Under the Indiana Worker's Compensation Act, injured workers are normally entitled to three (3) different types of benefits, including: (1) medical treatment at no cost to the injured worker; (2) wage replacement benefits, commonly known as Temporary Total Disability ("TTD") benefits; and (3) compensation for any permanency of the work-related injury that is calculated by looking at the Permanent Partial Impairment ("PPI") rating assigned by the treating doctor.
However, in some cases, when the injured worker's impairment is so severe that it might adverely affect his or her ability to engage in competitive employment, the injured worker may have a claim for Permanent Total Disability ("PTD") benefits.
PTD claims arise when the injured worker is unable to perform reasonable forms of work activity, such as a sit down job. In determining whether there is a viable PTD claim, the following considerations are taken into account: the injured worker's age, mental well-being, physical impairment, work experience and acquired skills, education level, and funcational capcity after reaching maximum medical improvement.
Under the Indiana Worker's Compensation Act, a claim for PTD benefits, if successful, provides the injured worker with a maximum 500 weeks of compensation from the employer and makes the injured worker eligible for compensation from the Second Injury Fund.
If an injured worker pursues a claim for PTD benefits, it is important to keep in mind that he or she is only going to recover the PTD benefits and that any previously paid TTD benefits or compensation advanced based upon a PPI rating will have to be credited to the employer and essentially reducing the amount of the PTD claim. However, the injured worker would still be entitled to any claim he or she may have for ongoing or future medical treatment which would be calculated through a Medicare Set-Aside or by way of a medical treatment cost projection analysis.
When it comes to PTD claims, both sides should give a lot of consideration to resolving the matter, rather than to litigate whether the injured worker is entitled to PTD claims. The reason why settlement should be considered is because to litigate a PTD claim, both sides will have to spend a lot of money in obtaining vocational experts and medical opinions.
There is no doubt that there is a lot at stake when dealing with a PTD claim. From the injured worker's standpoint, there is more at stake than for the employer. Unless the injured worker is in advanced age, winning a PTD claim makes it likely that the employee will receive the maximum 500 weeks of compensation from the employer and become eligible for compensation from the Second Injury Fund. The younger the injured worker, the more years of compensation he or she will receive from the Second Injury Fund.
Even if the evidence, including medical and vocational are conflicting, are not conflicting, it can be difficult to settle a PTD claim with a younger injured worker. The employer will not be willing to pay close to the 100% of the 500 weeks of compensation and the injured worker will be hesitant to waive all the potential Second Injury Fund benefits. In situations like this, the injured worker might want to explore other financial resources available to him or her and try to reduce the risks of litigating the PTD claim.
For example, the injured worker might be able to obtain Social Security disability benefits. By settling the PTD claim, the injured worker avoids the risks associated with litigating the PTD claim and by settlement, the PTD claim can be paid in a lump sum, but treated as if it were paid over the remaining lifespan, reducing or eliminating any Social Security offset. As a result, sometimes the injured worker actually obtains more benefit by accepting a settlement rather than litigating the PTD claim. As always, if you have questions about your worker's compensation claim, contact a worker's compensation attorney.