Workers’ Compensation Claim? Can The Insurance Carrier Just Cut-Off My TTD Benefits?
I’ve written previously about Temporary Total Disability (TTD) benefits for injured Alabama workers. If you are hurt on the job and entitled to workers’ compensation in Alabama, TTD can be an important benefit.
What is TTD? This benefit provides payments if you are unable to work during your medical treatment and healing. While TTD does not replace your full wage, it does replace 2/3 of it. This helps workers while off work undergoing medical care. If the authorized treating doctor restricts you from work (and your employer cannot accommodate your restrictions), you may be entitled to TTD while healing.
When do TTD benefits stop? This is often an issue impacting families. In Alabama, TTD benefits generally stop when you reach your Maximum Medical Improvement (MMI) or are able to return back to work if earlier. Maximum Medical Improvement does not mean you are totally healed. It just means you have healed as much as possible. Once you reach MMI, the insurance company will stop your TTD benefits. At that point, if you have any permanent impairments or disabilities, you may be entitled to other benefits. I’ve written several blog articles on Maximum Medical Improvement issues. You can read one of them at Workers’ Compensation Claim? What Happens When You Reach MMI? Issues involving MMI and TTD can be tricky. So, seek good advice to best protect your family following a serious personal injury.
Because the insurance company can stop paying TTD once you reach your maximum improvement, some adjusters put tremendous pressure on the treating physician to declare you have reached MMI. I’ve seen many cases where (under insurance company pressure) the authorized doctor will sign a note saying the patient is at MMI even though the issue was never discussed with that patient! When TTD benefits suddenly stop, it often puts injured workers and their families in very difficult situations.
Can the insurance company stop TTD without warning to you? In Alabama, the answer is yes. As soon as the treating doctor indicates you are at MMI in his notes, the insurance carrier can cut-off those benefits. Many other states have laws requiring the insurance company to notify you before stopping benefits. Those laws provide some protection by giving advance notice. Not Alabama. Over the years, I’ve received lots of phone calls from workers shocked that their benefits suddenly stopped.
If you were seriously injured at work, you need to consider a few things about MMI and your benefits. You need to consider them before these benefits stop. Here are several things to consider:
Be Aware Of Signals From The Doctor That He / She May Soon Place You At Maximum Medical Improvement (MMI)
Don’t expect clues from the insurance adjuster. The adjuster will likely say nothing. They don’t want you to take any action in advance.
But, your doctor may provide clues. Many doctors talk with their patients about treatment progress and approaching MMI. Many doctors begin discussing MMI with their patients in advance. Keep in mind the doctor may not use the phrase Maximum Medical Improvement or even the letters MMI. Some doctors start to talk about releasing you, start to discuss permanent changes in your life or work, or start to say you are about as good as you will get. Listen carefully to the doctor. Any language about reaching the point of permanency or maximum healing should be a signal. If you need more treatment, let the doctor know. If you are still suffering problems, let the doctor know.
When You Reach MMI, The Issue Then Becomes Whether Or Not You Will Have Permanent Impairments Or Restrictions
In the last section, I talked about the time period approaching MMI and what you may hear from the doctor. When you reach MMI, it doesn’t mean you are fully healed. You may have long-term or permanent issues from your injury. Now is the time to make sure your doctor knows.
Many times, doctors will release patients upon MMI. But, if you are still having problems, you may need continuing medical care. Under the Alabama Workers’ Compensation Act, you are entitled to it.
Many times, doctors will think their job is done at MMI. It is not. You are still entitled to ongoing care to maintain your level of functioning or to keep your level of pain down. You may also need to talk with the doctor about permanent restrictions or impairments. When you reach MMI, you lose TTD benefits. However, if you have permanent impairments or restrictions, you may be entitled to additional benefits. These additional benefits are typically Permanent Partial Disability (PPD) or Permanent Total Disability (PT or PTD) benefits.
If You Suffered A Serious Injury Consult An Attorney Before Benefits Are Cut-Off
We often receive calls from injured workers after their benefits were suddenly cut-off. Don’t wait. If you wait, you may face the sudden surprise of losing your benefits while still unable to return to your job.
If you suffered a serious personal injury, go ahead and call an experienced workers’ compensation attorney. You need to know the law and available benefits before being faced with MMI. Plus, an experienced lawyer can begin investigating or preparing your claim. That work can shorten the time it takes to obtain permanent benefits. An experienced work comp lawyer will typically provide a free consultation.
Don’t Let The Insurance Company Rush The MMI Date
Insurance companies like to save money. They will save money at your expense whenever possible.
With work comp claims, insurance companies always try to save money by cutting medical costs. Maybe the insurance company won’t authorize doctors to treat all your injuries. I’m helping clients in multiple cases with that issue. As I write this post, my office just filed a motion to secure medical treatment in a case here in Huntsville. Maybe the insurance company won’t pick a good doctor. You have some options in those cases. Maybe the insurance company is denying some prescribed procedure. The law does not allow the insurance company to dictate the doctor’s care. You have rights.
Often, insurance companies push the doctor to declare you’ve reached your maximum medical improvement (MMI) as soon as possible. Why? The insurance company can cut-off your TTD payments. In many cases, the insurance adjuster is not going to tell you the full benefits available. Don’t count on the insurance adjuster to discuss your rights to continued care or your rights to further permanent disability benefits.
Prepare To Seek Benefits For Your Permanent Disability After Reaching MMI
As I mentioned earlier, you will lose TTD benefits upon reaching MMI. However, if you have permanent problems, you may still be entitled to additional benefits. Don’t count on the insurance adjuster to tell you about those! Even if the adjuster mentions permanent benefits, don’t count on the insurance adjuster to tell you the full extent of what you may be entitled to receive. Workers’ compensation benefits are calculated by certain math formulas in the law. Adjusters frequently apply the wrong and lower formula to save the insurance company money at your expense.
If you suffered a serious injury, the best time to start preparing for permanent benefits is before you reach MMI. Get the advice you need. Workers’ compensation is too important to let the insurance company cheat you out of the medical and disability benefits you earned.