Temporary disability: causes, impacts, and recovery

Temporary Disability Law

What laws apply to temporary disability at the workplace?

Temporary Disability Insurance (TDI) programs are designed to provide wage replacement for non-work-connected sickness or injury. The TDI program complements the UI program by providing benefits to individuals who do not meet the UI program's "able" to work requirement. Although Federal law does not provide for a Federal-State TDI system, the SSA and the FUTA both authorize the withdrawal of employee contributions from a State's unemployment fund for the payment of TDI. (Temporary Disability Insurance, n.d..)

Another law providing for temporarily disabled workers injured on the job is Workers' Compensation. Workers' Compensation laws are designed to ensure that employees who are injured or disabled on the job are provided with fixed monetary awards, eliminating the need for litigation. These laws also provide benefits for dependents of those workers who are killed because of work-related accidents or illnesses. Some laws also protect employers and fellow workers by limiting the amount an injured employee can recover from an employer and by eliminating the liability of co-workers in most accidents. State Workers Compensation statutes establish this framework for most employment. Federal statutes are limited to federal employees or those workers employed in some significant aspect of interstate commerce.

The Federal Employment Compensation Act provides workers compensation for non-military, federal employees. Many of its provisions are typical of most worker compensation laws. Awards are limited to "disability or death" sustained while in the performance of the employee's duties but not caused willfully by the employee or by intoxication. The act covers medical expenses due to the disability and may require the employee to undergo job retraining. A disabled employee receives two thirds of his or her normal monthly salary during the disability and may receive more for permanent physical injuries, or if he or she has dependents. The act provides compensation for survivors of employees who are killed. The act is administered by the Office of Workers' Compensation Programs.

The Federal Employment Liability Act (FELA), while not a workers' compensation statute, provides that railroads engaged in interstate commerce are liable for injuries to their employees if they have been negligent.

The Merchant Marine Act (the Jones Act) provides seamen with the same protection from employer negligence as FELA provides railroad workers.

Congress enacted the Longshore and Harbor Workers' Compensation Act (LHWCA) to provide workers' compensation to specified employees of private maritime employers. The Office of Workers' Compensation Programs administers the act.

California's Workers' Compensation Act provides an example of a comprehensive state compensation program. It is applicable to most employers. The statute limits the liability of the employer and fellow employees. California also requires employers to obtain insurance to cover potential workers' compensation claims, and sets up a fund for claims that employers have illegally failed to insure against.

What are those benefits and who administers them?

Six states operate TDI programs. In California, New Jersey, Puerto Rico, and Rhode Island, the TDI programs are administered by the State employment security agency. The Hawaii law is administered by the Temporary Disability Income Division of the Department of Labor and Industrial Relations, and the New York law is administered by the worker's compensation board.

Unlike most social insurance programs (e.g., social security, unemployment compensation), workers' compensation in California, as well as in most other states, is not administered by a government agency. Workers' compensation benefits are administered primarily by private parties -- insurance companies authorized to transact workers' compensation and those employers secure enough to be permitted to self-insure their workers' compensation liability.

When an employer becomes aware of an on-the-job injury, the employer is expected to begin the process of providing the injured worker the benefits to which he or she is entitled under the law. The benefits are paid by either the employer (if the employer is authorized to self-insure) or the employer's insurer.

The state's role in benefit delivery is to oversee the provision of workers' compensation benefits, provide information and assistance to employees, employers, and others involved in the system, and to resolve disputes that arise in the process. ("Workers compensation: an overview." n.d.)

Under what general circumstances is the employee entitled to benefits?

In general, the temporary disability laws define disability in terms of the inability of an individual to perform the regular or customary work because of the individual's physical or mental condition. California also specifically includes individuals suspected of being infected with a communicable disease, acute alcoholics, and drug addicts undergoing treatment. The Puerto Rico law and two of the special systems for the disabled unemployed, in New Jersey and New York, contain more strict requirements with respect to disability during unemployment. The New Jersey law provides that the claimant must be unable to perform any work for remuneration. The New York and Puerto Rico laws provide that the claimant must be unable to perform any work for which the worker is reasonably qualified by training and experience. Different requirements may apply for worker compensation claimants.