Many benefits are available. Numbers 1-8 are mandatory; number 9 is a discretionary benefit which the state or employer can choose to offer.
- Medical Treatment – Proper and necessary medical care will be provided for your job-related injury or disease, including necessary prescription medications. You may choose your medical provider, who may refer you to a specialist if necessary. Medical care will be provided until your condition has reached maximum medical improvement or is fixed and stable. The Department or self-insured employer may periodically request an evaluation by medical examiners of their choosing (called an independent medical exam or an IME.) You may have a friend or family member accompany you to these exams, and you may obtain a copy of the written report. Your doctor should review this report and provide a written response. All of this information will be considered in making decisions about your claim.
- Property Damage – If your personal effects or protective equipment are lost or damaged as a result of your work-related injury, repair or replacement is covered. This would include items such as clothing and glasses.
- Travel Expenses – Travel expenses are reimbursable for travel that is necessary for the treatment of your injury or occupational disease. This includes travel for vocational services, medical exams arranged by the Department or self-insured employer and travel to your medical provider if adequate treatment is not available within 10 miles of your home. Travel expense vouchers can be obtained from the Department.
- Time Loss – Time loss is a non-taxable, partial wage replacement benefit paid while you are unable to work due to an industrial injury or occupational disease. Your time loss compensation rate is 60% of your monthly wage, with additional amounts if you are married or have children. Your monthly wage includes wages you were receiving from all employment at the time of injury. Monthly wage also includes the employer’s cost of your health care benefits, housing, tips, fuel, and other similar considerations. You must provide accurate wage information and double-check how your monthly wage and time loss rate are calculated.
- Loss of Earning Power (LEP) – Your employer may request your medical provider allow you to work part-time or at a lighter duty job while you are recovering. A written job description must be provided for your medical provider to review and approve or disapprove. If you return to some kind of work, but still have more than a 5% loss of earnings, then you will be eligible for LEP benefits.
- Permanent Partial Disability – Once you are able to return to some type of permanent work and your medical condition has reached maximum medical improvement, the extent of any permanent partial impairment will be determined. Partial disability awards are not based on lost wage-earning capacity and do not include pain and suffering, so returning to work does not reduce your award, and your level of pain will not increase your award. An impairment rating based on a medical exam will be obtained from your attending physician or a medical examiner selected by the Department or the self-insured employer. Your doctor is more familiar with your condition and should be encouraged to rate your impairment. Your impairment rating will be converted to a monetary award and will be paid to you at the time your claim is closed.
- Pension/Permanent Total Disability – There are two ways to become eligible for a pension or permanent total disability benefit. If your accident results in the loss or paralysis of both legs, both arms, one arm and one leg, or total loss of vision, you are considered totally disabled even if you are able to return to work. You may also be totally disabled if vocational and medical evaluations indicate your work injury prevents you from obtaining or maintaining reasonable continuous gainful employment. Your age, education, transferable work skills and pre-existing medical conditions must be considered in making this determination. If you are permanently disabled as a result of your injury, you will be paid a monthly pension benefit for life. The amount is based on the factors that determined your time loss rate.
- Survivor/Death Benefits – If a work-related injury or occupational disease causes death, your spouse and dependent children will receive a monthly pension benefit. This benefit is based on the same factors that determine your time loss rate. They are also entitled to receive an immediate cash payment and a burial benefit. A dependent child’s portion of the pension benefit is paid to the person who has legal custody of the child. The child’s benefit is paid until age 18 or until age 23 if enrolled full time in an accredited school.
- Return to Work Assistance – This is a benefit which can be provided at the discretion of your employer or the state. There are a number of programs or benefits that can assist you in returning to work after an injury or illness. These may include temporary or permanent modifications to your work duties or job station. You may receive early intervention assistance from a vocational counselor to help you return to work, either with your employer of injury or with a new employer. If your limitations and work skills leave you unemployable, you may be eligible for vocational retraining. If you are eligible, you will work with a vocational counselor to develop a retraining plan. This program may last up to two years and cost up to $12,000 (for retraining plans approved in 2008; the costs allowed after 2008 will be adjusted annually). While you are in retraining, you will receive on-going time-loss benefits until you finish the program and are considered employable.
