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How Long Does Workers Comp Take to Pay Benefits?

Posted by James Aspell | Mar 23, 2024 | 0 Comments

Discover When Workers' Compensation Will Disburse Income Benefits or Cover Medical Expenses in Connecticut

Injuries sustained at work or the diagnosis of an occupational ailment often bring forth unwelcome uncertainties.

Among the most distressing uncertainties is the timing of workers' compensation disbursements or the approval for essential medical treatment needed for recovery and a return to work.

Certain categories of workers' comp benefits should be promptly disbursed post-accident, even before filing a claim with the Commission or completing formal injury documentation.

However, other benefits may face delays—lasting days, weeks, or even months—due to procedural regulations or delays from employers, insurers, or their claim administrators like Sedgwick or Gallagher Bassett.

Continue reading for insights into the timing of workers' comp payments and medical coverage.

It's crucial to note that suffering a workplace injury entails both physical agony and emotional strain.

However, enlisting the services of a proficient and highly-rated workers' compensation attorney can expedite benefit disbursements and alleviate stress during the waiting period for payment or medical approval.

Contact us today to discover why fellow attorneys entrust us to negotiate substantial workers' comp settlements and how we can expedite payment and resolution of your claim.

How Soon Does Workers' Comp Cover Medical Bills?

What's the Timeline for Receiving Workers' Compensation Checks?

In 2017, the average disability duration per claim was approximately four days. This suggests that the majority of workers' compensation claims do not involve extended work absences exceeding the waiting period for cash benefits like temporary total disability and temporary partial disability benefits; they are typically "medical-only" claims.

Under the Workers' Compensation Act, employers or their insurance carriers are obligated to cover all medical expenses related to workplace accidents, regardless of whether the employee misses work or returns to work permanently disabled.

Seeking medical attention immediately after a workplace accident is imperative. You can seek treatment for an industrial accident or occupational disease even before filing a workers' compensation claim. No open workers' comp claim is required prior to receiving medical care.

However, it's essential to report the work injury to your employer and allow them reasonable time to offer a panel of physicians to assume responsibility for healthcare costs. Medical providers should be informed of the work-related nature of the injury or illness, and bills should be directed to the employer or their workers' compensation insurance carrier.

If you've filed for workers' comp benefits and encounter unpaid medical bills for a work-related injury, seeking legal assistance promptly is advisable. Measures can be taken to halt debt collection and safeguard your credit while awaiting processing and payment by the employer or their insurance company.

Many employers and workers' comp insurance carriers may cover initial medical expenses related to a work injury, even if they ultimately dispute or deny the claim. There are typically no penalties for doing so, as voluntary payment of medical bills does not signify acceptance of a workers' comp claim.

When Do Wage Loss Benefits Commence?

Understanding the three -Day Waiting Period for Workmans' Comp Cash Benefits in Connecticut

Temporary wage loss benefits under workers' compensation, including temporary total disability (complete wage loss) and temporary partial disability (partial wage loss), are subject to a waiting period, even if the claim is promptly accepted by the insurance carrier.

In Connecticut, the workers' compensation waiting period is three days. During the initial three calendar days of disability resulting from a workplace accident, no wage loss benefits are provided.

However, the Workers' Compensation Act allows for retroactive benefits for this waiting period if the injury is severe, resulting in an extended period of work absence. In Connecticut, this retroactive period extends to 21 days. If the work-related injury leads to more than 21 days of missed work, compensation for the first seven days of incapacity will be provided.

The waiting period for workers' comp may result in unrecoverable wage loss if the disability lasts for fewer days than the waiting period, or if it exceeds seven days but falls short of 21 days. These periods without compensation exacerbate the financial strain on the injured worker. Utilizing sick leave, paid time off, or disability coverage during this period is advisable.

Temporary disability benefits cease when: the employee returns to work with earnings equal to or surpassing their pre-injury average weekly wage, medical evidence indicates the employee is no longer entitled to disability benefits.

The timeframes mentioned are contingent upon the employer or insurance carrier approving the claim, or the Commission granting benefits.

When Do Permanent Total Disability Benefits Commence?

Permanent total disability benefits are disbursed to employees permanently disabled due to a workplace injury.

In Connecticut, permanent total disability (PTD) benefits are payable for life or until the employee can resume work. Qualifying for PTD benefits necessitates demonstrating an inability to work in any capacity, not solely in the pre-injury occupation.

PTD benefits commence only after attaining maximum medical improvement on all injured body parts and establishing eligibility for PTD benefits.

When Do Permanent Partial Disability Benefits Commence?

Permanent partial disability (PPD) benefits are provided to employees with permanent impairments resulting from a work-related injury.

In Connecticut, PPD benefits are not wage loss benefits and can be received irrespective of work absence.

Reaching maximum medical improvement (MMI) for the workplace accident is a prerequisite for PPD benefits. While some may achieve MMI within weeks or months, others may require years.

However, PPD benefits cannot be received concurrently with temporary disability benefits. Thus, one must cease receiving temporary disability benefits before PPD benefits can commence, which may entail a considerable delay.

Where Are My Workmans' Comp Checks? Is Weekly Payment Guaranteed?

Under the Workers' Compensation Act, employers are obligated to provide wage loss benefits according to the same schedule as regular payroll disbursements.

Employees paid weekly should receive workers' comp checks weekly, while those paid biweekly should receive checks every other week.

Unfortunately, workers' compensation payments often experience delays. Nonetheless, regulations stipulate timelines for payments, especially once the Commission issues an Order for wage loss benefits.

Delays exceeding 14 days may subject the employer and its insurance carrier to a 20% penalty.

Why Is My Workers' Comp Claim Protracted? Tips for Expedited Benefits

Workers' comp processes are typically protracted, even under optimal circumstances. The timelines discussed for wage loss and medical benefits represent best-case scenarios; many face lengthier waits if claims are denied or under scrutiny.

If three weeks elapse without workers' compensation benefits post-accident, consider the following:

  • Insurance adjusters may request additional medical records, including pre-accident records, to discern pre-existing conditions. Consulting an attorney can expedite this process.
  • Ensure you possess an out-of-work slip from your treating physician, as insurance carriers often require it before commencing benefits.
  • Failure to actively seek light-duty work may delay benefits; hence, efforts to secure employment should be documented.
  • Promptly filing a claim with the Commission accelerates the decision-making process.
  • Employers may cast doubt on injury credibility, necessitating legal intervention to resolve disputes.
  • Overburdened claims adjusters may overlook cases, warranting escalation to supervisory levels or legal representation.
  • Lack of an Award Order may impede benefit disbursement, underscoring 

    the importance of legal representation to navigate the complexities of workers' compensation claims.

    Expedite Your Connecticut Workers' Comp Benefits

    Seeking guidance from a seasoned work injury attorney immediately following a workplace injury is crucial. While entitlement to workers' comp benefits is clear-cut, actual payment initiation by employers or insurance carriers may not align with expectations.

    The workers' compensation system is intricate, with insurers often seeking avenues to delay, dispute, or deny claims. An adept attorney can guide you through the necessary steps, from compiling compelling evidence and completing paperwork to negotiating with insurers and representing your case at trial.

    Persist in your pursuit of benefits. Insurers often count on claimants abandoning their claims due to perceived inconvenience, but your persistence ensures you receive the compensation owed to you. Remember, by giving up, insurers save money, leaving you to grapple with life-altering injuries unassisted.

    Call now for a complimentary consultation to evaluate whether engaging a workers' compensation attorney is the appropriate course of action for you: Contact us at 860-523-8783 for a free consultation. I aid injured workers in Connecticut in securing their rightful benefits, and I'm committed to assisting you.


About the Author

James Aspell

Principal since August 1, 2006 James F. Aspell is the principal and managing attorney of the firm which he started in 2006 following 20 years of litigation practice in a mid -size firm in Hartford, Connecticut. Jim focuses his practice in the areas of worker's compensation and personal injury l...


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