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.
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.
The calendar for an injured employee usually runs similar to:
- The employee is injured
- 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.
- The investigation may cause the claim to have the first disability check mailed out even later.
- The injured employee will not see the first week of TTD until the third check is cut.
- 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.
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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.
Richard, thanks for your timely input.