If a medical provider states that the employee cannot work because of a job related injury or disease, the employee may be entitled to temporary total disability (“TTD”) or temporary partial disability (“TPD”) benefits until the employee is released to return to work. Return to work generally occurs at the point in time when the employee reaches maximum medical improvement (“MMI”). The employee may be entitled to temporary total disability (TTD/TPD) benefits if the injury or disease causes the employee to miss more than five days of work, or if the employee is hospitalized. Temporary total disability (TTD/TPD) benefits will then run from the time of the injury until the employee is released by their doctor as having reached maximum medical improvement (MMI). (Maximum medical improvement does not mean that you are one hundred percent returned to your pre-injury health, it simply means that you have reached your likely maximum recovery.)

If the injury is work-related, the employer’s workers’ compensation insurance is responsible for the “reasonable and necessary” medical care to treat the employee’s job-related injury or disease. The employee is not responsible for the medical costs. In certain circumstances, the insurance company is able to reduce the amount owed to the employer to “reasonable and customary” expense, and the medical care provider cannot bill the employee for the difference between the medical care provider’s billing and the reasonable adjusted bill. The medical benefits generally continue until the employee reaches maximum medical improvement (MMI).

Impairment is the extent to which the injured worker’s body or physical or emotional faculties are left less than whole as a result of the work injury. If it is determined that the employee has sustained a permanent impairment, less than whole, the employer’s workers’ compensation insurance carrier is required to pay to the injured worker the statutory value of that benefit. Permanent impairment is generally the effect of the injury to the injured worker’s body or mind and may either be a statutory impairment or an impairment as outlined by the AMA Guidelines.

If an injured worker does not have an impairment, they cannot have any permanent disability. If the injured worker has a permanent impairment (PPI), then, the employee may have sustained a permanent disability, which is determined, generally, by the effect which the injury has upon the worker’s ability to earn income, ability to re-engage in employment, and may be based on a number of other factors, including age.

Other benefits may also exist, including total permanent disability (TPD) and/or death benefits.