Temporary Disability. If you experience a Vermont work injury and are forced to miss time from work, you are most likely entitled to temporary disability benefits. Temporary disability benefits are intended to replace the wages you lose while recovering from a Vermont work injury. There are two types of temporary disability benefits: temporary total disability (“TTD”) benefits and temporary partial disability (“TPD”) benefits.
If your doctor concludes you are unable to work while recovering from your Vermont work injury, you are entitled to TTD benefits. Generally speaking, TTD benefits are calculated using 2/3rds of the average gross wages you received in the 26 weeks before your injury. You’re typically entitled to these TTD benefits until a doctor says you’ve reached “maximum medical improvement” or until you return to work, whichever occurs first. If your doctor concludes that you can work part-time or in some limited capacity, and your employer is able to accommodate those restrictions, you may be entitled to TPD benefits instead of TTD benefits. TPD benefits are more confusing to calculate, because you are paid 2/3rds of the difference between the average gross wages before your work injury and after your work injury. TPD supplements whatever smaller paycheck you’re still receiving from your employer.
As you can see, these calculations can be complicated and the insurance company may not actually be paying you the right amount. I have frequently been hired by people who didn’t realize the insurance company was underpaying them until I went through the insurance company’s calculations. One client was being paid $100 less per week than he was entitled to. It is also the insurance company’s goal to find a way to stop having to pay you anything, and they do that by filing a “Form 27” with the Vermont Department of Labor. It’s best to have a lawyer representing you before that happens, so that he or she can fight the insurance company’s efforts and keep your weekly checks coming in. If you have been receiving TTD benefits for a prolonged period of time, call Dickson Law Office for advice on whether you need an attorney.
Permanent Disability. You’re entitled to receive temporary disability benefits until you reach “maximum medical improvement” or you actually return to work, whichever occurs first. When that happens, the insurance carrier will stop paying you weekly temporary disability benefits. However, that doesn’t necessarily mean they’re off the hook for paying indemnity benefits. Once you’ve reached maximum medical improvement, you may be entitled to permanent partial disability (“PPD”) benefits, which are meant to compensate you for the “permanent” impact your injury has on your ability to function. These permanent impacts can be something as basic as lingering pain or as complex as the type of surgery you’ve had or the decrease in your range of motion.
Permanent partial disability (“PPD”) benefits are paid to an injured worker whose Vermont work injury permanently impairs their ability to function, but is not “totally” disabling. As with many workers’ comp issues, determining the amount of PPD benefits you’re entitled to can be complicated. First, a doctor must assign you a “permanency rating” using certain medical standards. That permanency rating is represents the percentage of your “whole person” which is affected by your work injury. Then, that percentage it is multiplied by a certain number of “weeks” of PPD benefits depending on your injury. A lower weekly compensation rate and/or a lower permanency rating results in a smaller PPD payment to you. A higher compensation rate and/or a higher rating results in a higher payment. In the end, the amount of PPD you’re entitled to for your Vermont work injury is based on how much you were earning before your injury and the extent to which your injury permanently affects your life.
As with the filing of a Form 27, it can be a good idea to talk to Vermont workers’ compensation lawyer before signing a Form 22 (PPD agreement) presented to you by an insurance company. There can be significant differences in doctors’ opinions of your permanent impairment rating, and lawyer can help you decide whether you should challenge the impairment rating you are given by the insurance company’s IME expert.
Medical Benefits. In contrast to the “indemnity” benefits discussed previously, medical benefits are simply based on whether the treatment provided or proposed is reasonable and necessary for your Vermont work injury. Workers’ compensation medical benefits can include everything from an initial trip to the emergency room, to physical therapy, to surgery, to any prescriptions you may need to manage your pain for the rest of your life. As long as the medical treatment and prescriptions are related to your work injury, you are entitled to have them paid for by the insurance company for as long as you need them.
When there is no dispute that your injury was caused by your work in Vermont (or for a Vermont employer), your medical providers will most likely send their medical bills directly to the workers’ compensation insurance carrier for payment. In that sense, medical benefits are not paid directly to you, but they allow you to avoid paying for treatment of your Vermont work injury with your own money. When a Vermont work comp claim is disputed by the insurance company, however, you may need to pay for any necessary treatment yourself, or to try and convince your private health insurer to pay for it. Often, this can be very stressful when you are convinced an injury happened at work, but the insurance company doesn’t want to believe it. In the end, you may have to hire a Vermont work comp lawyer to convince your employer’s insurance carrier to pay. As with temporary disability benefits, keep your eye out for a Form 27 from the insurance company — they may be trying to cut off your right to ongoing medical benefits.
Vocational Rehabilitation Benefits. Under certain circumstances, you may also be entitled to assistance in finding a new, more suitable job after your Vermont work injury. Specifically, if your work injury prevents you from returning to the work you were doing before your injury, the insurance company may be responsible for paying for you to work with a vocational rehabilitation (“VR”) counselor to find a new job. As long as you have been out of work for at least 90 days, the insurance company must begin the process of determining whether you’re entitled to VR benefits. If you are, a VR counselor can help you find a new job and/or obtain additional training and education in order to get that new job. This could mean taking a couple classes at a technical school or it could mean obtaining a Bachelor’s Degree in a field that interests you. At the end of the day, the goal of providing VR benefits is to get you back to work in a job that can accommodate your work injury, and that pays you similarly to your prior job.