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TEMPORARY TOTAL DISABILITY: When time-loss compensation benefits are payable

Posted by Foster Law on May 31, 2013

If you've been injured on the job or have developed an “occupational disease” and your injury or illness causes you to be unable to work, you may be temporarily totally disabled and entitled to time-loss compensation benefits under your allowed workers' compensation claim.

Temporary total disability is defined as an impairment of the mind or body that renders an injured worker unable to perform or obtain a gainful occupation with a reasonable degree of success and continuity. It is the loss of all reasonable wage-earning capacity. An injured worker is considered totally disabled if he or she is unable to obtain regular gainful employment within the range of his or her capabilities, training, education, and experience. An injured worker is not totally disabled solely because of the inability to return to the injured worker's former occupation. However, total disability does not mean the injured worker must have become physically or mentally helpless.

If an injured worker is temporarily and totally disabled, he or she may be entitled to receive time-loss compensation benefits. The amount an injured worker receives in time-loss compensation benefits is calculated based upon the injured worker's wages at the time of injury or illness manifestation date. If entitled to time-loss compensation benefits, injured workers receive a percentage of their wages at the time of injury based upon family status and number of dependents at the time of injury or illness. A single worker is entitled to sixty percent (60%) of his or her average gross monthly wages. An additional five percent (5%) is added for a spouse, and two percent (2%) is added for each dependent up to five children. The schedule of payments is contained in RCW 51.32.060, which can be found at: http://apps.leg.wa.gov/RCW/default.aspx?cite=51.32.060.

However, in order to receive time-loss compensation benefits, an injured worker must supply the Department with necessary documentation to enable the Department to make a determination of the worker's time-loss entitlement. Any determination on the extent of an injured worker's disability must be supported by medical evidence. Therefore, in order for time-loss compensation benefits to be paid, the Department must receive medical certification of the injured worker's inability to work. The most efficient way to provide this information to the Department is for the injured worker's attending physician to complete an Activity Prescription Form (APF). Most providers within the Medical Provider Network (MPN) have APF forms on hand. However, the form can be downloaded from the Department's website using the following link: http://www.lni.wa.gov/FormPub/Detail.asp?DocID=2286. APFs should be submitted to the Department every thirty days to ensure ongoing, timely payments of time-loss compensation benefits.

In addition to the APF, it is important for injured workers to verify their entitlement to time-loss compensation benefits by completing a Worker Verification Form (WVF). When completing the WVF, the injured worker must certify that, due to his or her work-related injury or illness, he or she is not working and was not able to work for the period that time-loss compensation benefits are sought. The injured worker must disclose if he or she her performed any work, paid or unpaid, and must also inform the Department if he or she has sought other monetary assistance from programs such as unemployment, Social Security Disability, retirement, or the Department of Social and Health Services (DSHS). It is critical that the WVF be completed accurately. Any willful misrepresentation submitted in a WVF could result in civil and criminal penalties against the injured worker. The WVF can also be downloaded from the following link: http://www.lni.wa.gov/FormPub/Detail.asp?DocID=1580. Like the APF, an updated WVF should also be submitted every thirty days.

At Foster Law, P.C. we are expert, we are fierce, and we are compassionate. Our team offers decades of experience to helping literally thousands of injured workers obtain the benefits that are so crucial to maintaining their welfare and that of their families. If you are an injured worker or medical provider and have questions or concerns about temporary total disability and time-loss compensation benefits, or any other aspect of workers' compensation law in this state, we invite you to contact us. Initial consultations are complimentary. Don't leave your workers' compensation claim to chance; consult with experts.

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