The two most common types of benefits paid to injured Wisconsin employees are temporary total disability (TTD) and permanent partial disability (PPD) benefits. Generally speaking, a workers compensation insurance carrier should pay these benefits without any need for an injured worker to hire an attorney.
Temporary Total Disability (TTD) Benefits
TTD benefits are paid to an employee to compensate for wage loss suffered between the date of injury and the date on which the employee reaches a healing plateau (sometimes also referred to as an end-of-healing or Maximum Medical Improvement date). An employee becomes entitled to TTD benefits after missing more than three days of work because of the injury. The TTD rate is two-thirds of the employee’s average weekly wage (AWW), determined as of the date of injury. In determining the TTD rate, the insurance carrier generally must pay a weekly benefit equal to the higher of 1) the employee’s hourly rate on the date of injury, multiplied by 40 hours; or 2) the total of the employee's 52 weeks of earnings prior to the date of injury, divided by 52. As an example, if an employee was earning $15.00/hour on the date of injury, and earned $35,000 during the 52 weeks prior to the date of injury, then he would be entitled to an AWW of $673.08 ($35,000 divided by 52) rather than $600.00 (the lower rate produced by $15.00/hour multiplied by 40 hours/week). The weekly TTD rate for this employee would be $448.72. The AWW calculation can differ for highly compensated employees (for whom the law imposes a cap on the AWW) or for part-time employees (for whom special considerations apply depending on the reasons for their part-time status). There are also situations in which employees can make a claim for temporary partial disability (TPD) benefits, such as when an employee’s injury-related restrictions prevent him from working more than a half-time schedule or from working overtime hours. It is best to consult an attorney if you have a question about these or other less common situations.
Permanent Partial Disability (PPD) Benefits
When an employee has reached a healing plateau, which generally coincides with the appointment at which her doctor discharges her from further medical treatment (including if the doctor says to return on an “as needed” basis), the doctor should determine whether permanent partial disability (PPD) has resulted from the work injury. PPD is a rating that takes into account whether the employee’s injured body part is permanently impaired as compared to its pre-injury status. This can occur due to loss of range of motion, loss of endurance, pain, or other elements of the employee’s particular injury that he will have to endure on a permanent basis. Some permanent injuries, such as amputations and joint replacements, carry with them an automatic minimum PPD rating per Wisconsin state statute. Others are more subjective in nature and the percentage of PPD the doctor assigns will depend on the doctor’s familiarity with the injury itself and assessment of how it is likely to affect the employee. It is not unusual that an insurance company will refuse to pay the PPD rating assigned by the employee’s doctor or that it will pay a lesser amount, based on a so-called “independent” medical evaluation. In such cases, employees are well-served to consult with an experienced worker’s compensation attorney in order to determine whether to file an appeal of the insurance carrier’s denial of that PPD rating.