When is a Worker entitled to receive Temporary Total Disability Benefits?
An injured worker who is kept off work by a treating physician, while undergoing treatment, is entitled to receive 2/3 of his average weekly wage. This is called temporary total disability. This is defined as regular pay, not overtime pay, unless the overtime is mandatory. These benefits are paid while the Petitioner is in active treatment and is unable to work due to his work related injury. No deductions, such as taxes or Social Security, are taken from the temporary total disability check. However, there are exceptions. For example, child support will be taken out if it is owed.
A treating physician also includes, a chiropractor who keeps the worker off work, providing his treatment is deemed to be reasonable and necessary and there is an indication that the injured worker is benefiting from the medical treatment received.
If the physician releases the injured worker to return to work with restrictions and the employer is unable to provide accommodations for the restrictions, then the worker is entitled to continue to receive the temporary total disability benefits. These benefits will continue until the injured worker's medical condition has stabilized and he has reached maximum medical improvement. Maximum medical improvement occurs when the injured worker has reached a state where his or her condition cannot be improved by any additional treatment. This does not mean that the injured worker's medical condition is what it was prior to the time of the injury. Quite often, when the injured worker has reached medical maximum medical improvement, he still is having problems associated with his injury. Those difficulties are factored in when a case is tried before an arbitrator or when a case is settled.
If the employer fails to pay the temporary total disability benefits without a reasonable excuse, they are subject to penalties. That is one reason why the injured worker is required, by the Illinois Workers Compensation Act, to be examined by a physician chosen by the employer. This is called an independent medical examination. If, in fact, the doctor chosen, has a legitimate reason for stating that the injured worker is not entitled to receive temporary total disability benefits, then penalties will not be assessed against the employer. This does not mean, however, that the arbitrator will not still award the temporary total disability benefits, as it would be an issue to be determined by the Illinois Workers Compensation Commission. Finally, you should be aware that when an injured worker receives temporary total disability benefits for an extended period of time, the insurance company will more than likely hire surveillance to follow you around to see if you are violating the restrictions.