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disability pay indiana

Permanent Partial Impairment (PPI)

Oftentimes as physicians we are asked to calculate permanent partial impairment ratings. Impairment is defined as a significant deviation, loss or loss of use of any body structure or function in individual with a health condition, disorder or disease. Impairments are determined as a percentage of the body part involved and then converted to a percentage of the whole person. An injury may result in an impairment from 0 to 100% of the whole person depending on the severity of the condition. Impairment ratings are defined by anatomic, structural, functional and diagnostic criteria. An accurate exam is also important in determining impairment as is the specific diagnosis. Ultimately the system for determining impairment should be reliable so that different raters arrived at consistent impairment ratings when assessing the same individual.

To achieve consistency the American Medical Association has been publishing The Guides to  Evaluation of Permanent Impairment since the 1950s. Every seven years a new edition is printed. The most recent edition is the Sixth Edition published in 2008. This addition continues to emphasize diagnosis as a key contributor to determining the impairment rating. There are also adjustments for the significance of the patient symptoms and functional abilities. The physical findings and diagnostic studies can also influence the impairment. In my opinion The 6th Edition provides a better template for determining impairment. However it is a more complicated process and physicians have been slow to accept and utilize this edition. Many physicians still rely on the Fifth Edition. Some jurisdictions require the use of specific references for determining impairment.

Generally impairment should not be determined until the patient has reached a point of maximum medical improvement (MMI). Until the patient reaches a point of maximum improvement their impairment may change. For instance if a patient needs surgery for an unstable joint their impairment prior to the surgery would be much higher as they would likely lack motion and stability of the joint. After the surgery they would potentially improve functionally and symptomatically. Furthermore their joint would become more stable and have greater range of motion. Their impairment would be much less after the surgery if the outcome was as described above. Similarly when determining impairment for brain or nerve injuries we need to wait until the patient has made maximum medical improvement. After they have fully benefited from therapy and time we can then accurately measure their neurologic findings which will help to determine the significance of their loss and resultant impairment.

When determining impairment the physician should cite the reference and include the page or tables that were used in calculating the percentage. Furthermore if a body part is converted to a larger part or whole person the methodology needs to be described. A properly calculated impairment rating should be easily understood by those reading the report.  It should also be easily supported by the reference utilized to determine the PPI.

Partial Impairment

Don’t Let The Insurance Company DENY YOU Medical Care!

Workers’ comp carriers, more than ever, look for ways to avoid paying expensive treatment.  Whether you’ve been ordered to have an MRI, surgery, a spinal cord stimulator or pain treatment, be aware that the workers’ comp carrier may seek to avoid paying for these necessary treatments.  Tactics used by these carriers may include utilization review, a second medical opinion, a psychological evaluation or simply denying the treatment.

Don’t let the insurance company get away with denying you needed medical care!  Under the law in Indiana, the workers’ comp carrier MUST provide you with all necessary care as deemed medically needed by the attending physician.  If you need assistance, please contact our office.

If you would benefit from legal counsel, our office does not charge for a consultation.  We’re here to offer our experience to make sure you receive what you’re legally entitled.

Did you know that all Indiana Worker’s Compensation attorneys charge the same fees? The fees are set by Indiana law.  Under the Indiana Workers’ Compensation Act, attorney fees are limited to 20% of the first $50,000.00, and 15% of any remaining balance.

Klezmer Maudlin can only charge a percentage of any recovery received and never charge you an up-front fee for our services.  With limited exceptions, we also will collect our out-of-pocket expenses from the recovery and not from you. If you hire us with an offer already given to you, we will typically agree not to charge an attorney fee unless we recover additional money.  For example, if you hire us with an offer already of $5,000.00 and 3 months later we tell you we can only get you $5,000.00, we will typically not charge you.

We will discuss this in more detail at the initial meeting and put our agreement in writing. If you have any questions regarding our attorney’s fee, please contact us at 1-800-809-3776.

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Temporary Partial Disability (TPD): What Injured Workers Need to Know

 

The law in Indiana provides injured workers with three forms of disability pay: Temporary Total Disability (TTD), Temporary Partial Disability (TPD), and Permanent Total Disability (PTD).

Temporary Partial Disability

Temporary Partial Disability (TPD) is paid when an injured worker is only PARTIALLY unable to work for a TEMPORARY period because of a work-related injury. In other words, the injured worker is either limited in the number of hours he or she can work OR needs to be temporarily re-assigned to a job that earns less than what the worker earned prior to the job accident and the amount he or she earns in this temporary re-assignment is less than sixty-six and two-thirds (66 2/3%) percent of the difference between his or her average weekly wage before and after the injury.

Another way of stating this is if you return to your job with restrictions while still under the care of the worker’s compensation insurance carrier’s doctor, and the earnings you bring home are the same or more than the amount you received when completely off work and earning TTD benefits, then you will NOT be entitled to any additional disability pay. If, however, you are able to return to your place of employment, but what you bring home is less than what you would have earned if you were completely off work for the injury, then you will be paid this difference.

An injured worker can earn a maximum of 300 weeks of TPD pay.

Example:

Barbara is a cook for the local college. One day at work, she dropped a heavy pot on her foot, injuring a couple of her toes bad enough to require surgery. The doctor said she could return to work while her toes and foot healed if she was in a sit down job that allowed her to prop her foot. He also said she should work no more than four hours a day. Before the accident, Brenda worked 8 hours a day.

Barbara’s employer was able to meet her restrictions by having her work the cash register for 4 hours each day. Since she will be able to work while healing, Barbara is only PARTIALLY disabled from her job. Barbara’s toes will heal, so her disability is TEMPORARY.

In the above example, if Barbara’s income from this temporary, cash register job is less than 66 2/3% her average weekly wage before the accident, then she will receive the different in TPD benefits. However, if her income from working 4 hours a day as a cashier is equal to or more than 66 2/3% her average weekly wage before the accident, then she will not receive any TPD pay.

TPD Guidelines

Remember that before you receive any type of disability pay, the following must occur:

  1. Your claim has been accepted by the worker’s compensation insurance carrier.
  2. Their doctor has ordered you off work or put you on restrictions that your employer is unable to meet.
  3. You have been ordered off work for more than 7 days (not necessarily consecutive days).

End of TPD Benefits

You will no longer qualify for disability pay if your job can accommodate the doctor’s restrictions and you income is equal to or more than what you drew in  TPD benefits.

Once you have been released at maximum medical improvement by their doctor, your disability checks will stop even if you are unable to return to the job you held before the work accident. The only exception to this rule is a case involving permanent and total disability.

Depending on your situation, it is likely that you will receive notice from the insurance carrier when your disability pay is about to stop.

 

To learn more about other types of disability pay, like Temporary Total Disability, click here.

Temporary Total Disability (TTD): What Injured Workers Need to Know

 

The law in Indiana provides injured workers with three forms of disability pay: Temporary Total Disability (TTD), Temporary Partial Disability (TPD), and Permanent Total Disability (PTD).

Temporary Total Disability (TTD)

The Guide to Indiana Worker’s Compensation, written by the Worker’s Compensation Board of Indiana, says that TTD is paid when an injured worker is TOTALLY unable to perform his or her regular work for a TEMPORARY period because of a work-related injury. TTD is paid at sixty-six and two-thirds (66 2/3%) percent of the injured worker’s pre-injury average weekly wage (AWW), or the average wages he or she earned for the fifty-two week period prior to the date the injury occurred.

An injured worker can earn a maximum of 500 weeks of TTD pay.

Example: Jim, a construction worker, trips over some tools left out by one of his coworkers and breaks his ankle. Because of his on-the-job injury, Jim cannot perform his regular job duties and the company has no light duty jobs available that meet his injury restrictions. So, Tom is now TOTALLY disabled from his job. However, since a broken ankle will heal, Tom will only TEMPORARILY be disabled from his construction job. Until he is able to return, Tom will receive TTD benefits.

TTD Guidelines

Before you can receive any type of disability pay for your work injury, the following things must happen:

  1. Your claim has been accepted by the worker’s compensation insurance carrier.
  2. The doctor has ordered you off work or put you on restrictions that your employer is unable to meet.
  3. You have been ordered off work for more than 7 days (not necessarily consecutive days.
End of TTD Benefits

You will no longer qualify for disability pay if your job can accommodate the doctor’s restrictions and your income is equal to or more than what you drew in TTD benefits. Once you have been released at maximum medical improvement by their doctor, your disability checks will stop even if you are unable to return to the job you held before the work accident. The only exception to this rule is a case involving permanent and total disability.

Depending on your situation, it is likely that you will receive notice from the insurance carrier when your disability pay is about to stop.