In addition to medical benefits, an employee may be entitled to temporary total disability benefits and permanent partial or permanent total disability benefits. Upon the death of a worker who has suffered a compensable work injury, certain surviving individuals may be entitled to weekly benefits from the employer/insurer. The employer/insurer is also responsible for paying for funeral expenses for up to $5,000.
Payment for Lost Wages
If the doctor says that you are unable to return to work due to your injury(ies) or you are off work recovering from a surgery, you may be entitled to temporary total disability (TTD) benefits. If the doctor states that you can perform light or modified duty work and your employer offers you such work, you may not be eligible for TTD benefits. TTD benefits should be continued until the doctor says that you can return to work or when your treatment is concluded because your condition has reached “maximum medical improvement,” whichever occurs first.
If you return to light or modified duty at less than full pay, the workers’ compensation law requires that temporary partial disability benefits be paid to you.
Permanent partial disability means that your work injury affects your ability to do certain jobs or work tasks but you are still able to work in some capacity (not necessarily the job you had at the time of your injury). Permanent total disability means that you are no longer able to work at any job. If your last work-related injury alone causes your permanent total disability, you may be entitled to weekly payments for life from your employer and its insurer, or you may want to negotiate a lump-sum settlement instead of the weekly lifetime payment. If your last work-related injury combined with prior disabilities causes your permanent total disability, your employer and its insurer may only be responsible for permanent partial disability and you will have to file a “claim for compensation” against the Second Injury Fund to receive any permanent total disability payments.
Compensation is not paid for the first three business days or less of disability if you are unable to work (this is called a waiting period). If you are unable to work for more than 14 days the “three-day waiting period” will be paid. Disability payments and medical bills are paid by your employer’s workers’ compensation insurance company. If a medical bill is not paid or you do not receive a disability check in a timely manner, contact your employer or insurer. Workers’ compensation payments are tax free.
- Temporary Partial Disability
- These benefits are generally paid weekly and should be 66 2/3% of the difference between the average earnings prior to the accident and the amount which the employee, in exercise of reasonable diligence, will be able to earn during the period of disability, subject to the maximum TTD rate.
- Temporary Total Disability
- The benefits provided for temporary total disability are calculated at 66 2/3% of the injured worker’s average weekly wage, not to exceed a maximum amount set by the law. The average weekly wage is based on your gross wages (your pay before taxes and other deductions).
- Permanent Partial Disability
- The benefits are calculated at 66 2/3% of the employee’s average weekly earnings as of the date of the injury, not to exceed a maximum amount set by the law. However, if you suffer from a permanent partial disability, you may receive a lump-sum payment based upon the nature and extent of the disability.
- Permanent Total Disability
- If you are permanently and totally disabled, you may receive weekly payments for your lifetime, or you may negotiate a lump-sum settlement. The amount of the weekly payment is based upon 66 2/3% of your average weekly earnings at the time of the injury, not to exceed a maximum amount set by law (this maximum amount is much higher than the maximum amount for permanent partial disability).
Additional Benefits for Occupational Diseases Due to Toxic Exposure - Permanent Total Disability and/or Death
SB1, effective January 01, 2014, provides for some enhanced weekly payments if it is shown that an employee is permanently, totally disabled (or has died) due to one or more "occupational diseases due to toxic exposure," which are defined as: mesothelioma, asbestosis, berylliosis, coal worker's pneumoconiosis, brochiolitis, obliterans, silicosis, silicotuberculosis, manganism, acute myelogenous leukemia, and myelodysplastic syndrome.
For all claims filed on or after January 1, 2014, for occupational diseases due to toxic exposure that results in permanent total disability (PTD) or death, an employee is entitled to:
Such amount due to employee during employee’s life based upon an award of PTD and death; except the PTD and death shall only be paid when the enhanced benefits have been exhausted.
The enhanced benefit for occupational disease due to toxic exposure not including mesothelioma is an amount equal to 200 percent of the state average weekly wage (SAWW) as of the date of diagnosis for 100 weeks.
The enhanced benefit for occupational disease due to toxic exposure that is diagnosed to be mesothelioma, is an amount equal to 300 percent of the SAWW for 212 weeks.
Employee who obtains additional benefits for acquiring asbestosis who later gets an award for mesothelioma shall not receive more benefits than the employee would have received for mesothelioma
The enhanced benefits cannot be greater than mesothelioma benefits even if the employee later acquires asbestosis.
If the employee dies before the enhanced or additional benefits have been paid, the additional benefits are payable to the employee’s spouse or children, in addition to the benefits under §287.240, RSMo.
If there is no surviving spouse or children and the employee has received less than the additional benefits, the remainder shall be paid in one single payment to the employee’s estate.
Subdivision 6 of §287.200.4 states that the provisions of subdivision 1 of §287.200.4 shall not be construed to affect the employee’s ability to obtain medical treatment at the employer’s expense or other benefits otherwise available under this chapter.
Effects of Your Workers’ Compensation Case on Other Benefits
For information about the effect on other benefits, read Effects of Your Workers’ Compensation Case on Other Benefits.
Emergency Personnel Killed in the Line of Duty
Benefits are available for survivors of firefighters, volunteer firefighters, law enforcement officers, air ambulance pilots, air ambulance registered professional nurses, and emergency medical technicians who are killed in the line of duty when:
- death is caused by an accident or willful act of violence of another;
- the individual is in the active performance of his/her duties and there is a relationship between the accident or commission of the act of violence and the performance of the duty, even when off duty;
- the individual is traveling to or from employment; or the individual is taking a meal break or other break while on duty;
- the injury is the cause of the death.
See the Line of Duty Compensation Act Section 287.243 RSMo.
A $25,000 death benefit shall be awarded to the estate of the individual killed in the line of duty. The death benefit is in addition to any other pension rights, death benefits, or other compensation to which the claimant may otherwise be entitled by law. To claim benefits, the estate of the deceased must file a Claim for Compensation with the Division within one year from the date of death.
Related: Obtaining A Lawyer