Temporary total disability or TTD benefits are the weekly checks paid to an injured worker who is “disabled.” A worker is disabled when he has been written out of work by his doctor or his employer cannot accommodate the work restrictions assigned by his doctor. After a seven-day waiting period, a disabled worker is paid weekly benefits of 66-2/3 percent of his average weekly wage. Subject to some limitations discussed below, these benefits can continue for as long as an injured worker remains out of work because of his injuries.
A worker’s “average weekly wage” is usually calculated by determining his total pre-tax wages – including overtime, bonuses, and payments in lieu of wages (housing and meals, for example) – during the 52-week period prior to the date of injury. That sum is then divided by 52.
If the worker has been employed with the employer for fewer than 52 weeks, the number of weeks the employee actually worked is used. However, if that time period is so short that using it would be unfair to either the employee or the employer, the average weekly wage of a comparable employee can be used. If no comparable employee is available, a wage is determined that is fair to both the employee and the employer.
Once the average weekly wage is determined, it is multiplied by 66-2/3 percent to determine the weekly benefits payable to an injured worker.
There is a seven-day waiting period before a worker is entitled to receive TTD benefits. The seven days do not have to be consecutive. Often, employers will allow the injured worker to use vacation and sick time for the seven-day period so that the worker is not without pay. If the injured worker remains out of work for more than 21 days, he or she will then be entitled to compensation for the seven-day waiting period, and the insurance company must issue a check for that week.
TTD benefits last for as long as an injured worker is “disabled” as a result of a work-related injury. In the context of workers’ compensation, an injured worker is disabled if he is incapable of earning the wages earned before the work-related injury.
The injured worker is entitled to TTD benefits so long as he is written out of work by his doctor or he is on light-duty restrictions that his employer cannot accommodate. If the employer cannot accommodate the worker’s restrictions, the worker does have a duty to make a reasonable effort to obtain another job.
Workers injured before June 24, 2011 (the date on which the 2011 workers’ comp “reform” bill became law) can receive TTD benefits indefinitely, even for the rest of their lives if they are never able to return to work. Workers injured on June 24, 2011 or after can receive TTD benefits for up to 500 weeks after the date of injury. An injured worker can, however, petition the Commission for permanent disability, which would allow benefits to continue beyond the 500-week period.
Temporary partial disability or TPD benefits are paid when an injured worker has returned to work at a lower wage than he earned before the injury. The injured worker is entitled to 66-2/3 percent of the difference between his pre-injury average weekly wage and the amount he earns upon returning to work.
A worker injured before June 24, 2011 (the date on which the 2011 workers’ comp “reform” bill became law) can receive TPD benefits for up to 300 weeks after the date of injury. A worker injured on or after June 24, 2011 can receive TPD benefits for up to 500 weeks after the date of injury.
Injured workers are often assigned a “permanent partial impairment rating” by their doctors after the work-related injury has healed. The rating is stated as a percentage of disability – a 25 percent rating to the back, for example – and is meant to reflect the amount of permanent damage to the injured body part. Based on the rating assigned by his doctor, the injured worker may be entitled to a lump sum payment of benefits. These benefits are sometimes called permanent partial disability, or PPD benefits.
At some point, the worker may be asked to make an election between wage-loss benefits and rating benefits. Under North Carolina law, workers are entitled to their more favorable remedy, or the benefits that pay the most money.