenses and/or vocational
rehabilitation as a result of their injury.
Indemnity
Indemnity benefits are not taxed. The amount of the
compensation the worker is entitled to depends on the length and degree of
disability.
Temporary Total Disability (TTD) is payable when the
employee is disabled and cannot work for a temporary period of time. TTD
benefits are paid at 66 2/3% of the employee’s average weekly wage, based on the
employee’s earning during the twenty six (26) weeks prior to the injury. There
are no indemnity payments for the first seven (7) days. The employee is only
paid retroactively for these first seven days if the disability extends beyond
forty two (42) days.
Temporary Partial Disability (TPD) is paid when a worker is
able to return to work, but is not earning his or her pre-injury average weekly
wage as a result of being assigned to alternate duty or a curtailed work week.
In this case, the employee is owed 2/3 of the difference between his or her
average weekly wage and his or her current weekly wage.
Temporary Total Disability or Temporary Partial Disability
end when one of the following occurs:
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A doctor releases the employee to full duty (Return to Work Form).
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A doctor declares that the employee has reached Maximum
Medical Improvement (MMI) for the injury
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Temporary Total Disability ends when the worker returns
to work
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Temporary Partial Disability ends when the employee is
earning the equivalent of or more than his or her pre-injury average weekly
wage.
Permanent Partial Disability is payable when an employee
reaches maximum medical improvement for his or her injuries and is determined to
have suffered a permanent impairment in accordance with the American Medical
Association’s Guide to permanent impairment.
Medical Benefits
Medical care must be reasonable, necessary and directly
related to a work injury.
The injured worker may choose his or her own physician if
he/she or an immediate family member has seen this physician prior to the
injury. If the employee does not choose a physician, the employer may choose a
physician for him or her.
Prescriptions are reimbursed if they are related to a work
injury.
Mileage to medical appointments may be reimbursed only if
the required services are not available in the community where the employee
works or lives or in a closer community than the one in which the employee is
choosing to receive care.
Vocational Rehabilitation
Workers whose injuries leave them with permanent
restrictions may be eligible for vocational rehabilitation. In order to be
eligible, the employee must be unable to obtain other suitable employment as a
result of these restrictions. In developing a vocational rehabilitation plan, a
number of goals are usually explored:
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The plan may first attempt to return the employee to
his old job.
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The plan may attempt to place the employee in a new job
with his or her old employer.
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The plan may attempt to place the employee in a
suitable new job with a new employer.
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As a final option, the plan may try to retrain the
employee through schooling or other vocational training.
Any vocational rehabilitation plan must be court approved
and must be agreed to by the employee and the employer’s insurance carrier.
If the plan is approved, the employee shall be paid total
temporary disability during the course of rehabilitation. In order to continue
with his or her vocational rehabilitation program, the injured worker must take
an active role in that program by:
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Keeping the court, his/her counselor and insurer or
employer informed of any changes in address, condition or any concerns about
the program. The employee must inform the court if he or she chooses to
terminate involvement in the approved program.
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The employee must comply with reasonable efforts to
evaluate his or her condition and progress towards suitable employment. He
or she must also cooperate with efforts to facilitate his or her return to
former employment or other suitable employment.
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The employee must accept reasonable offer of employment
from his or her old employer or a new, suitable employer.
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