If you were injured or became ill because of your job in Hawaii, you may be eligible to receive benefits through the state workers' compensation system. The amount of workers' comp benefits that you receive will depend on a number of factors unique to your case, including the nature of your injuries, your ability to return to work, and how much you were earning at the time of your injury. This article explains how the most important workers' comp benefits are calculated in Hawaii.
Unless your employer (or its insurance company) pays benefits voluntarily after you report your injury or illness, you'll need to file a workers' comp claim to receive these benefits. In Hawaii, the law presumes that your injury or illness is work related when you file a claim, unless your employer provides substantial evidence to the contrary. (Haw. Rev. Stat. §§ 386-82, 386-83, 386-85 (2020).)
If your doctor says that you need to be off work while recovering from your injury, you should receive temporary total disability (TTD) benefits to replace part of your lost income. In Hawaii, these benefits don't start until your fourth day of missed work. To ensure that you get TTD benefits on time, it's very important to get a note from your treating physician verifying that you can't work.
TTD benefits are calculated as two-thirds of your average weekly wage before your injury (usually determined based on your earnings during the previous 12 months). Like other states, however, Hawaii law sets maximum and minimum weekly rates for TTD benefits, based on a percentage of statewide average wages. For 2020, the maximum is $925, and the minimum is $231. (Like most workers' comp benefits, TTD benefits are not taxed.)
You'll continue receiving TTD benefits as long as you are unable to return to work, until you reach maximum medical improvement (MMI)—meaning your medical condition has stabilized and isn't likely to improve any more. (Haw. Rev. Stat. §§ 386-31(b), 386-51 (2020).)
You're entitled to receive temporary partial disability benefits if you can return to work in some capacity after your injury, but you can't perform your normal job duties while you're recovering from your injuries. (For instance, your doctor may temporarily restrict you to sedentary or part-time work.) The benefits will continue until you're able to return to your normal, full-duty job or you've reached MMI.
In Hawaii, temporary partial disability benefits are calculated as two-thirds of the difference between your pre-injury average weekly wages and what you're currently earning, subject to the same maximum and minimum rates as for TTD benefits. For example, if your pre-injury wages were $900 a week but you're currently earning $600 at a light-duty job, you would receive two-thirds of $300, or $200 a week in benefits. (Haw. Rev. Stat. § 386-32(b) (2020).)
Once you've reached MMI, a doctor will evaluate you to determine if your injury or illness has left you with any permanent impairment and, if so, to what extent. In most cases with any lasting impairment, you'll receive permanent partial disability (PPD) benefits. Except for awards based on disfigurement, the total amount of a PPD award is calculated by multiplying the maximum TTD rate by a certain number of weeks, depending on the affected part(s) of your body and the extent of your impairment, expressed as a percentage.
In Hawaii, your eligibility for PPD benefits isn't dependent on your ability to work. You may receive these benefits regardless of your current earnings. (Haw. Rev. Stat. § 386-32(a) (2020).)
A schedule in Hawaii law lists a number of weeks for the loss or lost use of certain body parts—basically the extremities, eyes, and ears. For example, complete loss of a hand is worth 244 weeks. If you've lost partial use of a hand, the number of weeks would a proportion of that total based on the percentage of your impairment. For instance, 25% lost use of a hand would be worth 61 weeks (25% of 244). The PPD award for that impairment would be 61 multiplied by the maximum weekly benefit ($925 in 2020), for a total of $56,425.
If you have a permanent impairment to a part of your body not listed in the schedule—such as your back, neck, or head—or a loss of any physical or mental function, the doctor will give you a PPD rating expressed as a percentage of impairment to the “whole person.” That percentage will be multiplied by 312; the resulting number will then be multiplied by the maximum PPD rate to come up with the total award.
For instance, if you had a back injury that resulted in a 5% whole person impairment, your PPD award would be calculated by multiplying 15.6 (5% of 312) by the maximum weekly benefit ($925 in 2020), for a total of $14,430.
If your injury (including the medical treatment for the injury) resulted in permanent scarring or another kind of disfigurement, you may also receive a separate disfigurement award. The amount will depend on what's considered fair under the circumstances, up to a maximum of $30,000.
Even though the maximum TTD rate is used in calculating the total amount of PPD awards, your actual pre-injury wages will determine the weekly rate at which you'll receive the award. The weekly installments will be two-thirds of your average weekly wage. For example, if your pre-injury earnings were $900 a week, you would get PPD benefits at the rate of $600 a week until you received the full amount of your award. However, you may apply to receive your award in a lump sum. (Haw. Rev. Stat. §§ 386-32, 386-54 (2020).)
If you're permanently and totally disabled, you may receive weekly benefits at the same rate as TTD benefits, subject to the same maximum and minimum. However, these benefits are adjusted annually, in proportion to changes in the maximum weekly benefit amount. Hawaii doesn't set a time limit or maximum amount for permanent total disability benefits.
Hawaii will presume that you're permanently and totally disabled if you have any of the following injuries:
For other injuries, disability will be determined on a case-by-case basis. (Haw. Rev. Stat. § 386-31, 386-35 (2020).)
The following benefits are also available through workers' comp in Hawaii:
Navigating the worker's compensation system can feel overwhelming, especially when you're dealing with the effects of your injuries and getting medical treatment. In order to receive the benefits you deserve, it's important to obtain quality medical care, follow your doctor's orders, and show that you're eager to return to work when you can do so. But if the insurance company is denying treatment or benefits, you should consider getting help from a qualified workers' comp attorney. (Learn more about when you need a lawyer for your workers' comp case.)