Your Temporary Total Disability Benefits (TTD)
INTRODUCTION TO OKLAHOMA TEMPORARY TOTAL DISABILITY (TTD)
Temporary total disability benefits (“TTD”) are not a lump sum workers compensation settlement amount or award, but rather are a periodic cash payment made to an injured Oklahoma City or Tulsa area worker with these benefits being paid only during the injured workers’ ‘healing period’. Oklahoma workers comp Temporary Total Disability benefits are in the nature of ‘wage replacement’ payments or benefits, commenced either upon the injured workers’ date of accident, date of surgery or other significant medical procedure &/or treatment, or otherwise when the injured employee’s injury prevents him or her from doing the work he or she was performing at the time of the injury or alternative work offered to such employee by his or her employer, its insurance company or lawyers or attorneys. Oklahoma Work Comp Court Law provides that in all cases–the ultimate detemination of an injured workers’ temporary total disability or TTD–shall be with a Judge of either the Oklahoma City or Tulsa Workmens Compensation Court. However, there is a rebuttable presumption in favor of the treating physician’s opinion on the issue of temporary disability.
Oklahoma temporary total disability or TTD benefits are generally paid by the Tulsa or Oklahoma City Workmans Compensation Court every week at seventy percent (70%) of the disabled employee’s pre-injury average weekly wage (or ‘AWW’–the calculation of which is discussed in full detail elsewhere on this site) up to a statutory maximum (which presently is $716 per week) and shall be paid to the employee during the continuance of his or her disability subject to a maximum time limit (discussed elsewhere on this page). Although paid at less than the injured Oklahoma City or Tulsa area employee’s usual wage, these workmans comp TTD benefits are generally not subject to state or federal taxes and are designed to allow the employee to maintain his or her previous lifestyle and remain financially viable during the time he or she is under active medical treatment for his or her injury and otherwise unable to work.
SCOPE OF TEMPORARY TOTAL DISABILITY IN OKLAHOMA
Oklahoma City & Tulsa Workmens Comp law provides for a three (3) day waiting period before an injured employee or his or her attorney or lawyer can ask for the payment of temporary total disability (‘TTD’) and, as such, no temporary total disability or TTD benefits will be paid for the first three calendar days of disability following an injured worker’s accident or in the alternative, from any other date he or she becomes unable to return to work because of his or her on-the-job accident & injury.
Oklahoma Workers Compensation Temporary Total Disability benefits are in all instances payable without a judgment, order or award by either the Oklahoma City or Tulsa Workers Comp Court. As such and as plainly stated by Oklahoma law–the first payment of temporary total disability compensation shall become due on the tenth day after the employer &/or its insurance company has received timely and proper notice of of the accident from the injured worker &/or his or her attorney or lawyer, as the case may be. All temporary total disability compensation owed on that date, according to Oklahoma Work Comp Court rules, shall be paid immediately and as a lump-sum cash settlement–and thereafter payments shall be made weekly except if otherwise ordered by the Oklahoma or Tulsa Workmans Compensation Court. To be clear, and as expressly stated by the Oklahoma Workmans Comp Act–Upon the receipt of proper & timely notice by the injured employee &/or his or her attorneys or lawyers–that the employee has been injured, the employer & its insurance company has an obligation under the workmens comensation act to commence temporary total compensation in the event that the injured worker is disabled and unable to return to work for more than three (3) calendar days. It is absolutely not necessary for there to be any order, judgment or TTD settlement award of either the Oklahoma City or Tulsa Workmens Comp Court directing the employer &/or its insurance company to provide these temporary benefits.
PENALTIES FOR NON-PAYMENT OF TEMPORARY TOTAL DISABILITY
FIFTEEN PERCENT (15%) PENALTY: If the employer has notice of the worker’s injury and the injury is not disputed and weekly workmans compensation temporary total disability benefit payments are not commenced within twenty (2o) days or if any subsequent installment of temporary total disability benefits is not made within ten (10) days after it becomes due, the insurance company of the employer shall pay to the employee a penalty of fifteen percent (15%) of the unpaid or delayed weekly benefits or settlement. This penalty may be imposed by either the Oklahoma City or Tulsa Workmans Comp Court for good cause shown on a case by case basis & upon proper application of the injured worker &/or his or her attorneys or lawyers.
LIMIT ON DURATION OF TEMPORARY TOTAL DISABILITY PAYMENT
Total payments of workers comp for TTD benefits may not exceed a maximum of one hundred fifty-six (156) weeks (or three years) in the aggregate except for good cause shown, as determined by either the Oklahoma City or Tulsa Workmens Compensation Court, upon timely application and proper proof to the Work Comp Court of such an extension by the injured worker &/or his or her attorney or lawyer. Even considering this–total Payments of compensation for Oklahoma temporary total disability benefits or settlements, inclusive of consequential injuries, may not exceed a maximum of three hundred (300) weeks in the aggregate.
LIMIT ON TEMPORARY TOTAL DISABILITY FOR ‘SOFT-TISSUE’ INJURY
Oklahoma Workers Compensation Court rules severely limit the weekly temporary total disability benefits an injured Tulsa or Oklahoma City area worker can receive for so-called “soft tissue injury” cases. Generally, in any case of a nonsurgical soft tissue injury, in which the employer &/or its insurance company has promptly provided medical care, temporary total disability benefits and compensation shall not exceed eight (8) weeks–period. However, there are two limited exceptions to the 8-week limitation on TTD benefits for those hurt workers whose injuries have been medically classified as “soft tissue” injuries–and they are as follows:
WHERE THE INJURED WORKER RECEIVES INJECTIONS: Any injured employee in Oklahoma who has been recommended by his or her ’treating physician’ for one or more injections may petition either the Oklahoma City or Tulsa Workmans Comp Court either individually or through his or her attorneys or lawyers for a one-time extension of temporary total disability benefits or compensation and the Oklahoma Workmens Comp Court may order such an extension, not to exceed eight (8) additional weeks.
WHERE THE INJURED WORKER RECEIVES SURGERY: Any injured employee or worker who has been recommended by a ‘treating physician’ for some form of surgery for his or her so-called ‘soft tissue’ injury may likewise ask or petition, either individually or through his or her attorneys or lawyers, the Oklahoma City or Tulsa Workers Compensation Court for a one-time extension of temporary total disability or TTD compensation benefits and the Workers Comp Court may grant or order such an extension, not to exceed sixteen (16) additional weeks, and only if the treating physician indicates that such an extension is appropriate or if such an extension is fully agreed to by all parties, to include the employer, its insurance company and any attorney or lawyer for either the employer, insurance company &/or injured worker–as the case may be.
However, in the event the recommended surgery is not performed within one hundred twenty (120) days of either (1) the approval of the surgery by the employer &/or the employer’s insurance company, or (2) an order of the Oklahoma City or Tulsa Work Comp Court authorizing such surgery, any benefits awarded for the extension period shall be terminated by the Oklahoma City or Tulsa Workmans Compensation Court, unless the Workmans Comp Court finds upon proof provided by the injured employee &/or his or her attorneys or lawyers, that any such delay was wholly beyond and outside the control of the injured worker. NOTE: In the event surgery is in fact performed on the injured worker, the period of temporary total disability is subject to the limitations discussed above on this page under the section titled: LIMITS ON DURATION OF TEMPORARY TOTAL DISABILITY PAYMENTS.
The Oklahoma City and Tulsa Workmens Compensation Courts have defined a “SOFT TISSUE” injury as damage an injured employee sustains to one or more of the tissues that surround his or her bones and joints and by statute this specifically includes, but is not be limited to sprains, strains, contusions, tendonitis, and muscle tears. According to the Oklahoma Courts, cumulative trauma is to be considered a soft tissue injury.
In contrast, the Oklahoma City and Tulsa Workmens Comp Courts have determined that the term “Soft tissue injury” does not include any of the following injuries:
- Injury to the spine, spinal disks, spinal nerves or spinal cord, to include herniated, ruptured and bulging discs, where corrective surgery* is performed;
- Brain or closed-head injury (CHI) or traumatic brain injury (TBI)–as evidenced by sensory or motor disturbances, communication disturbances, complex integrated disturbances of cerebral function, &/or episodic neurological disorders, which may include post-concussion syndrome;
- Any joint replacement, including hip and knee replacements;
- Any other comparable injury wherein the injured worker &/or his or her attorneys or lawyers can properly demonstrate that there is objective medical evidence of a permanent anatomical abnormality. In determining the existence of such an abnormality, the Oklahoma City and Tulsa Workers Compensation Court may consider if there is credible medical evidence that the ability of the injured employee to earn wages at the same level as before the injury has been permanently impaired.
*NOTE: The particular Oklahoma Workers’ Compensation Court statute dealing with the definition of “surgery” provides, in pertinent part, that “surgery…does not include an injection, or the forcing of fluids beneath the skin for treatment or diagnosis”.
TERMINATION OF YOUR TEMPORARY TOTAL DISABILITY BENEFITS
Under Oklahoma Law an injured employee’s temporary total disability or TTD check & benefits can be terminated immediately without notice by his or her employer &/or its insurance company, at will for a good reason, bad reason or no reason at all–if the injured worker &/or his or her attorney or lawyer has not filed certain paperwork with either the Oklahoma City or Tulsa Workers Comp Court properly and officially commencing the claim. If, on the other hand, proper paperwork is lodged with the Oklahoma Work Comp Court, the employer &/or its insurance company can terminate an injured worker’s temporary total compensation check without an order from either the Oklahoma City or Tulsa Workmans Compensation Court only if one of the following events occur:
- The injured worker returns to full-time employment with either his previous or another employer;
- The hurt Oklahoma City or Tulsa area employee &/or his or her attorneys or lawyers fail to object to the termination of temporary total disability or TTD benefits as provided for in two separate sections of the Oklahoma Workmans Comp Law within either fifteen (15) or twenty (20) days after receipt, as the case may be, by the injured worker’s attorney or lawyer of record or by the claimant if urepresented, of written notice of the termination from the employer &/or its insurance company;
- The injured worker is determined by a Workmens Compensation Court-appointed independent medical examiner (“CIME”) to be capable of returning to work and the hurt employee chooses not to do so. Specifically, the injured workers’ temporary total disability or TTD check will stop when the hurt worker has reaching maximum medical improvement (“MMI”) on all body parts in dispute, is released from active medical care and can return to full or permanently restricted full duty, all as indicated by the court-appointed independent medical examiner. In any case where the injured employee &/or his or her attorneys or lawyers contest the cessation of such benefits, the Oklahoma City or Tulsa Workmens Comp Court shall hear the dispute within thirty (30) days after the filing of the employee’s or his or her attorney’s or lawyer’s objection. Any trial on the objection will not be delayed unless both parties &/or their attorneys or lawyers agree*;
- The injured worker is released from treatment by the treating physician for all body parts injured and the employer or its insurance company notify the injured employee of the termination. The injured worker individually or through his or her attorney or lawyer is entitled to one objection under this provision of the Oklahoma Workers Compensation Act. If an objection to the termination is timely filed by the hurt employee &/or his or her attorneys or lawyers upon receipt of the notice of termination, then the Oklahoma City or Tulsa Workers Comp Court, as the case may be–shall appoint an independent medical examiner (“CIME”) to determine if further medical treatment is reasonable & necessary. Any dissatisfied party shall have the right to object to the opinion of the court-appointed independent medical examiner, take his or her deposition, and have the matter submitted to the Oklahoma City or Tulsa Work Comp Court for a final determination*;
- The treating physician releases the injured worker for light-duty work and provides written restrictions from normal work duties, and the employer &/or attorney or lawyer makes a good-faith offer in writing to provide a light-duty position at the same rate of pay that the hurt worker was receiving at the time of the injury, and the injured employee refuses to accept the light-duty assignment. In other words–if the injured worker declines a light-duty position offered to him or her by his or her employer, he or she is not entitled to any further temporary total disability checks, provided, before compensation may be denied or terminated, as the case may be, the injured employee shall be served with a notice setting forth the consequences of the refusal of light-duty employment and that his or her workmans compensation temporary total disability check will be discontinued fifteen (15) days after the date of such notice. The hurt worker &/or his or her attorney or lawyer, upon receipt of such notice, can request a hearing or trial before either the Oklahoma City or Tulsa Workmans Comp Court.* At such hearing or trial the Oklahoma City or Tulsa Workmens Compensation Court, as the case may be, may enter an order, award or judgment allowing the discontinuation of such benefits, denying the discontinuation of such benefits, or even temporarily denying the discontinuation of such benefits pending further hearing or trial. Any order or finding denying or temporarily denying the discontinuation of temporary benefits shall be based on a finding by the Workmens Comp Court that probable cause exists to believe that the work does not meet the conditions of the treating doctor’s restrictions or that the restrictions are unreasonable.
- The injured worker &/or his or her attorneys or lawyers, as the case may be, file with the Oklahoma City or Tulsa Workers Compensation Court a permanent partial or permenant total disability rating report–or otherwise requests a trial or hearing on either or both the issues of permanent partial or permanent total disability settlement benefits;
- The hurt employee or his or her attorney or lawyer voluntarily agrees in writing with the employer, its insurance company and its lawyers or attorneys to termination of the injured worker’s temporary total disability check & compensation; or
- The injured employee or worker dies.
*NOTE: If the injured worker objects to the termination of temporary total disability benefits–he or she, or her attorney or lawyer, may request an expedited hearing or trial on the issue of reinstatement of his or her temporary total disability or TTD check.
In all other instances, a hurt employee’s temporary total disability check can only be terminated by an order, award or judgment from either an Oklahoma City or Tulsa Workers Comp Court judge.
PENALTIES FOR WRONGFUL TERMINATION OF TEMPORARY BENEFITS
If an employer &/or its insurance company is found to have improperly terminated an injured employee’s temporary total work comp check, the Oklahoma City or Tulsa Workmans Compensation Court, as the case may be, will order the injured worker’s temporary total disability check and compensation reinstated retroactive to the date of the wrongful and otherwise unlawful termination–and assess as well a fifteen percent (15%) penalty against the offending employer &/or its insurance company on all unpaid benefits as of the date of the Oklahoma Workmans Comp trial on the termination issue. The Oklahoma City or Tulsa Workmens Compensation Court Judge shall also require the guilty employer, its insurance company, attorneys &/or lawyers, as the case may be–to start the whole termination process over anew again and show full compliance with the above described rules regarding the proper termination of temporary benefits before any new trial on the employer’s or its insurance company’s request to terminate temporary compensation will even be conducted.
OKLAHOMA TEMPORARY PARTIAL DISABILITY BENEFITS
If an injured Oklahoma City or Tulsa area worker, while still under active medical treatment for his or her on-the-job injury, returns back to work with either his previous or a new employer either: (1) working less hours at his or her pre-injury hourly or other rate; (2) working full-time or generally the same hours he or she worked pre-injury at a reduced wage; or (3) otherwise is making less money per week than he or she was generally earning at the time of the workers’ compensation injury–the injured Oklahoma worker, upon proper application of his or her attorney or lawyer, is entitled to appropriate TEMPORARY PARTIAL DISABILITY BENEFITS (‘TPD’) from the Oklahoma Workmens Comp Court.
In any case where Temporary Partial Disability benefits are owed and payable by either the Oklahoma City or Tulsa Workers Compensation Court–an injured employee will receive seventy percent (70%) of the difference between the injured worker’s average weekly wage (or “AWW”-computed and discussed elsewhere on this site) at the time of his or her injury and the employee’s wage-earning capacity thereafter in the same employment or otherwise, if less than before the injury, during continuance of such partial disability, but not to exceed fifty-two (52) weeks. Provided, after compensation has been paid for a period of forty-two (42) weeks the employee &/or his or her attorneys or lawyers can request a review of the case by a judge of either the Oklahoma City or Tulsa Workers Comp Court for continued temporary partial disability benefits all as provided by & under the Oklahoma Work Comp Act. Upon an appropriate finding that the injured worker’s temporary partial disability benefits should be extended beyond the intitial fifty-two (52) week period, the injured employee’s weekly compensation check may be continued by either the Oklahoma City or Tulsa Workmans Compensation Court for additional successive fifty-two-week periods. However–temporary partial disability may not exceed a maximum of three hundred (300) weeks in the aggregate. However–total payments of compensation for temporary partial disability, inclusive of consequential injuries, may not exceed a maximum of three (300) weeks in the aggregate.
MANDATORY REPORTING BY WORKER RECEIVING TEMPORARY CHECK
Any injured Tulsa or Oklahoma City area worker receiving either temporary total or temporary partial disability benefits from an employer or the employer’s insurance company must promptly report in writing to the employer &/or its insurance company, either individually or through his or her attorney or lawyer–any change in a material fact or the amount of income he or she is receiving or any change in his or her employment status, occurring during the period of receipt of such weekly benefit check or settlement.
CHILD SUPPORT OBLIGATIONS VS TEMPORARY TOTAL DISABILITY
A lien against Oklahoma Workmans Comp benefits is authorized for the purpose of enforcing a judgment for child support. Child support liens are specifically authorized and shall be paid without any order of the Oklahoma City or Tulsa Workmens Compensation Court. Additionally, all income assignments or wage assignments for child support are specifically authorized and shall be paid by the injured worker &/or his or her attorneys or lawyers on the worker’s behalf, out of any temporary or permanent weekly check or cash settlement–all without any order of either the Tulsa or Oklahoma City Workmens Comp Court.
UNEMPLOYMENT COMPENSATION VS TEMPORARY TOTAL DISABILITY
Oklahoma Workers Compensation Court rules are clear: No Tulsa or Oklahoma City area injured employee may receive temporary total disability or TTD benefits covering the same period of time as unemployment compensation benefits received by the employee as provided by the Oklahoma Employment Security Commission.
SOCIAL SECURITY DISABILITY VS TEMPORARY TOTAL DISABILITY
SOCIAL SECURITY SUPPLEMENTAL SECURITY INCOME (“SSI”) & TEMPORARY TOTAL DISABILITY (“TTD”) BENEFITS: Since Social Security Supplemental Security Income benefits (‘SSI’) are needs based, i.e. subject to monetary income and resource limits which reduce or even eliminate any payment of SSI benefits if the disabled person has above a certain level of household income or property–unless an injured Oklahoma City or Tulsa injured worker’s temporary total disability check is extremely low-he is she will probably not qualify for supplemental security income payments for any month in which he is she also receives temporary total disability benefits (even if the injured employee otherwise meets the Social Security Administration’s (‘SSA’) requirements for establishing that he or she is medically disabled).
SOCIAL SECURITY DISABILITY INSURANCE BENEFITS (“DIB”) & TEMPORARY TOTAL DISABILITY (“TTD”) BENEFITS: If an injured Oklahoma City or Tulsa area worker is receiving both monthly Social Security Disability Insurance benefits (‘DIB’) and weekly Oklahoma Workers Comp Temporary Total Disability benefits for the same period of time, his or her monthly social security benefit will be subject by law to an offset and will be significantly reduced by the workers receipt of his weekly work comp temporary total disability check. However, the offset is never complete or 100%–meaning the injured worker’s monthly income will always be higher when he or she is drawing both a weekly workmans compensation check and a monthly social security disability payment–even when he or she is subject to the offset or reduction against the social security payment.
SOCIAL SECURITY DISABILITY INSURANCE BENEFITS AND LAWFUL TERMINATION OF THE INJURED WORKER’S TEMPORARY TOTAL DISABILITY CHECK: A Tulsa or Oklahoma City area workmans comp claimant who is drawing both a social security disability insurance benefit check and a temporary total disability check will certainly be greatly benefited when, as always happens, his or her temporary total disability check is lawfully terminated at the end of his case, usually because he or she is released from active medical care and treatment from his or her treating physician. When this termination of TTD happens not only will the injured workers’ monthly social security disability income check continue on unabated, it will also increase to its pre-offset maximum benefit amount, no longer affected by the worker’s receipt of Oklahoma Workmens Compensation–but only upon proper & timely presentation by the injured worker &/or his or her attorney or lawyer to the social security administration with adequate proof that indeed the worker’s weekly workmens comp check has indeed terminated and the date of termination. This certainly will benefit greatly the injured worker otherwise unable to return to work after lawful termination of his or her temporary total disability check in that he or she will have at least some income to sustain themselves while waiting for a permanent disability award or settlement of the case.
NOTE: Many injured Oklahoma workers are incorrectly told by their workers compensation attorneys or lawyers that they cannot apply for and receive social security disability and a workers comp check at the same time–this is false: an injured Oklahoma worker entitled to social security disability can receive both a weekly temporary total disability check and a monthly social security disability check at the same time and in doing so will receive much greater monthly income than receiving only a temporary total disability check or social security check alone.
DISPUTES BETWEEN INSURANCE COMPANIES RE: PAYMENT OF TTD
In the event that two or more insurance companies or employers disagree as to which entity is liable for the payment of temporary total or partial disability benefits, the Oklahoma City or Tulsa Work Comp Court, as the case may be, upon request of the injured worker &/or his or her attorney or lawyer, shall determine which insurance company or employer is liable and order reimbursements as determined appropriate. The Tulsa or Oklahoma City Workmans Compensation Court shall have full authority to require an employer and an insurance company to remimburse other employers and insurance companies for benefits paid pursuant to the Oklahoma Workmans Comp Act in appropriate cases.
OVERPAYMENT OF TEMPORARY TOTAL DISABILITY BENEFITS
It is not uncommon for an employer &/or its insurance company to continue issuing temporary total disability benefits or payments past the time they should have been terminated by operation of law. In the event temporary total or partial disability benefits are overpaid by any insurance company or employer, the Tulsa &/or Oklahoma City Workmens Compensation Court will award the employer &/or its insurance company a credit or offset against any subsequent order for permanent partial or permanent total disability award or settlement in favor of the insurance company & the employer.
NOTE: There is absolutely nothing illegal or wrong about an injured Tulsa or Oklahoma City area worker receiving, cashing and otherwise spending a temporary total disability check received after his or her treating doctor has released him or her from active medical treatment or back to full-duty employment, unless the injured worker is receiving both temporary disability benefits and working and earning income for the very same period covered by any such indemnity payment. In other words–it is clearly illegal to draw a temporary total disability check and work and receive a paycheck at the same time and for the same period of time.
NOTE: In the event salary or other renumeration is paid in lieu of temporary total compensation during the period of temporary total disability or for any other period of time, no respondent or insurance carrier shall be allowed to deduct from the amount of the award for permenant or partial permanent disability any amounts paid for temporary total disability, nor shall he be given credit for such additional payments on future temporary total disability, permanent partial disability, disfigurement, or any other compensation provided by the workers’ compensation law. Notwithstanding the provisions of this law, a qualified individual self-insured employer that pays temporary total disability benefits at a higher weekly rate that required by statute, without diminishing that employee’s accrued leave on such payments, shall be given credit for such overpayment against any permanent partial disability owed, after payment of attorney fees and taxes. This provision shall not apply where salary continuation was made by the self-insured employer pursuant to an applicable collective bargaining agreement.
Any claim submitted by an employee for compensation for permanent disability must be supported by competent medical testimony which shall be supported by objective medical findings. Medical opinions addressing compensability and permanent impairment must by stated within a reasonable degree of medical certainty. An independent medical examiner in a case involving permanent disability shall not be a treating physician of the employee and shall not have treated the employee with respect to the injury for which the claim is being made or the benefits are being paid. In the event the Independent Medical Examiner determines that more medical treatment is necessary or in the event the treating physician refuses to treat, the employer shall designate a treating physician to provide the indicated treatment. In no event may an independent medical examiner, whether directly, or indirectly by virtue of a pecuniary interest, economically benefit from the performance of treatment of an employee whose claim the independent medical examiner has reviewed for permanent impairment, return to work, or the necessity of further medical treatment, unless both employee and employer agree through written stipulation and said stipulation occurs prior to appointment, referral and notice to said independent medical examiner.
NOTE: benefits for an injury shall be determined by the law in effect at the time of injury.