If you’re hurt at work, workers’ compensation is supposed to help. It covers medical bills and replaces some of the wages you lose while you’re recovering.
But when does workers comp start paying lost wages? That’s what we’ll explore in this article, focusing on waiting periods and the steps involved in getting those benefits.
Keep in mind that workers’ compensation laws are different in every state. What’s true in Mississippi might not be the same in Florida or Oregon, so it’s always best to check the specific regulations in your state.
The waiting period: A common hurdle
In most states, there’s a waiting period before you can collect lost wage payments through workers’ compensation. A waiting period is simply a certain number of days you have to be out of work before the payments kick in. The idea behind it is to reduce the administrative costs of processing claims for minor injuries that don’t keep people out of work for very long.
Waiting periods vary by state. Here are a few examples:
- Mississippi has a five-day waiting period, so workers’ comp won’t cover your lost wages for the first five days you’re out.
- Oregon has a three-day waiting period.
- [I’d need to research the waiting period for Florida.]
In some states, if your disability lasts a certain amount of time, the waiting period may be waived, and you’ll be paid retroactively for those days.
Who is eligible for lost wage benefits?
To receive lost wage benefits, you’ll typically need to meet these requirements:
- Work-Related Injury or Illness: You have to prove that your injury or illness happened as a direct result of your job. If you had the condition before your employment, it can make the claim more complex.
- Medical Documentation: A doctor must provide documentation that proves your injury and how it prevents you from working. You will also need a doctor’s authorization to take time off or modify your work duties.
- Timely Reporting: You must report the injury to your employer as soon as possible. In Mississippi, you have 30 days to report the injury. If you don’t report the injury in time, you may not be able to receive workers’ compensation.
Calculating Lost Wage Benefits
When you’re sidelined from your job due to a work-related injury, workers’ compensation benefits are generally based on a percentage of your average weekly wage (AWW). Your AWW is figured out based on what you were earning at the time you were injured.
Many states, like Mississippi and Florida, pay benefits at a rate of 66 2/3% of your AWW. However, there are often maximum and minimum weekly benefit amounts. To give you an idea, the maximum weekly compensation rate in Florida was $1,011 in 2021. Over in Oregon, the maximum weekly time-loss rate was $1,658.68 (starting July 1, 2021).
If you’re able to return to work in a modified capacity, your benefits will be reduced if you’re earning less than your AWW. For example, if your AWW was $900, and you’re now earning $600 in a modified role, your benefits would be adjusted to reflect the difference.
Types of Lost Wage Benefits
If you’re hurt on the job, workers’ compensation may cover lost wages. Here’s a quick look at the types of benefits offered in Florida.
Temporary Total Disability (TTD)
These benefits are paid when your injury prevents you from working at all. In Florida, TTD benefits are available for up to 104 weeks.
Temporary Partial Disability (TPD)
These benefits are paid when you can do some work but you’re earning less than you did before your injury. As with TTD benefits, Florida TPD benefits are available for up to 104 weeks.
Permanent Total Disability (PTD)
These benefits are paid when your injury means you’ll never be able to return to work. Florida PTD benefits continue until you turn 75.
Impairment Income Benefits (IIB)
These benefits are based on your impairment rating and any work restrictions you may have.
Common Challenges and How to Overcome Them
Navigating workers’ compensation can be tricky. Here are a few common problems and how to handle them:
- Delays in Reporting: Don’t wait to report your injury! Delays can make it harder to get your claim approved.
- Disputes over Causation: The insurance company might argue that your injury isn’t really work-related. Good medical records are key to winning this argument.
- Claim Denials: It’s possible your claim will be denied. If this happens, talk to a lawyer.
In Summary
Each state has its own rules about how long you have to wait for workers’ compensation to start paying lost wages, who is eligible, and how the payments are calculated.
Filing your workers’ comp claim on time and making sure your medical documentation is accurate are vital to getting your payments started as soon as possible.
If you’re having problems with your claim, or if you think you’re not getting all the benefits you deserve, it’s a good idea to talk to a workers’ compensation attorney.