Are Workers Comp Waiting Periods Really Worth It?

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Workers Comp Waiting Periods

Most Workers Comp waiting periods are 7 calendar days retroactive to 21.   This means that any injured worker will not be paid for the first 7 days unless the disability period extends to 22 days.

Graphic of Red Calendar Workers Comp Waiting Periods Check Mark
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Workers Comp waiting periods  are almost always measured in calendar days and not workdays.

Does this seem fair?  Is the waiting period actually an anti-return-to-work variable?

There has been a large amount of debate recently over the fairness of requiring an injured employee to be penalized for returning to work before the 22 days expire.

Does the waiting period in concert with the retroactive period  cause employees to stay out longer to ensure they will receive all 22 days of Temporary Total benefits?

The other side of the coin is the initial reason Workers Comp waiting” periods were legislated into being was the avoidance of the “WC paid vacation.”  The waiting period was seen as a deterrent to employees taking off a few days here and there by reporting an accident and receiving subsequent treatment that will keep the injured employee off of work for a few days.

Man Wrapping Workers Comp Waiting Periods Woman Hand Injured
StockUnlimited

The calendar for an injured employee usually runs similar to:

  1. The employee is injured
  2. The employee is out of work 14 days before the first check is mailed.   This will make the employee to not even have the first benefit check until 18 days after an accident.   The 18 days is if the claim is reported and accepted immediately.
  3. The investigation may cause the claim to have the first disability check  mailed out even later.
  4. The injured employee will not see the first week of TTD until the third check is cut.
  5. The third week and first week of benefits may not be received until 25 – 28 days after the injury.   This time-lagged situation may cause the employee to have only one week off TTD until a month in time has passed on the claim.  

In my humble opinion, many attorneys are hired by the injured employee due to lag in benefits in the first month that is in no way the fault of the insurance carrier or TPA.

A recent study was recently published on the effects of different waiting period lengths and retroactive periods.  This will be covered in tomorrow’s article.

©J&L Risk Management Inc Copyright Notice

 

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2 Responses

  1. James,

    When I handled NY WC…we called the employer to get certain information, such as average weekly wage, or to get them to fill out a form that would have that information, and if the employee has lost any time. If yes, after the seventh day, we would begin payment. Generally, we diaried it for the seventh day. How long it took before he got the check, I did not know.

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James Moore

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Mgmt Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

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  • Bloomberg Business News
  • WorkCompCentral.com
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  • Risk & Insurance Magazine
  • Insurance Journal
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