An injured employee has the right to file for the status of temporary total disability. The conditions established by the insurance company determine what happens, once a given employee has sought to attain such a status.
An Examination takes place
The employee that has filed for the changed status undergoes a physical examination. An independent medical professional conduct that exam. The same professional must answer 2 questions:
1) Does the worker’s injury qualify as a permanent or temporary?
2) Is the worker’s injury partial or total?
What finding would cause the examining physician to answer, “temporary” to the first question and “total” to the second one?
In that case, the physician would find that the examined employee lacked the ability to perform his or her job duties, while recovering from the effects of the sustained injury. After the insurance company has learned about the physician’s finding, it could initiate delivery of promised benefits. The Personal Injury Lawyer in Saint John knows that same insurance company would expect the injured worker to schedule time for receiving the prescribed treatment.
Wouldn’t the insurance company be required to deliver the benefits?
No, it could challenge the physician’s findings. If that were to happen, then the injured employee would undergo a second examination. A Qualified Medical Examiner would conduct that second exam, if the examined worker did not have an attorney.
Employees that have been told by one physician that they qualify for the temporary total disability status, only to have the doctor’s declaration challenged, have the right to retain a lawyer. After retaining a lawyer, any of those same employees should expect to get examined by an Agreed Medical Examiner.
For how long does an employee with a temporary total disability receive treatments?
The doctor that has examined that worker prescribes the length of the treatments. Once that prescribed period has finished, the treated worker needs to undergo another examination. It could be that the doctor’s findings from that follow-up exam forced a change in the worker’s status. For example, if the treatment had been effective, the worker should have recovered fully. Hence, the insurance company would have a reason to discontinue the delivery of benefits.
On the other hand, it is possible that the examining physician might find that the employee has failed to respond to the treatments. At that point, it could be that the same employee’s injury had been shown to be permanent in nature.
That would mean that the treatment had failed to allow for achievement of a complete recovery. Hence, the employee could not return to work, despite having reached the stage of maximum medical improvement (MMI). As a result, the disabled employee’s temporary disability payments would stop, and permanent total disability payments would replace them.