Your employer must fill out and sign the “employer” portion of the claim form and give the completed form to a claims administrator. This person handles claims for your employer and usually works for your employer’s insurance company. Your employer must give you a copy of the completed form within one working day after you filed it. Keep this copy. The claims administrator usually must decide within 90 days whether to accept or deny your claim.

If your injury is covered by workers’ compensation, your first TD payment is due within 14 days after your employer learns that:

• You have a job injury or illness;

and

• Your treating doctor says your injury prevents you from doing your job.

You should receive this payment from the claims administrator. The claims administrator must also send you a letter explaining how the payment amount was calculated.

After the first payment, TD benefits must be paid every two weeks, for as long as you are eligible.

Not necessarily. You do not get paid for the first 3 days off work unless your disability lasts 14 days or more. 

Sometimes payments are delayed. If the claims administrator can’t determine whether your injury is covered by workers’ compensation or whether TD benefits must be paid, he or she may delay your first TD payment while investigating. A delay is usually not longer than 90 days.

If there is a delay, the claims administrator must send you a delay letter. It must explain:

• Why you won’t receive payments within the first 14 days
• What information the claims administrator needs in order to decide if you are eligible for TD benefits
• When a decision will be made.

If there are further delays, the claims administrator must send you additional delay letters. (Even if you received delay letters, if the claims administrator doesn’t send you a letter denying your claim within 90 days after

Temporary disability payments end when:

• 1. Your treating doctor says that you can return to your usual job, whether or not you actually return to work;

or

• 2. You return to your usual job or to modified work at your regular pay;

or

• 3. Your treating doctor says that you will never recover completely and that you are permanent and stationary, i.e., your condition neither improving nor getting worse.

When temporary disability payments end, the insurance company must send you a letter explaining why the payments are ending. The letter must be sent within 14 days after your final temporary disability payment and must list all temporary disability payments sent to you. 

TD payments end when:

• Your treating doctor says you can return to your usual job (whether or not you actually return to work); or
• You return to your usual job or to modified or alternate work at your regular wages (or at wages associated with a maximum limit on TTD payments); or
• You have reached a point where your condition is not improving and not getting worse (when this happens, your condition is called “permanent and stationary”); or
• You were injured on or after January 1, 2008, and received up to 104 weeks of TD benefits within five years from the date of injury, or you were injured sometime on or after April 19, 2004, through December 31, 2007, and received up to 104 weeks of TD benefits within two years from the start of payments. (Workers whose injuries involve acute and chronic hepatitis B, acute and chronic hepatitis C, amputations, severe burns, human immunodeficiency virus, high-velocity eye injuries, chemical burns to the eyes, pulmonary fibrosis, or chronic lung disease may receive up to 240 weeks of TD benefits within five years from the date of injury.)

Most workers recover from their job injuries. But some continue to have problems. If your treating doctor says you will never recover completely or will always be limited in the work you can do, you may have a permanent disability. This means that you may be eligible for permanent disability (PD) benefits.

You don’t have to lose your job to be eligible for PD benefits. On the other hand, if you lose income because of a permanent disability, PD benefits may not cover all the income lost.

You may also be eligible for a Supplemental Job Displacement Benefit.  A supplemental job displacement benefit is a voucher that promises to help pay for educational retraining or skill enhancement, or both, at eligible schools. You can use the voucher to pay for tuition, fees, books, tools, or other expenses required by the school for retraining or skill enhancement, and for licensing or professional certification fees, related examination fees, and examination preparation course fees.

Up to $600 of the voucher money may be used to pay for services of a licensed placement agency, a vocational or return-to-work counselor (a person who helps injured workers develop their goals and plans for returning to work), and resumé preparation.

Up to $1,000 may be used to purchase computer equipment.

Up to $500 of the voucher money may be used upon request for miscellaneous expenses without receipts or other documentation.

You may also be eligible for future medical benefits.