Unlike permanent disability benefits, which are for long-term or lifelong injuries, temporary disability benefits cover you while you're in the recovery phase. In this post, we'll break down everything you need to know about temporary disability benefits: who qualifies, how payments are calculated, and what happens if your condition changes. Let’s dive in!
Who actually qualifies for temporary disability benefits? The key factor here is that you must be recovering from a work-related injury or illness that keeps you from doing your job. Essentially, if you're unable to work because of your injury, and it’s not yet considered a permanent condition, you may be eligible.
It’s important to understand that temporary benefits apply when you're in a phase of recovery where things are still uncertain—your condition might improve, get worse, or fluctuate. As long as you're unable to return to work and haven’t reached maximum medical improvement (the point where doctors believe your condition is as good as it’s going to get), you can receive these benefits.
One thing to note is the distinction between temporary total and temporary partial disability. If your injury completely prevents you from working, you could be eligible for temporary total disability benefits. But if you’re able to return to work with restrictions (such as a part-time or light-duty role), you may still receive temporary partial disability benefits, which help supplement your reduced earnings.
The answer depends on your earnings before the injury and the specific rules of your state's workers' compensation system. In general, you're entitled to receive up to two-thirds of your gross average weekly wage.
Now, this might sound simple, but there’s a bit more to it. Your average weekly wage is typically calculated by looking at your gross earnings over the 52 weeks leading up to your injury. This means they average out what you earned per week during the year before your accident to come up with a figure.
But here’s the catch: while you're entitled to two-thirds of that average, there’s often a maximum cap in place. This cap changes each year based on the state’s average wage, and it can limit how much you receive, especially if you were earning a high salary before your injury. For example, if you were making $3,000 a week, two-thirds of that would be $2,000, but if the state's cap is lower—say $1,145—you’ll only receive up to that maximum amount, no matter how much you were earning before.
This cap ensures that benefits remain standardized, but it can feel limiting for those with higher incomes. On the upside, these payments are tax-free, so what you see is what you get.
Generally, these benefits are paid out on a bi-weekly basis, even though the award is calculated weekly. So, instead of getting a check every week, you’ll get one every two weeks covering that time period.
Most of the time, payments come in the form of a physical check sent to your home. However, if you'd prefer not to wait for the mail—especially if it’s unreliable or slow in your area—you can opt for direct deposit. Direct deposit allows the insurance company to send your payments directly into your bank account.
Setting up direct deposit is usually simple. You or your lawyer can provide the necessary bank information (like your routing and account numbers) to the insurance company, and from there, your payments will arrive straight to your account every two weeks.
Choosing direct deposit often makes life easier—your money shows up quickly, reliably, and you won’t have to worry about missing a payment when you need it most.
One of the key things to understand about temporary disability benefits is that they aren’t set in stone. Your payments can change based on your condition as you recover. If your health improves, your benefits may decrease, and if your condition worsens, your benefits could increase. It all depends on what your doctor reports and how your recovery progresses.
For example, if your doctor says you're improving and can return to light-duty or part-time work, your benefits might be reduced since you're able to earn some income. On the other hand, if your condition gets worse—like if you need surgery or additional treatment—your benefits could increase, reflecting a higher level of disability.
Also, if you do return to work full-time and earn the same wage as before your injury, your temporary benefits will likely stop altogether. Even if you're still dealing with some pain or ongoing treatment, as long as you're earning your pre-injury wages, workers' compensation may no longer view you as "disabled" from a wage-earning standpoint.
The important thing to remember is that temporary disability benefits are designed to support you while you're unable to work or if your ability to earn is limited. As your situation changes, so do your benefits, which is why it's essential to keep your doctor updated on your progress and stay on top of any necessary paperwork.
If you’ve been assigned a temporary partial disability, one important obligation you need to be aware of is the work search requirement. This means that, in order to keep receiving your temporary benefits, you may need to actively search for work that fits within the physical limitations set by your doctor.
The work search requirement typically kicks in when your doctor or the workers' compensation judge determines that, while you can’t return to your full job duties, you’re still capable of doing some form of work—whether it’s part-time, light-duty, or a modified role. At this point, the workers' comp system expects you to make an effort to find suitable employment.
This doesn't mean you need to find a job right away, but you do have to show that you’re making a good faith effort. This could include things like attending job interviews, applying for positions that match your limitations, or participating in vocational training. If you don’t comply with this requirement, your benefits might be reduced or cut off.
In some cases, your employer may offer you a light-duty position. If that happens, you’re expected to give it a try, as long as it falls within your doctor's restrictions. However, if your employer can’t accommodate your restrictions, the obligation to look for work may still apply unless you remain employed.
It’s critical to stay on top of this requirement to ensure you don’t lose your benefits unexpectedly. A lawyer can guide you through this process and help ensure you meet all your obligations while recovering.
If you're feeling uncertain about your temporary disability benefits or just want to make sure you're getting everything you deserve, don’t hesitate to reach out. I’m here to answer your questions and guide you through the process, no pressure.
Whether you just need some advice or you're ready to take the next step in your case, feel free to give me, Rex Zachofsky, a call at 212-406-8989. My team and I are ready to help however we can.