FAQs
Here are the answers to our most frequently asked questions.
How do I qualify for TTD?
A worker qualifies for temporary total disability (TTD) payments if they lose wages because:
a) Your treating doctors says you are unable to work in your usual job for more than three days, or you are hospitalized overnight: and
b) Your employer does not offer you alternative work that covers your usual wages while you recover; and
c) You cannot work at all while recovering.
How do I request for mileage reimbursement?
The expenses accrued while travelling to and from the doctor’s office or pharmacy to receive medical treatment is called mileage. If the medical treatment is covered by worker’s compensation benefits, you are entitled to be reimbursed for the costs of mileage. To recover mileage costs, use the DWC medical mileage expense form to keep a log documenting:
a) The date of each trip
b) The address of the place you began your trip from
c) The name and address of the doctor, therapist, etc.
d) The round-trip mileage, parking fees, and tolls.
Submit the completed form to your worker’s compensation insurer within one year of the treatment, and you will be entitled to prompt reimbursement within fifteen days.
What happens if I am discharged from care?
If you are discharged from care, it means that your treating doctor has determined that your condition has reached a permanent and stationary (P&S) status and there is no need for continuing or future medical treatment. In this case, your TTD payments will end. If your treating doctor says that you will never recover completely, however, you may be eligible to receive permanent disability (PD) payments or supplemental job displacement benefits.
What is P&S
P&S stands for permanent and stationary, meaning that your medical condition has reached a point where it is not improving and not getting worse.
What happens if I am P&S?
If your treating physician designates you as P&S, they will file a P&S report that describes your injury’s status, restrictions on the types of work you can do, and whether you can return to your old job (Among other factors). At this point, you no longer qualify for TTD but may be entitled to permanent disability (PD) payments or supplemental job displacement benefits.
What is PD?
PD stands for permanent disability. Permanent disability means that you will always have limitations on the type of work that you can do. If you have a permanent disability you may qualify for PD workers compensation benefits.
What does it mean if my claim is denied?
After being injured at work, you can make a worker’s compensation claim to be reimbursed for the costs of your injury. After you file this claim with your employer, they pass it on to their insurance provider’s claims administrator who either approves or denies the claim. If your claim is denied, it means that the claims administrator believes that your claim is not covered by their worker’s compensation policy. You have a right to challenge this decision.
What is AME/QME?
When there is a dispute about what benefits you should receive in your workers compensation claim, you may request an unbiased qualified medical evaluator (QME) to examine your medical condition and resolve the dispute. If your attorney and the claims administrator mutually agree to use a certain examiner without going through the process to pick a QME, they are called an agreed medical evaluator (AME).
How long does a QME report take?
A QME report must be issued within thirty (30) days of the end of the evaluation. This time period can be extended by an additional thirty days if requested by the QME.
What is a lien doctor?
A lien doctor is a workers compensation doctor that treats on a denied basis. These doctors understand the workers compensation system and can provide medical records to support your claim. Lien doctors are paid by the insurance company toward the end of your case.
How long does a supplemental report take?
If the QME report did not address all your medical issues, you are entitled to ask the QME for a supplemental report that accommodates your concerns. The QME should file the supplementary report within sixty (60) days of your request. If the parties agree on it, a thirty (30) day extension is possible.
Can I use my own personal doctor?
You have the option to predesignate your personal doctor to treat your workplace injuries. You must predesignate your doctor before the injury. To predesignate your personal doctor, you need to notify your employer in writing, preferably using the optional DWC Form 9783.
How long do TTD checks last?
Your temporary total disability (TTD) checks last until one of the following conditions are satisfied:
a) Your treating doctor says you can return to work
b) You return to your usual job or an alternative at your regular wages (Or wages that meet the maximum limit on your TTD payments)
c) Your condition has become permanent and stationary (P&S)
d) You have received 104 weeks of TTD payments within five years of the injury.
What is a Depo?
A deposition (Or Depo) is a legal proceeding where the injured worker is questioned outside of the courtroom about their injury. This process is meant to provide the parties with more information about the specifics and circumstances surrounding the injury.