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If you have suffered from a severe injury, illness, or another impairment that renders you permanently unable to work, then you might qualify for permanent total disability (PTD) benefits.
With these benefits, you can get the financial compensation needed to help you through this difficult time. Let’s examine the important aspects of these permanent total disability benefits, including eligibility for and the process to secure them.
What Are PTD Benefits?
According to the National Safety Council, there were 4.53 million work-related injuries in 2022, some of which resulted in long-term impairments. In these cases, permanent total disability benefits can help cover the costs of medical care and lost income.
You may qualify for PTD benefits if you have been injured on the job or suffer from a work-related illness that prevents you from returning to the workforce. The most common way to receive these benefits is through workers’ compensation.
While these programs will vary by state, they are used to help provide financial assistance for those workers who have sustained work-related illnesses or injuries. These injuries or illnesses must have resulted in a long-term or permanent impairment that affects an individual’s ability to work.
Workers’ compensation coverage provides financial assistance for those medical expenses related to the injury or illness. These can include:
- Medical care
- Rehabilitation & therapy costs
- Compensation for lost wages
The reimbursement amount will depend on your specific state and the coverage allowed under its workers’ compensation program.
Qualification for these events will also depend on an assessment from a medical professional. During this time, the degree of impairment must be measured, and an impairment rating must be assigned. If that rating shows that a worker has suffered a total permanent disability, then they can apply for PTD benefits.
However, workers’ compensation is not the only program providing financial benefits to job-injured workers. Social Security Disability Insurance (SSDI) offers financial support to individuals with disabilities, including those who are permanently unable to work.
Unlike workers’ compensation, these benefits are based on a person’s work history and contributions to the Social Security program throughout their lifetime. With workers’ comp, those benefits are available to employees from the first day of employment.
SSDI is also available to those who cannot work, whether the injury was related to their job or not. If you receive workers’ compensation and SSDI, the combined benefits cannot exceed 80% of your pre-disability earnings.
Illnesses or Injuries That Qualify for Permanent Total Disability Benefits
While every case is different, and each state sets its own criteria, some conditions can lead to qualification for PTD benefits. For example, some of these illnesses and injuries may include:
- Paralysis resulting from spinal cord injuries, such as quadriplegia (paralysis of all four limbs) or paraplegia (paralysis of the lower limbs)
- Catastrophic injuries, including traumatic brain injuries, severe burns, or loss of multiple limbs
- Work-related chronic illnesses, such as advanced-stage cancer, end-stage renal disease, or degenerative neurological disorders
If you would like to know if your condition qualifies for these benefits, you will want to contact your state’s workers’ compensation board.
What To Know About the Duration of PTD Benefits
If you are eligible for permanent total disability benefits, they will continue for the duration of your disability. While temporary total disability benefits may have a predetermined ending date, that is not the case with PTD. You can receive continuous financial assistance without termination.
How will you be paid? Once again, the payment structure and schedule will depend on your state’s program. However, the majority of these benefits are calculated as a percentage of your pre-injury or disability weekly working wage. Generally, this percentage is around two-thirds of your income, which is about 66.67%
Some programs may also take into consideration the number of dependents of the worker, such as a spouse or children. These payments can help alleviate some of the financial responsibility faced by the injured workers’ families.
A few jurisdictions may also use a cost-of-living adjustment to increase benefits annually. However, these increases will depend on the specific state’s workers’ compensation guidelines.
How To File for These Disability Benefits
Like any workers’ compensation claim, you must notify your employer immediately after the incident occurs. Timely reporting is essential as it may affect your eligibility for benefits.
After reporting the incident, you can get your workers’ compensation claim forms from your employer. All of these forms must contain accurate and detailed information about the incident and your injuries or illnesses. You will also need to provide information about the treatments and medical care you’re receiving to assist with your injuries or illness.
Documentation is key during this process. You will want to keep copies of all documents related to your claim, including medical records, correspondence, and receipts. These records will be important for supporting your claim.
Medical attention is also essential to receive PTD benefits. Your health care provider will conduct a thorough evaluation of your condition. The doctor will assess the severity of your injuries and recommend appropriate treatment. They will also determine when your condition stabilizes and is unlikely to improve significantly, a point known as maximum medical improvement (MMI). You will be assigned an impairment rating based on the extent of your disability.
At this stage, you can submit your workers’ compensation claim to the appropriate agency. You will want to make sure that you follow all the state-specific guidelines for submission and adhere to all deadlines. Missing the filing deadline could jeopardize your claims and benefits.
Once completed, a claims administrator will review your application, medical records, and supporting evidence. If your claim meets the criteria, you will be approved for benefits. However, if your claim is denied, you can appeal. This process may involve administrative hearings, presenting additional evidence, and seeking legal representation to advocate for you in your case.
Permanent total disability benefits can provide a lifeline when you have suffered an illness or injury due to work-related activities. Knowing the criteria and whether you qualify can help you get the benefits you deserve during this difficult time.
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This website was created and is maintained by the legal team at Thomas Law Offices. Our attorneys are experienced in a wide variety of personal injury and work injury cases and represent clients on a nationwide level. Call us or fill out the form to the right to tell us about your potential case. We will get back to you as quickly as possible.
