In the state of Indiana, an injured worker is entitled to receive all necessary medical care, free of charge, until the date the worker is placed at maximum medical improvement (MMI). This should include full payment of all prescription medication costs, and there should never be any co-pays, deductibles, or other “out-of-pocket” costs for the injured worker. In some cases, long term pain management, or palliative care, is also recoverable.
An injured worker, who is restricted from working, is entitled to receive lost wage replacement referred to as temporary total disability (TTD). This compensation will be calculated from the worker’s average weekly wage (AWW) and should take into consideration all income including regular pay, overtime, and bonuses. In some cases, special consideration is given for a worker who is missing supplemental income from a second job.
At the end of an injured worker’s medical treatment the insurance company must acquire a report from the doctor assessing the amount of the worker’s loss of function. This is called a permanent partial impairment (PPI) rating and is one of the tools used to determine a fair settlement amount. Insurance companies sometimes suggest that an injured worker should accept the PPI rating given by the worker’s compensation doctor, but often times that is not the best way to proceed. Various options exist to challenge an initial PPI rating.
Permanent Total Disability (PTD)
An injured worker who is unable to return to any reasonable employment can receive five hundred (500) weeks of TTD from the insurance company, and possibly additional lost wage payments through the Second Injury Fund. Such an individual may also be eligible for Social Security Disability benefits and in order to maximize the “total recovery”, it is important to understand how these two different benefits affect one another.
An injured worker who loses the use of a limb or digit is entitled to a lump sum recovery, and Indiana law includes a “doubling provision” in cases involving amputations.
A dependent of a worker who is killed on the job may receive up to five hundred (500) weeks of TTD checks. These benefits are payable on a week-by-week basis, unless a full-and-final lump sum settlement is negotiated. It is important to fully understand who qualifies as a “dependent” and what events could change someone’s status, thus potentially terminating this stream of payments.
Insurance companies usually terminate all payments when the worker’s compensation doctor places the worker at maximum medical improvement (MMI). However, in many cases, the worker will need future surgeries or ongoing pain management (i.e. medications, injections, etc.), and certain medical evidence can be utilized to acquire this extended treatment and to include the cost of this treatment into the worker’s settlement proposal.