OKLAHOMA TEMPORARY TOTAL DISABILITY BENEFITS (TTD)

 In OKLAHOMA TEMPORARY TOTAL DISABILITY BENEFITS (TTD), OKLAHOMA WORKERS COMPENSATION BENEFITS

AMOUNT OF TEMPORARY TOTAL DISABILITY IN OKLAHOMA (TTD)

If it is determined that an injured worker is physically or mentally incapable of performing his or her “pre-injury or equivalent job”, said worker is entitled to receive a Temporary Total Disability benefit, or TTD check, said amount computed at seventy percent (70%) of the injured employee’s  pre-injury average weekly wage (or “AWW”), said compensation amount not to exceed a maximum statutory rate equal to seventy percent (70%) of the state average weekly wage, which is recomputed yearly. Title 85A § 45.A.1.

Note: The Oklahoma Workers’ Compensation Court has determined that the term “pre-injury or equivalent job” means that job that the injured worker was performing for his or her employer at the time of his or her on-the-job injury or any other work offered by the injured employee’s employer that pays at a minimum one hundred percent (100%) of the injured worker’s pre-injury average weekly wage.

Note: The current maximum rate, or cap if you will, for a weekly TTD check in Oklahoma is $590.63.  This is surprisingly down from the previous year’s TTD cap due to a decrease in the average amount of money Oklahoman’s are earning when compared to earnings from the year prior. Hopefully this trend will not continue.

Duration of Temporary Total Disability (TTD) Benefits in Oklahoma

In Oklahoma Temporary Total Disability (TTD) Benefits are limited to a maximum duration of two years (104 weeks).  However–if it is agreed by and between the parties (or found by an Administrative Law Judge of the Oklahoma Workers’ Compensation Court) that an injured worker has suffered a “Consequential Injury” and that additional time is needed for said injured employee to in fact achieve “Maximum Medical Improvement” or “MMI”, Temporary Total Disability (TTD) can be ordered paid for an additional year, or fifty-two (52) week period.  In no case will a temporary total disability check be paid longer than three years under Oklahoma law. Title 85A § 45.A.1.

Note: Any finding by an Administrative Law Judge that an injured worker has either (1) suffered a “Consequential Injury”; or (2) needs additional time to recover from that consequential injury–must be proven by the injured worker &/or his or her Oklahoma Workers’ Compensation Attorney by producing “Clear & Convincing” evidence of these facts. Title 85A § 45.A.1.

Note: The Oklahoma Workers’ Compensation Court has defined the term “Consequential Injury” to mean any bodily injury or structural damage to a part of the injured worker’s body that is a direct and proximate result from the original compensable injury or medical treatment to that body part which is the subject of the original claim.  Furthermore, a Workers’ Compensation Judge cannot make a finding of a “Consequential Injury” unless and until it is proven by the injured worker &/or his or her Oklahoma Workers’ Compensation Attorney that medical treatment for such Consequential Injury is required and in fact given. Title 85A § 2.11.

Note: The Oklahoma Workers’ Compensation Court has defined the term “Maximum Medical Improvement” as being that point in time where no further medical improvement can be expected from medical or surgical treatment or the simple passage of time. Title 85A § 2.28.

Limitation on Oklahoma Temporary Total Disability (TTD) Benefits for Mental Injury & Illness

Under Oklahoma Workers Compensation Law an injured employee will be limited to twenty-six weeks of  TTD benefits for a mental injury or illness–unless and until it is proven by ‘clear and convincing’ evidence that benefits should continue under the particular circumstances of that case.  In no case will temporary total benefits extend beyond a total of fifty-two (52) weeks in a mental disease case. Title 85A § 13.B.1

TEMPORARY TOTAL DISABILITY BENEFITS PAYABLE FOR OKLAHOMA HERNIA INJURIES

An Oklahoma worker who suffers a compensable hernia injury will be paid six (6) of TTD–regardless of whether he or she has even been off work that long.

An injured worker who chooses to forego a hernia repair surgery as recommended by a general surgeon will be paid temporary total disability benefits for a period of thirteen weeks in addition to reasonable and necessary non-surgical medical treatment.

3-Day Waiting Period for Temporary Total Disability Benefits in Oklahoma

There is a three (3) day waiting period, during which no Temporary Total Disability (TTD) Benefits are paid, under Oklahoma Workers’ Compensation Law.  This waiting period only applies to the initial period TTD is paid to the injured worker–in other words, if an injured worker returns to work or his benefits are suspended for any other reason–he or she will not suffer another waiting period if his or her temporary total disability benefits are again restarted. Title 85A § 45.A.1.

Employer to Commence Temporary Total Disability Benefits within fifteen (15) days of Notice of Injury

As noted above, upon notice &/or knowledge that its employee has sustained injury, an Oklahoma employer is required under the Oklahoma Workers’ Compensation law to pay TTD if that employee is unable to perform his or her usual job (or any light duty or alternative work offered by the employer) for more than three days.  These benefits are to be paid even without an order from the court.

Temporary total disability compensation must be paid within fifteen (15) days after employer receives notice of its employee’s injury: Under Oklahoma law temporary total disability compensation is due and payable no later than the fifteenth day after the employer has notice of its employee’s injury, unless the employer disputes the employee’s right to compensation as provided in 85A § 86 by filing a Form-2A Employer’s Intent to Controvert Claim form with the Oklahoma Workers’ Compensation Court within this same fifteen (15) day period.

Termination of Oklahoma Workers' Compensation Temporary Total Disability (TTD) Benefits

Termination when worker has not filed a claim with the Court: In Oklahoma an employer can terminate its injured employee’s temporary total disability check unilaterally and without notice or court approval if the employee has not filed a formal claim for benefits with the Oklahoma Workers’ Compensation Court (i.e. the employee &/or his or her Oklahoma Workers’ Compensation attorney has failed to file a CC-FORM 3: Employee’s First Notice of Claim for Compensation with the Workers’ Compensation Commission).

Termination of temporary total disability where injured worker has a claim for compensation on file:  If an injured worker has properly filed a CC-FORM 3: Employee’s First Notice of Claim for Compensation with the Oklahoma Workers’ Compensation Commission then the employer &/or its insurance company can terminate said employee’s temporary total disability benefits without a commission order only if and when one of the following occurs:

  1. Employee returns to full-time work: The injured worker’s TTD benefits will terminate when and if he or she returns to full-time work at the job where he or she got hurt or with another employer.
  2. Employer provides written notice to employee (& employee’s attorney) of termination for an event enumerated in Title 85A § 45(A)(2): A worker’s Temporary Total Disability check can be terminated without an order from the workers’ compensation court where the employer provides written notice to its injured worker of  termination for a reason stated in 85A § 45(A)(2).  However–the reason for termination must be clearly stated in the notice.  The injured worker &/or his or her Oklahoma workers’ compensation attorney can file an objection to the employer’s notice to terminate TTD and request an expedited court hearing on the issue of reinstatement of his or her temporary total disability check.  The injured worker’s objection must, however, be filed within ten (10) days of termination of his or her benefits to be timely.
  3. Incarceration of injured employee: Upon notice of incarceration in a jail or prison an employer &/or its worker’s compensation insurance company can terminate its employee’s TTD check without further order from the workers’ comp commission.
  4. Injured employee &/or his attorney requests a hearing on or files a report addressing permanent disability: If an injured worker &/or his or her workers’ compensation attorney files with the Oklahoma workers’ compensation court a permanent disability rating report (or simply requests a hearing or trial on either permanent partial disability, permanent total disability, or both), said worker’s temporary total disability benefit is fair game for termination unilaterally by the worker’s employer without an order from the court.
  5. Parties agree to termination of worker’s temporary total disability check and such agreement is put in writing: The injured employee &/or his or her Oklahoma Workers’ Compensation Lawyer agrees with said hurt worker’s employer &/or its workers’ compensation insurance company to termination of that employee’s temporary total disability benefit–and said agreement is committed to writing.
  6. Injured worker receiving TTD dies during the pendency of his or her case: Temporary total disability benefits will terminate immediately upon the death of the injured worker whether or not his or her death is the result of his or her on-the-job accident.
  7. Any other cause enumerated under Title 85A § 62: In Oklahoma an injured worker’s temporary total disability settlement check can be terminated with or without an order from an Oklahoma Workers’ Compensation Judge for any other reason properly described in Title 85A § 62 of the Oklahoma Administrative Workers’ Compensation Act.

In all other instances TTD can only be lawfully terminated with a court order: In all other cases where an injured worker has a claim on file with the Oklahoma Workers’ Compensation Commission, an employer &/or its compensation carrier can only terminate temporary total disability with an order allowing it to do so by a judge of the Oklahoma Workers’ Compensation Court.  In these instances an employer must strictly follow the following procedures before it can terminate its worker’s temporary total disability check.

Employer must request a rehearing conference on termination of employee’s TTD check: An employer &/or its workers’ compensation carrier can initiate the process to terminate its injured employee’s temporary total disability check by filing with the workers’ compensation court CC-Form-13 Request for Prehearing Conference.  A copy of this Form 13 must be mailed to the injured employee, his or her workers’ compensation attorney, or both, and include a medical report or any other evidence the employer intends to rely upon to support its motion to terminate the worker’s temporary check.

Employer must be in full compliance with rules before hearing on termination of temporary total disability benefits will be held: If the Court determines that an employer has improperly terminated its employee’s temporary total disability benefits the Court will require the employer to file a brand new CC-Form-13 Request for Prehearing Conference, start the termination process anew, and demonstrate full compliance with Court rules before a hearing on termination of TTD may be had.

Termination when worker reaches maximum medical improvement: When an injured worker reaches maximum medical improvement (defined above) and is discharged from active medical &/or surgical treatment by his or her authorized treating doctor on all body parts (including any “Consequential Injury” as defined above) found compensable by the Oklahoma Workers’ Compensation Court, the employer &/or its workers’ compensation insurance company can then terminate Temporary Total Disability (TTD) by properly notifying that injured worker or his or her Oklahoma Workers’ Compensation Lawyer of its intent to so terminate. Title 85A § 45.A.2.

Other events causing temporary total disability benefits to terminate under Oklahoma Law: Temporary Total Disability benefits in Oklahoma can be terminated as well for any of the following enumerated reasons:

  1. Failure to comply with treatment: If an injured worker refuses or otherwise fails to adhere to medical orders or treatment recommended by his or her authorized doctor his or her temporary check will be terminated.
  2. Worker abandons treatment: If an injured employee ‘abandons’ or otherwise withdraws from treatment for his or her injury his or her TTD benefit will terminate. Title 85A § 45.A.2.

To be sure–An injured worker’s Temporary Total Disability check will be reinstated if the injured worker &/or his or her Oklahoma Workers’ Compensation Attorney can prove to the Oklahoma Workers’ Compensation judge a valid excuse for either: (1) his or her failure to follow medical recommendations and treatment from his authorized treating physician; or (2) his or her abandonment of medical care. Title 85A § 45.A.2

Termination of Temporary Total Disability Check for Missed Doctor’s Appointments: An injured worker, otherwise without good cause or a justifiable excuse, who misses or fails to attend more than three (3) consecutive medical appointments for active medical treatment with or ordered by his or her treating physician, will not be entitled to receive a Temporary Total Disability Benefit (or will have his or her TTD check terminated), unless and until that injured worker &/or his or her Oklahoma Workers’ Compensation Lawyer can demonstrate that the injured worker’s absence was:

  • Caused by unexpected circumstances outside the injured employee’s direction and control; or
  • The employee gave his or her employer at least two (2) hours prior notice of his or her inability to attend these appointments and had a legitimate reason for not being able to attend these examinations. Title 85A § 57.A

Lack of Transportation Not a Legitimate Excuse for Employee Missing Medical Appointments: An injured employee’s inability to get transportation to and from his or her medical treatment will not be considered a legitimate reason nor a valid excuse for his or her failure to attend a regularly scheduled appointment with or at the direction of his or her treating physician. Title 85A § 57.B

Objecting to Termination of Worker’s Temporary Total Disability Check in Oklahoma: An injured worker &/or his or her Oklahoma Workers’ Compensation Attorney can dispute and fight termination of said worker’s Temporary Total Disability Benefit by filing with the Oklahoma Workers’ Compensation Court a proper objection to said termination.  The deadline for an attorney filing this objection is ten (10) days after termination of the injured employee’s TTD Benefit.

Procedure on Objection to Termination of Temporary Total Disability Benefits in Oklahoma: If a timely objection is filed by the injured worker &/or his or her Oklahoma Workers’ Compensation Attorney the Oklahoma Workers’ Compensation Court will set the case for a court hearing to determine if the worker’s TTD  benefit should properly be reinstated.  By law said hearing on reinstatement must occur within twenty (20) days of the filing of the injured worker’s objection to termination of his or her TTD benefits.

Utilizing a Court Appointed Independent Medical Examiner (CIME) to Resolve TTD Termination Cases: At any hearing regarding reinstatement of a worker’s TTD benefit the Oklahoma Workers’ Compensation Court most probably will schedule an appointment for the injured party to be examined by a Court Appointed Independent Medical Examiner (or “CIME”) to determine both whether: (1) the injured worker needs further treatment to reach maximum medical improvement; and (2) whether he or she continues to be disabled from his or her usual work. Title 85A § 45.A.2.

TTD benefits not paid during any time worker refuses to be examined by Court-appointed or employer selected doctor

If an injured worker, who is claiming entitlement to or otherwise receiving temporary total disability benefits under the Oklahoma Workers’ Compensation Act, refuses to either attend a medical examination: (1) ordered by the Workers’ Compensation Court; or (2) requested by said workers’ employer or the employer’s workers’ compensation insurance company–his or her right to receive a temporary total disability check will be suspended during the period of any such refusal. Title 85A § 50.E.

In cases where an injured worker refuses to submit himself or herself to an examination requested by the worker’s employer &/or the employer’s workers’ compensation insurance company the employer (or insurance carrier) can file a CC-Form-13 requesting that the hurt worker’s temporary total disability check or right to proceed to court on a request for TTD be suspended during the time the injured worker refuses to be so examined.  At any subsequent hearing on the matter the injured worker &/or his or her Oklahoma workers’ compensation attorney must show proper cause as to why his or her TTD check should not be terminated or suspended for noncompliance with the employer’s request for a medical examination.

Termination of Temporary Total Disability Benefits for failure of refusal to be examined by a Court Ordered Medical Examiner

The Oklahoma Workers’ Compensation Commission may from time to time order that an injured worker submit to a medical examination or even active medical treatment by a physician other than that employee’s designated or current treating physician.

If an injured worker refuses to be examined or treated by the Court Ordered physician that employee’s workers’ compensation case will be suspended and he or she will not be paid temporary total disability during the time said employee refuses or fails to submit to examination or active treatment by the Court Ordered examining physician or otherwise obstructs said physician’s examination of the hurt employee.  Furthermore, an injured worker’s failure or refusal to comply with a Workers’ Compensation Commission Court Order directing him or her to submit to an examination or treatment by a Court-ordered medical examination for a period of one (1) month or more will cause him or her to forfeit his or her right to further compensation under the Oklahoma Workers’ Compensation Act, including his or her right to additional temporary total disability benefits, with respect to that workers’ injury. Title 85A § 53

No Temporary Total Disability Paid during any period injured worker receives Unemployment

Under Oklahoma law no temporary total disability benefit check will be paid to an injured worker for any week for which such worker also receives an unemployment compensation check either from the Oklahoma Employment Security Commission or a unemployment benefit check under a similar law of another state.

Injured worker permitted to draw both TTD and unemployment for any period of time his or her benefits are contested: If an employer contests or otherwise disputes its injured worker’s claim for Temporary Total Disability benefits and that period of TTD is later found compensable by the Oklahoma Workers’ Compensation Court, that worker will be permitted to draw a temporary total disability benefit check for this period so disputed even if she also drew an unemployment check for the same period.  However–the amount of temporary total disability paid during this concurrent period will be limited to the difference between the injured worker’s TTD check and his or her unemployment benefit and only to the extent that the worker’s TTD check exceeds his or her unemployment benefit received by the injured worker for that same period of time.

Temporary Total Disability Benefit Not Paid During Any Time Injured Employee Refuses to Perform Light-duty work

For any period during which an injured worker in Oklahoma refuses to perform alternative work offered to him or her by his or her employer, such work being within temporary restrictions given to him or her by his or her treating doctor, he or she will not be entitled to a Temporary Total Disability benefit or check during any such period under Oklahoma Law. Title 85A § 45.B.3.

LIMITS ON TTD FOR 'SOFT-TISSUE' INJURIES IN OKLAHOMA

Oklahoma Workers’ Compensation Law places arbitrary limits on how long a hurt worker can draw a temporary total disability check for what it calls a “soft-tissue” injury.  The term ‘soft-tissue’ injury is somewhat misplaced because really the limits are based largely on the treatment recommended or actually given for the worker’s injury not the actual injury itself–although, as will be discussed below, some injuries are excluded from these limits since, by the law’s definition, these injuries are not “soft-tissue” injuries.

The law regarding ‘soft-tissue’ injuries goes as follows:

  1. 8 weeks for a non-surgical ‘soft-tissue’ injury: A hurt worker with an injury for which a surgical procedure is either not recommended nor performed will be limited to eight weeks of temporary total disability checks
  2. 16 weeks for soft-tissue injury with injection(s): An injured worker who undergoes one or more injections will be eligible for an additional eight (8) week period of temporary total disability.
  3. 24-week limit for soft-tissue case where injured worker receives recommendation for surgery but has not received an injection; 32 week limit for surgical recommendation case where one or more injections have been done: Any injured worker who has been recommended for a surgical procedure by a treating surgeon or doctor for his or her ‘soft-tissue’ injury will be eligible for an additional sixteen (16) week period of temporary total disability benefits.   However–if the recommended surgical procedure allowing this extension is not performed within thirty (30) days of authorization of the procedure by the workers’ employer or its insurance company, or following an order approving the surgery entered by the Oklahoma Workers’ Compensation Court, and this delay is caused by the worker acting in bad faith, any temporary total disability period allowed by this extension will be terminated and the workers’ employer &/or its insurer will be entitled to repayment for any TTD paid beyond the initial eight (8) week period (or 16 week period in the case of an injection) described above.

Title 85A § 62.A

Injection not considered a surgical procedure for 16 week extension of TTD for soft tissue injury: An epidural steroid or other similar injection will not be considered a surgical procedure for purposes of an extension of TTD for any ‘soft-tissue’ injury. Title 85A § 62.A

NOTE: The Oklahoma Workers’ Compensation Court defines a ‘soft-tissue’ injury to be one that causes damage to tissues that surround bones and joints and includes, but is not limited to, sprains, strains, contusions, tendonitis and muscle tears.  Cumulative trauma is considered a soft tissue injury.

mmmmINJURIES NOT SUBJECT TO THE ‘SOFT-TISSUE’ LIMITS ON TEMPORARY TOTAL DISABILITY IN OKLAHOMA: The following medical conditions or injuries are excluded from the definition of “Soft tissue injury” under Oklahoma law and Temporary Total Disability benefits are not subject to the above limitations for these type of injuries:

1. Spine, disc and spinal cord injuries where one or more spine surgeries are performed;

2. Traumatic brain (TBI) or closed-head (CHI) injuries accompanied by either: (1) sensory and motor disturbances, (2) communication disturbances, (3) complex integrated disturbances of cerebral function, or (4) episodic neurological disorders;

3. Joint Replacements: Total or partial knee, hip, shoulder or other joint replacements.

Title 85A § 62.A

Offsets, Deductions and Non-payment of Temporary Total Disability Benefits in Oklahoma

Temporary total disability benefits will not be paid during and for any period of time during which an injured Oklahoma worker receives his or her regular salary &/or wages: Oklahoma Workers’ Compensation Law provides that any injured worker who gets paid his or her full wages &/or salary following his or her injury will not be entitled to a Temporary Total Disability check for that period during which his or her full salary or wages have been so paid.

Oklahoma Employers to be given credit for any amount of pay or salary paid to injured worker following his or her injury which exceeds the Oklahoma maximum TTD rate: In those cases where a hurt worker receives wages &/or salary over the Oklahoma Temporary Total Disability maximum rate-this sum or amount will be credited to the injured worker’s employer as an overpayment to be deducted from the employee’s permanent partial disability settlement or award, if any, after any attorney fee on the permanent disability award has been made.

Employer entitled to a credit for any advance payment made to an employee said credit to be recouped out of any subsequent award or payment of temporary total disability made on the case: an employer will be entitled to repayment or a credit for any monetary amount it has advanced to a worker for his or her injury with said advance payment to be taken out of that worker’s subsequent or unpaid temporary total disability payments. Title 85A § 89

Temporary total disability benefits will not be paid to any worker while he or she is incarcerated or otherwise confined to a prison or jail: Temporary Total Disability payments will not be paid to any worker during any period or while said individual is in Department of Corrections custody or otherwise incarcerated in a jail or prison. Title 85A § 94

Oklahoma Workers' Compensation Temporary Total Disability Benefits not subject to garnishment, attachment, levy or execution

In Oklahoma a worker’s temporary total disability check cannot be garnished, levied on or attachment: Under Oklahoma law an injured worker’s temporary total disability check cannot be garnished, attached, or subject to an execution or levy to pay said worker’s debts.

Child support liens are enforceable against and will be deducted from any award or payment of temporary total disability in Oklahoma

A child support lien or judgment is valid and enforceable against an injured worker’s temporary total disability check in Oklahoma.  To be clear–any child support liens or judgements or income and wage assignments filed under Title 43 § 135; Title 12 § 1170 and/or Title 56 § 237.7 will be recognized and paid out of an injured worker’s temporary total disability benefit or award with or even without on order of the Oklahoma Workers’ Compensation Court.

When a child support lien is filed in a case before the Oklahoma workers’ compensation court the judge presiding over the case must acknowledge and order that any such lien be paid out of any award of temporary total disability benefits thereafter made by the court.  Furthermore, when a child support lien has been properly filed in an Oklahoma workers’ compensation case the employer &/or its insurance carrier must include the name of the person &/or government agency (usually the Department of Human Services, or DHS) asserting the support lien on any check for temporary total disability issue to the injured employee for which said child support lien applies.

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