Jenkins Fenstermaker’s West Virginia (WV) workers’ compensation defense team often receives questions regarding the handling of claims for workers' compensation in WV. Specifically, clients and other interested parties frequently need information on WV temporary total disability (TTD) benefits, including rates, time limits, and closure of claims. In response to this need, our WV workers’ compensation lawyers created a “cheat sheet” with quick facts to answer some of the most common WV workers’ compensation questions.
Challenges in Answering WV Workers’ Compensation Questions
In this blog, a second to follow, and the accompanying “cheat sheet,” we answer some frequently asked questions about TTD benefits under WV workers’ compensation law and rules. These answers can be difficult to provide and keep updated because the law can change suddenly through new statutes, regulations, and court decisions.
Still, we appreciate that people want to be proactive in handling claims properly. As a result, we've decided to create a series of cheat sheets, known as "Brief Facts," to provide initial, point-in-time quick references. To receive the TTD benefits fact sheet and future distributions of “Brief Facts,” sign up for Jenkins Fenstermaker’s newsletter here.
Common questions about WV TTD benefits discussed here and outlined in the first edition of “Brief Facts” include the following:
- What is the rate of pay for WV temporary total disability benefits?
- What is the maximum period a claimant may receive WV TTD benefits?
- Is there a waiting period for WV temporary total disability benefits?
- What is the prospective period for WV TTD benefits?
- What reasons permit the stoppage of WV TTD benefits?
- What is the procedure for stopping WV TTD benefits?
- Can a claim be reopened for WV TTD benefits?
- What other situations can result in the closure of WV TTD benefits?
The first four WV workers’ compensation questions are addressed here, while the final four answers will be provided in a blog to follow.
What Is the Rate of Pay for WV Temporary Total Disability Benefits?
The rate of pay for WV temporary total disability benefits under WV Code § 23-4-6(b) is 66 2/3 percent of the employee’s daily rate of pay on the date of injury or the average weekly wage based on the best quarter of the four quarters preceding the injury, whichever is greater. TTD benefits may not exceed 100 percent of the average weekly wage in WV.
Instructions for calculating TTD benefits are provided by the WV Insurance Commission. Employers may review the Commission’s informational letter regarding TTD benefits or use the TTD wage calculator resource on the agency’s website to determine applicable rates of TTD benefits.
What Is the Maximum Period a Claimant May Receive WV TTD Benefits?
Under WV Code § 23-4-6(c), the maximum period for which a claimant may receive WV TTD benefits is 104 cumulative weeks.
Is There a Waiting Period for WV Temporary Total Disability Benefits?
There is a waiting period for an employee to receive WV TTD benefits, as established by WV CSR § 85-1-5.1. The rule requires a claimant to be disabled for three consecutive calendar days before he or she may receive TTD benefits. To receive TTD benefits for the first three days of disability, the employee must continue to be unable to work due to the compensable injury for more than seven consecutive calendar days.
What Is the Prospective Period for WV TTD Benefits?
WV Code § 23-4-7a(c) established the prospective period of payment of WV temporary total disability benefits. The period for which a claimant may receive benefits is not to exceed 90 days under the law. The insurer or self-insured employer must issue a notice of continuation of benefits or suspension of benefits at least every 90 days to comply with this rule.
Get More Answers to Your WV Workers’ Compensation Questions
The second blog in this two-part series will address the acceptable reasons for stopping WV temporary disability benefits, the procedure for cessation of benefits, reopening of workers’ compensation claims, and special rules regarding TTD benefits in WV.
Attorneys Steven Wellman, James “Mac” Heslop, and Jillian Moore counsel and represent employers and insurers across WV in matters related to workers’ compensation defense, regularly advocate for reforms that benefit the business community, and track changes that impact companies’ administration and management of workers’ compensation issues.
If you have WV workers’ compensation questions related to the topics covered here or otherwise, the WV workers’ compensation lawyers at Jenkins Fenstermaker, PLLC can help. Contact the team by calling the law firm’s Huntington, WV office at (304) 523-2100 or complete this online contact form.