If you are injured at work and you cannot work for a period of time while you recover, you are entitled to receive money to help replace your lost income. Through your employer’s workers’ compensation insurance company, you will receive what’s called temporary total disability benefits, or TTD. You can also apply for Social Security disability insurance benefits (SSDI) if you expect to be unable to work for more than 12 months, but you will receive reduced SSDI benefits if you’re collecting workers’ comp benefits at the same time.
In some states, TTD benefits are called time loss benefits or wage loss benefits.
You qualify for temporary total disability benefits if you can’t do any kind of work because of your work-related injury. Your treating doctor will decide whether you are temporarily totally disabled; that is, whether you can go to work or not. The doctor will give you a doctor’s note stating for how long you should stay home from work.
Generally, you can collect temporary total disability benefits until one of the following occurs:
When your treating doctor says you have reached maximal medical improvement (MMI), your temporary disability payments will stop. If you have suffered any kind of permanent impairment, or limitation on how you can do your job, you will start getting permanent disability payments right away. If not, you may no longer receive any payments from the insurance company.
In some states, TTD payments are extended for certain illnesses, such as amputations, severe burns, HIV, certain eye injuries, some forms of hepatitis, and some forms of lung disease.
Temporary disability benefits are generally two-thirds of your average weekly wage, up to a weekly maximum. For instance, the weekly maximum in California is $1,074.64 in 2015. Temporary disability benefits are not taxed.
If the claims adjuster at your employer’s insurance company disagrees with the treating doctor’s opinion (that is, the claims adjuster says you should be able to go back to work), it can ask for a qualified medical evaluator (QME) to examine you. (If you have an attorney, you will be seen by an agreed medical examiner (AME) instead.) The QME or AME will give an opinion as to whether you are temporarily disabled or not. If you or the insurance company disagrees, you can request a hearing before your state’s workers’ compensation board.
If you are collecting worker’s comp benefits when you are approved for SSDI disability benefits, your SSDI benefits will be reduced. Your SSDI benefits will be decreased so that the combined amount of your SSDI plus your worker's compensation payments don't exceed 80% of your average earnings when you were working. (You won’t get less than you would collecting SSDI alone, however, and your combined monthly payment should be higher than if you were just collecting worker’s comp benefits.)