1. Job-related injury occurs.
2. Worker notifies employer within ten days.
3. Employer notifies the insurance carrier.
4. Employer mails or delivers information packet to employee or legal beneficiary.
5. Employer and insurance carrier files accident report with the Division of Workers Compensation.
6. Division of Workers Compensation mails written claim form to employee.
7. Employee files written claim form with employer.
8. Insurance provider pays medical expenses and temporary disability benefits to employee, as appropriate.
9. If employee and employer disagree on entitlement to medical and temporary disability benefits, the employee requests a preliminary hearing.
10. The case is assigned to an administrative law judge for a preliminary hearing. The judge takes evidence and makes a ruling.
11. At any time in the process, any party to a workers compensation claim may request a mediation conference, which will be scheduled upon agreement by the other party.

Categories of Disability Benefits

Temporary Total Disability
Exists when the employee, on account of injury, is unable to engage in any type of substantial and gainful employment.  Benefits are paid for the duration of the temporary total disability (TTD).  There is a one week waiting period before TTD benefits are paid.  If the disability continues for three consecutive weeks, the employee is reimbursed for the waiting period.  Employees may collect medical benefits during the first week.

Benefits are 66.67 percent of an employee’s average gross weekly wage, but not less than $25 nor more than the statutory maximum. Temporary total compensation may not exceed $100,000 per injury.

Employees may not collect temporary total disability and unemployment benefits for the same week.

Temporary Partial Disability
Exists when the worker returns to any employment at a wage less than the time of in injury wage.  Compensation is calculated on a weekly basis, and is paid until the wage loss is no longer present, or the benefit maximum is reached, whichever comes first.

Benefits are 66.67 percent of the difference between the employee’s average gross weekly wage before the injury and the employee’s wage after the injury.  Benefits may not exceed the state’s statutory maximum.

Permanent Partial Scheduled Disability
Exists when there is complete or partial loss of use of a body part, such as an arm, due to a job-related injury.  Compensation for permanent partial disability is limited to a percentage of the following schedule.  A healing period is available in most cases of amputation.  Benefits are 66.67 percents of employee’s gross weekly wage, but not less than $25 nor more than the statutory maximum.