Temporary Total Disability. This is supposed to be the most straightforward benefit available in the worker's compensation system. On its face, nothing would seem simpler.
If the doctor has told an injured worker they cannot work at all in the wake of their injury, that injured worker is considered temporarily totally disabled, and is entitled to benefits.
That person is then supposed to receive 2/3 of their average pre-accident earnings. Nothing could be more straightforward? Nothing could be less complicated? No one has to hire an attorney to to figure this out. It's a doctor's note, and simple math.....
Enter the workers' compensation insurance company.
I've battled with insurance companies in countless cases on these contested claims involving the seemingly uncontested situation in which a persons doctor says they cannot work due to their injury. The reasons to contest the claims are as boundless as the creativity of the adjuster involved, but some of the most common include:
- No accident. The accident did not happen, or, the injury was not accidental.
- Pay a doctor to say something different. In almost every workers' compensation case, the insurance company is going to hire a doctor to give opinions favorable to their position. In this instance, the opinion would be that the injured worker really can work.
- MMI. The concept of maximum medical improvement is a significant one in workers' compensation. The most significant is that is operates as a cut-off for temporary benefits. So, if an insurance company doctor states the person was reached MMI, and this position is accepted, there are no more temporary benefits.
- The disability is related to every prior accident, the age of the worker, or disease known to mankind, and, well, related to everything imaginable,except of course, the workplace injury.
If you've been denied temporary disability, it really is vital that you consult with an experienced worker's compensation attorney. These are not the types of cases that unrepresented worker's typically win. Make no mistake about this. The workers' compensation insurance industry is not regulated by the Maryland Insurance Administration. The industry as a whole denies thousands of cases a day. Once these claims have been denied in whole or in part, these insurance companies hire some of the finest, most able, most respected workers' compensation attorneys in this region to defend their denials in court.
-This Article was updated by Eric Kirk on 5/13/20.