Duration of Benefits

DURATION OF BENEFITS


The length of time that weekly compensation benefits continue depends on whether compensation is being paid for total disability or partial disability. Benefits for total disability continue for as long as total disability continues, even if that means the rest of an injured worker’s life. If there is an end of total disability and a person becomes partially disabled, then benefits will continue for partial disability.

Benefits for partial disability, for employees who were injured after September 1, 1990, continue for a maximum of 312 weeks (6 years). After 6 years, benefits for partial disability continue only if the injured worker can establish that his/her injury poses a “material hindrance” to obtaining employment suitable to his/her limitations.

Only benefits that are paid for partial disability are included in the calculation of the six year period. Benefits that are paid for total disability are not included in the six year benefit period for partial disability. For example, if an injured worker is totally disabled following an injury and then becomes partially disabled, the six year period begins to run when benefits start for the period of partial disability. Furthermore, periods of disability may be broken up with different periods of partial disability and total disability. For example, an injured worker who is partially disabled may become totally disabled upon undergoing surgery. In that event, benefits paid for the period of total disability following the surgery are not included in the six year calculation of partial disability. The six year “clock” does not begin to tick again until the injured worker again becomes partially disabled. When all periods of partial disability total six years, then benefits will stop subject to a continuation of benefits if “material hindrance” can be proven.

Read full text of statute » 28-33-18(d) and 28-33-18.3

Any change in disability status from partial to total or vice-versa must be legally documented in order to count toward calculation of the six year period for payment of partial disability benefits. The initial documentation of disability status is contained within the Memorandum of Agreement (View form) or Court Order establishing the claim. Changes in disability status may be documented by Court Orders or by written agreements (Mutual Agreements » View form) signed by the injured worker and the insurance company.
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