We are frequently asked, “how long can I collect workers comp?” The short answer to this is every lawyer’s favorite answer: it depends. It depends on when you are able to return to work, and how long it takes to treat your work injury. For some people this is two weeks, for others it is two years.
Injured workers get workers compensation weekly wage benefits (called “Temporary Total Disability” or “TTD”) when they are out of work for more than three days. (For most people, the amount of the weekly wage replacement is the same as your take-home pay when you were working. To learn how your weekly wage benefit is calculated, see [link to blog].)
Once the insurance company starts paying you TTD, they can’t stop paying until: (1) you return to work at the same weekly pay as before the injury; (2) you are cleared to return to part-time; or (3) you reach what is called “medical end.”
Return to Work at the Same Weekly Pay
If you return to work at the same weekly pay as before the injury, then the insurance company can stop paying you TTD. For people who usually work overtime, this means returning to the same overtime schedule, not just to full-time work. If your employer or the doctor limits you to 40 hours a week and you usually work more than that, then this is returning to “light duty” (see below).
If you return to work but then have a hard time because of your work injury, make sure you tell your doctor. If a doctor takes you out of work again, the insurance company has to re-start the weekly TTD payments.
Return to Work Part-Time or Light Duty at Less Pay
If you are cleared to return to work but are getting less pay (either because it’s part-time or light duty), they can stop paying you TTD, but you are entitled to receive partial weekly benefits instead. This partial weekly payment is called “Temporary Partial Disability” or “TPD”. (The amount that you are paid is 2/3 of the difference between your normal gross weekly pay and the new gross weekly pay. So if you normally work 40 hours at $17/hr, your normal gross weekly pay is $680 (40 x $17); and if you are cleared to return to 32 hours, then your new weekly pay is $544 (32 x $17), and the weekly TPD amount would be $680 – $544 x 2/3, or $90.67.)
If you are cleared to return to work part-time or light duty and your employer has no work for you, the insurance company cannot stop your TTD benefits, unless the insurance company tells you to engage in a work search and you do not comply.
Medical End Point
Lastly, the insurance company can stop your weekly TTD benefits once you reach a medical end. This is the point where there is no medical treatment that will lead to any substantial improvement. It does not mean that you are all better, just that there is no other treatment that will change your underlying condition. You might still need medication or other treatment to deal with pain. The medical end determination is made by a doctor. Medical end is sometimes also referred to as “maximum medical improvement”.
For those who have had surgery, medical end is typically six months to a year after surgery.
One very important point about medical end is that it is completely unrelated to whether you are working. Even if you are still unable to work, if you reach maximum medical improvement the insurance company can stop paying TTD.
Once you reach medical end, the insurance company should send you to a doctor to evaluate whether you are entitled to permanency payments.
Form 27 Notice of Intention to Discontinue Payments
If you return to work at full pay, the insurance company can just stop paying you TTD. But if it wants to stop TTD because you were cleared for part-time or lower pay work, or because you reached a medical end point, it must complete a “Form 27” first. The Form 27 Notice of Intention to Discontinue Payments must be sent to you and filed with the Vermont Department of Labor with supporting documentation. If it is not both sent to you and filed with the VT Department of Labor, or if it does not include supporting evidence, then the insurance company cannot stop your TTD benefits.