When a work-related injury completely prevents an individual from being able to work, he may be entitled to two types of workers’ compensation benefits. The first is temporary total disability (TTD) benefits, which are typically paid for a maximum of 104 weeks. The second is permanent total disability (PTD) benefits, which are paid to people that are incapable of ever returning to work because of limitations caused by their injuries. In most cases, the victim will receive TTD benefits until one of the following occurs:
- He has recovered from his injuries and is able to return to work.
- His doctor has informed him that he has obtained maximum medical improvement (MMI), meaning his condition will not improve any further, and he is permanently disabled, which means he is unable to return to work.
In the first scenario, the injured worker would return to work and he would stop receiving benefits, whereas in the second scenario, the victim would most likely begin to receive PTD benefits. But, what happens if the 104-week time limit on your TTD benefits runs out before you have fully recovered?
In Oneal R. Gillispie v. Estes Express Lines Inc, the claimant had received 104 weeks of TTD benefits, but was still not fully recovered from his injuries. In fact, he was scheduled for additional surgeries and was still unable to work. The claimant requested PTD benefits since his TTD benefits had expired, but the insurance company denied his request. The insurance company stated that the claimant did not qualify for PTD benefits because the doctor had not diagnosed him with a permanent disability yet. The claimant argued that there was no way for the doctor to determine if he was permanently disabled until he had undergone additional treatments and obtained MMI.
In the end, the judge ruled in favor of the claimant. Judge Sommer stated that PTD benefits are supposed to be given to those that have received 104 weeks of TTD benefits and are still not able to work because of their injuries. Even though the claimant had not obtained MMI, he was still unable to work as a result of his injuries and therefore deserved PTD.
It is not the norm to qualify for PTD benefits while you are still recovering from your injury. But, this case proves that it is possible to obtain PTD benefits before you are fully recovered in order to avoid a gap in compensation.
If you have been injured at work, let an experienced attorney at Armstrong & Vaught, P.L.C. help you recover the benefits you deserve. Call Armstrong & Vaught, P.L.C. at 918-582-2500 or toll free at (800) 722-8880. You can also contact us online for a free consultation with an experienced attorney.