Benefits Flashcards
What is the Three Day Waiting Period (3DW)
3 consecutive calendar days beginning with first day the worker loses time or wages as a result of the compensable injury
How is the 3DW determined
First day IW loses time or wages due to injury
Three consecutive Calendar Days
When is the 3DW payable
The IW is authorized and totally disabled for 14 days
The IW is admitted as an inpatient to a hospital within 14 days of the onset of total disability
**If the 3DW is payable, pay one-half for the initial day if worker leaves during the first half of shift and dose not return to work. No pay for first day if worker leaves during second half of shift.
What information is required before paying time loss (TL)
The AP or NP verifies the IW inability to return to work and then authorize time loss.
Generally when is the first TL payment due by statute
14 days from EDOK or disability
When is TL payment due within SAIF best practices
13 days from EDOK
How often is TL benefits paid
Every 14 days
When would you pay TPD temp. partial disability
Worker has returned to modified work at reduced hours or wages
When would you pay Sup TD supplemental disability
When IW has more than one job and is unable to work their secondary jobs
Can Sup TD be paid on a Non disabling claim
Yes - when there is TL on secondary jobs
When you pay PPD in a lump sum
When it’s less than $6,000
More than $6,000 and IW requests lump sum
How long do insurers have to pay PPD award
30 day from mailing date of notice
