Medical Care – A Claims Administrator (Insurance Company or Third Party Administrator) will pay all reasonable and necessary medical care for your work injury or illness. Medical benefits may include doctor visits, hospital services, physical therapy, lab tests, X-ray and medicines. The Claims Administrator will pay the costs directly so your workers should never see a bill.
Temporary Total Disability (TTD) - If an employee cannot work while recovering from a job related injury or illness, he/she will receive temporary disability payments. Typically these represent 2/3 of the employee weekly compensation subject to a minimum and maximum as stated by law. These payments may change or stop once the doctor says the employee is able to return to work. These benefits are tax-free. Payments are not made for the first three days an employee is off the job unless employee is hospitalized overnight or cannot work for more than 14 days.
Permanent Disability (PD) - If a doctor says that an employee’s injury or illness results in permanent disability, the employee may receive additional payments. The amount will depend on the type of injury, age of the employee, occupation and date of injury.
Vocational Rehabilitation (VR) - If a doctor says an employee injury or illness prevents him/her from returning to the same type of job and you as an employer fail to/cannot offer modified or alternative work, the employee may qualify for Vocational Rehabilitation. If the employee does qualify, the Claims Administrator will pay the costs up to the maximum set by state law. In California, VR is for injuries that occurred prior to 1/1/04.
Supplemental Job Displacement Benefits (SDJB) - If an employee does not return to work within 60 days after the temporary disability ends, and you do not offer modified or alternative work, the employee may qualify for nontransferable voucher payable to a school for training and/or skill enhancement. If the employee does qualify these costs will be paid by the Claims Administrator up to maximum prescribed by state law based on the employee’s percentage of permanent disability. In California, SJDB is a benefit for injuries that took place after 1/1/04.
Death Benefit - If the injury or illness causes death, payments may be made to relatives or household members who were financially dependent on the deceased worker. The amount varies by state and is determined by a variety of factors.