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What are "TTD" benefits,
and when do they apply?
An employee is entitled to Temporary Total Disability (TTD) benefits
when he or she is unable to work as determined by an authorized
physician. An employee is eligible for TTD benefits after being
unable to work for more than three (3) calendar days as a result
of an on-the-job injury or occupational disease.
The TTD benefit amount is calculated according to statute as 70%
of the employee’s average weekly wage, not to exceed the
maximum of $717 per week.
What are "PPD" benefits,
and when do they apply?
Permanent Partial Disability (PPD) benefits are allowed for an
injury resulting from an on-the-job accident or occupational
disease that is permanent but does not result in total disability.
This benefit is based on the type and extent of the disability. The
PPD benefit amount is determined and paid according to statute and based
on the Workers’ Compensation benefits schedule.
What are "PTD" benefits,
and when do they apply?
Permanent Total Disability (PTD) benefits are allowed for
disability from an on-the-job injury or occupational disease
resulting in permanent and total disability.
Before being judged permanently and totally disabled, an
employee must first be evaluated as to the practicability of
returning to gainful employment through
vocational rehabilitation
or training. During the period when an employee is actively
participating in a qualified retraining or job-placement program,
he may be entitled to receive payments at the same rate as his
TTD benefits.
When are death benefits paid?
Death benefits are paid to a surviving spouse and/or surviving
dependent heirs of an employee who dies as a result of an on-the-job
accident or occupational disease. Death benefits are set by state
statute and include lump sum payments and continuing weekly benefits.
Total weekly benefits cannot exceed what the deceased employee would
have received if he or she had been permanently and totally disabled.
In cases of death occurring on or after November 1, 2005, a maximum
of up to $10,000 may be paid for funeral expenses.
What benefits are paid for
disfigurement?
As determined by the Workers’ Compensation Court, a lump
sum benefit (not to exceed $50,000) may be paid for serious
and permanent disfigurement resulting from an on-the-job
injury or occupational disease.
What medical costs are covered?
Workers’ compensation coverage provides for all reasonable
and necessary medical care for job-related injuries or occupational
diseases. This includes fees for medical, surgical, hospital, nursing,
ambulance, and other related services. It also includes costs for
medication, crutches, braces, supports, prosthetic devices, and physical
rehabilitation.
If a compensable claim for workers’ compensation has been
filed, the injured employee is not responsible for medical
charges resulting from his/her injury.
What other expenses are covered?
If an authorized examination or medical treatment requires travel
outside the home town of the injured employee, that employee may
be reimbursed for amounts spent on meals, lodging, mileage and
transportation. Accurate records must be kept of these
expenses. These expense records must also be submitted when
filing a claim for travel reimbursement.
Travel expenses paid to the worker shall include only expenses
for travel from the residence at the time of medical treatment,
not to exceed 600 miles round trip.
The employer is not liable for travel which is wholly within
the limits of the city or town of the claimant’s residence.
What is an "occupational
disease"?
An occupational disease arises out of the employment only if
there is a direct causal connection between the occupational
disease and the conditions under which the work is performed.
What is "vocational
rehab"?
Vocational rehabilitation (job retraining) is available as an
option to the injured employee who is unable to return to the
same job as a result of an on-the-job injury or
occupational disease.
What happens if an
employee doesn't report a claim in a timely manner?
Provisions to the Workers’ Compensation Law (Title 85)
effective November 1, 1997, state that there is a presumption
against compensability if an employee or former employee fails
to give oral or written notice of an injury to the employer
or former employer within 30 days of the single event accident,
or obtain medical treatment within 30 days. A presumption
against compensability is also created if oral or written
notice is not given to the employer by the employee within
90 days of the employee’s separation from employment,
in the case of an occupational disease or injury caused by
cumulative trauma.
With regard to injuries sustained prior to November 1, 1997,
60 days notice is required in a single event trauma and 180
days notice in the case of occupational disease or cumulative
trauma.
What is a "medical
only" claim?
A med-only claim usually involves a minor injury, medical
treatment, and requires no time off work for recovery.
What is a "lost
time" claim?
A claim is considered lost time when the injured worker has
missed enough work to be eligible for
TTD or PPD benefits.
What is a "CWMP"?
A Certified Workplace Medical Plan (CWMP) is a provider-sponsored network
with experienced health care professionals carefully selected to
provide appropriate and effective medical treatment for the injured
workers of participating employers.
Managed care may reduce lost workdays and temporary total
disability and focuses on safe return to work programs.
Some health care professionals under this plan have agreed
to contract at reduced rates from the Oklahoma State Workers’
Compensation Fee Schedule, thus lowering overall medical costs
for employers.
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