Fowler v. Vista Care: How an Employee’s TTD Rating Can Affect Workers’ Compensation Benefits

Charlotte Workers’ Compensation lawyers understand that your Temporary Total Disability (TTD) rating can have a major impact on the amount of benefits you receive after being injured on the job.

surgeon.jpgIn Sherrie Fowler v. Vista Care and Emergency Home Insurance, the Supreme Court of the State of New Mexico ruled on the issue of whether state statutes imposed a limit on TTD benefits.

In Fowler, the appellant, Sherrie Fowler, injured her back on the job while working for Vista Care. As a result of her injuries, she had back surgery in 2003. After three years of treatment, a doctor determined that she reached maximum medical improvement (MMI). In Charlotte, the applicable MMI is set pursuant to Chapter 97 of the North Carolina Code (Workers’ Compensation Act). Basically a workers’ compensation claimant reaches his or her MMI when a doctor reports that everything feasible has been done to treat the employee’s injury. It does not mean that the patient is no longer experiencing pain or that the injury has fully healed. It just means that in the doctor’s opinion, there is no point in further treatment, because it won’t improve the patient’s condition. In other words, the employee has received the maximum level of benefits allowable under a TTD rating and cannot receive any further benefits unless he or she qualifies for a permanent disability.

In Fowler, after the appellant had reached her MMI limit, she applied for a lump-sum payment under the Partial Permanent Disability (PPD) statute.

Her application was approved by the Workers’ Compensation Administration (WCA) and she resumed treatment. Soon after, her doctor determined that her back injury had progressed and that she needed a second surgery. Fowler filed a complaint to the WCA to have her TTD rating increased to cover the cost of the surgery. Her employer agreed to pay for the surgery, but her employer’s insurance company claimed that her current back injury was not related to the original on-the-job injury and refused to pay. This case went before an administrative law judge to determine if Fowler was entitled to have her TTD rating reinstated and, if so, if her TTD benefits were subject to a duration limit. The administrative law judge found that the benefits were not subject to a durations limit. The appellee filed an appeal with the Court of Appeals, which agreed with the workers’ compensation administrative judge’s finding. This case was then appealed to the state Supreme Court, which further affirmed that TTD benefits were not subject to a duration limit under state law.

In North Carolina, workers’ compensation cases are technical and complex. You should contact an attorney who regularly handles these types of case to discuss your particular situation. Even if your employer is on your side, as if often the case, its workers’ compensation insurance company may be more concerned with its bottom line than your well being.

If you have been injured at work in North Carolina, contact the Lee Law Offices at 800-887-1965.

Additional Resources:

Fowler v. Vista Care and Emergency Home Insurance June 5, 2014, Supreme Court of the State of New Mexico
More Blog Entries:

Burley v. U.S. Foods – The Commission Isn’t Always Right, June 14, 2014, Charlotte Workers’ Compensation Lawyer Blog

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