How Lost Time Benefits Work


You may have heard of the lost time benefits concept. Maybe you’ve never heard about it before. In case you don’t know about lost time benefits, we’ll take a few moments to talk about them right now. It’s a concept you should understand if you ever need to spend some time away from work with an injury.

What Are Lost Time Benefits?

Lost time benefits consist of money you will receive if an applicable healthcare plan covers you through your job. Ideally, you’ll want to look for a position where you can sign up for lost time benefits, just in case you hurt yourself while on the job and you need to miss a long time recovering at home.

In most instances, for you to get these benefits, you need to find a doctor to diagnose that you have a disability situation. In other words, you’ll need a doctor to examine you and determine that you’ll need some downtime, during which you can hopefully recover and eventually return to work.

How Much Money Can You Get Through Lost Time Benefits?

If you want to know how much of your regular wages you can get if you’re eligible for lost time benefits, that depends on your plan’s details. You can recover two-thirds of your pre-injury salary in some cases. You can’t usually get the full amount you’d typically receive if you were healthy and working, so don’t expect that if you’re pursuing one of these claims.

You probably won’t want to hear that you’ll only get two-thirds of your pre-injury salary or less, but that’s better than nothing. You may have to live frugally until you recover, though.

Are Lost Time Benefits Like Total Disability?

Lost time benefits might sound like total disability, but they’re not quite the same. If you apply for total disability, you have to contact the federal government and not your employer. With lost time benefits, your employer’s policy pays you money while you recover, assuming a doctor agrees that you can’t immediately return to work.

Also, with full disability, the Social Security Administration determines that you probably can’t ever return to work because of a serious injury or illness. With lost time benefits, the plan pays you, and your employer assumes that you can eventually return to work.

It can take weeks or months, but your doctor generally says in those instances that you’ll return to work at your old job. The money can keep your household going until you reach that point.

What Should You Do if You Can’t Get Lost Time Benefits?

Let’s say you pay into your employer’s insurance plan every week. That’s probably optional, but if your workplace offers insurance, you likely want it.

If you hurt yourself while on the job and you see a doctor, the plan should give you lost time benefits, assuming you’re paid up with your employer’s insurance plan and the doctor agrees you can’t currently work. However, you might have a situation sometimes where the insurance company doesn’t want to pay out your claim.

Insurance companies are for-profit businesses. They want to keep as much money as possible, which is why they’ll sometimes dispute a lost-time benefits claim if they think they can get away with it. They have mercenary dispositions in that way. They might think about profits before people.

If that happens, you may need to find a lawyer who knows about this kind of thing and pursue legal action against the insurance provider. You may have to see an additional doctor that the insurance company stipulates before they’ll pay your claim. You might have to take them to court with your lawyer and try to establish that you have a legitimate case.

Often, if you get a good lawyer who knows about this kind of situation, you can get the lost time benefits you deserve. You might not want to go through this whole process, but if you’re dealing with a stubborn insurance company, you may have no alternative.

Any time you can sign up for a workplace healthcare plan with lost time benefits as part of it, you should do that. You may not want to pay money from your weekly paycheck for that plan, but you never know if you might injure yourself on the job.

If you ever do, you’ll appreciate having this fallback option. You’ll feel grateful when the lost time benefits kick in, and you can keep feeding your family until you’re functional again.  

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