Whether or not your insurer approves your claim, you may be granted temporary compensation benefits for up to 90 days. These benefits may stop at any time during the 90 days if your employer’s insurer chooses to deny your claim. Once you have been approved to receive compensation, your wage-loss benefits may continue until your employer and insurer have evidence to show that you are back to work at wages that are equal to or more than what you were making before the injury. Benefits may also stop if a judge determines that you are not eligible to receive them. Additionally, if you receive partial disability benefits, those benefits will expire after 500 weeks.
In addition, the length of time you can receive payments for lost wages depends on whether you have a total or partial disability benefits status.
Total disability benefits. Total disability status applies to employees who have been injured to such an extent that they cannot work for a period of time because of a disability. After you have received total disability benefits for 104 weeks, your employer’s insurance carrier has the right to request a medical exam. During the exam, a physician will assess if you are at least 35 percent disabled as defined by American Medical Association (AMA) standards. If you are less than 35 percent impaired, your employer’s insurance company can change your benefits status to partial disability.
Partial disability benefits. Any injury that leaves you less than 35 percent impaired falls under the umbrella of partial disability. You can receive partial disability benefits for up to 500 weeks. If you visit a doctor during this time, and he or she determines you meet the 35 percent threshold, you can petition workers’ compensation for total disability status. You could also receive 500 weeks of partial disability benefits if you return to work and make less money as a result of injury-related restrictions.