Temporary Total Disability in the California Workers' Compensation System- 2017 Update
While the length of time an injured worker may receive temporary total disability (TTD) benefits was slashed to a 104-week maximum by the California legislature in 2004 as part of a major reform act, the weekly maximum rates for TTD continue to climb higher.
An Injured Employee Certified as Medically TTD by a Physican May Collect Up to 104 Weeks of PaymentsSince 2004, when the legislature significantly revamped the California workers' compensation system with the goal of reducing its costs to employers and insurance carriers, medical temporary total disability (TTD) benefits have been limited to 104 weeks, with some exceptions in rare circumstances. The two-year cap on medical TTD benefits, and the reduction of workers' compensation benefits, mirrors a nationwide trend.
The restrictions for obtaining the full 104-week maximum of TTD benefits have been somewhat liberalized since 2004. For injuries on or after January 1, 2008, the injured worked can collect up to 104 weeks of TTD benefits at any time within five years form the date of the work injury.
For injuries before April 2014, there was no limit on the amount of weeks an injured worker could qualify for medical TTD benefits. Those days are now long gone, and there is little movement within the legislature to extend the 104-week limit.
In all cases of medical TTD status, an injured worker needs a report from a physician finding medical TTD status.
If the claim is denied, an injured employee should ask his or her physician for certification for benefits from the State of California Employment Development Department (EDD) who will pay a similar amount and also place a lien on the case subject to reimbursement by the insurance carrier if the claim is later accepted and a finding issues that the worker was entitled to TTD benefits during the period in which EDD paid benefits.
The TTD rate is calculated at 2/3 of the worker's Average Weekly Wages (AWW) for 52-weeks prior to the date of injury. There are many alternative methods utilized to calculate the TTD rate and an injured worker should consult an attorney if he or she feels she is not being paid at the proper rate. Oftentimes, an employer neglects to include overtime pay in reporting wages to its insurance carrier. Evidence in the form of payroll records, W-2 forms, and tax returns are persuasive and evidence from prior years can be used to establish earnings capacity and the frequent provision of overtime by an employer.
In Limited Circumstances TTD Benefits can Extend Beyond the 104-MaximumIn the case of certain serious injuries, an injured employee can receive up to 240 weeks of medical TTD payments within five years from the date of the injury. The exceptions to the 104-week limit include workers who contract:
Hepatitis B or C,
high velocity eye injuries,
chemical burns to the eyes,
pulmonary fibrosis, or
chronic lung disease.
As such, if a hospital worker contracts HIV-AIDS from a patient, the injured employee can collect up to 240 weeks of medical TTD benefits within five years from the injury date. If a police officer is shot in the eye, the officer can collect up to 240 weeks of medical TTD benefits (with a credit of full year of salary continuation under Labor Code 4850) subject to a physician finding TTD status.
in 2017 the Maximum TTD Rate equals $1,172.57 and the Maximum Rate Goes Up in 2018For injuries that occur in 2017, the maximum weekly TTD rate equals $1,172.57 and the minimum rate is $175.88.
For injuries on or after January 1, 2018, the maximum rate increases to $1,215.27, and the minimum rate increases to $182.29.
Again, the weekly TTD rate is calculated at 2/3 of the employee's average weekly wages.