(1) In case of temporary
total disability of more than three regular working days' duration, the employee
shall receive sixty-six and two-thirds percent of said employee's average weekly
wages so long as such disability is total, not to exceed a maximum of ninety-one
percent of the state average weekly wage per week. Except where vocational
rehabilitation is offered and accepted as provided in section 8-42-111 (3), temporary
total disability payments shall cease upon the occurrence of any of the events
enumerated in subsection (3) of this section. If vocational rehabilitation is offered
and accepted, any party may at any time terminate vocational rehabilitation upon
fourteen days' written notice to the other parties and the director. For purposes of
this section, termination of vocational rehabilitation shall be the same as if
vocational rehabilitation had never been offered and accepted, and the employer or
insurance carrier shall not be entitled to recover any temporary total disability
benefits paid during the period that vocational rehabilitation was provided.
(2) (a) The first installment of compensation shall be paid no later than the
date that liability for the claim is admitted by the insurance carrier or self-insured
employer. If the insurance carrier or self-insured employer denies liability for the
claim, the claimant may request an expedited hearing on the issue of
compensability if the application is filed within forty-five days after the date of
mailing of the notice of contest. The director shall set any such expedited matter
for hearing within forty days after the date of the application, when the issue is
liability for the disease or injury. The time schedule for such an expedited hearing is
subject to the extensions set forth in section 8-43-209. If a claimant elects not to
request an expedited hearing pursuant to this paragraph (a), the time schedule for
hearing the matter shall be as set forth in section 8-43-209. Compensation shall be
paid at least once every two weeks, except where the director determines that
payment in installments should be made at some other interval. The director may by
rule convert monthly benefit schedules to weekly or other periodic schedules.
(b) Temporary disability compensation is not due and payable for any period
of time for which the insurer or self-insured employer has requested from the
employee's attending physician verification of the employee's inability to work
resulting from the claimed injury or disease and the physician cannot verify the
employee's inability to work, unless the employee has been unable to receive
treatment for reasons beyond the employee's control. Failure of the physician to
submit such verification, through no fault of the employee, shall not affect the
payment of temporary disability compensation under this section.
(c) If an employee fails to appear at an appointment with the employee's
attending physician, the insurer or self-insured employer shall notify the employee
by certified mail that temporary disability benefits may be suspended after the
employee fails to appear at a rescheduled appointment. If the employee fails to
appear at a rescheduled appointment, the insurer or self-insured employer may,
without a prior hearing, suspend payment of temporary disability benefits to the
employee until the employee appears at a subsequent rescheduled appointment.
(d) If the insurer or self-insured employer has requested and failed to receive
from the employee's attending physician verification of the employee's inability to
work resulting from the claimed injury or disease, medical services provided by the
attending physician are not compensable until the attending physician submits
such verification.
(3) Temporary total disability benefits shall continue until the first
occurrence of any one of the following:
(a) The employee reaches maximum medical improvement;
(b) The employee returns to regular or modified employment;
(c) The attending physician gives the employee a written release to return to
regular employment; or
(d) (I) The attending physician gives the employee a written release to return
to modified employment, such employment is offered to the employee in writing,
and the employee fails to begin such employment.
(II) In the case of employment by a temporary help contracting firm, once the
employee has received one written offer of modified employment meeting the
requirements of subparagraph (III) of this paragraph (d), the employee shall be
deemed to be on notice that modified employment is available. Subsequent offers
of modified employment need not be in writing so long as the job requirements of
such modified employment are within the restrictions given the employee by the
employee's attending physician and the employee is allowed a period of at least
twenty-four hours, not including any part of a Saturday, Sunday, or legal holiday,
within which to respond to any such offer.
(III) A written offer of modified employment under subparagraph (II) of this
paragraph (d) shall clearly state:
(A) That future offers of employment need not be in writing;
(B) The policy of the temporary help contracting firm regarding how and
when employees are expected to learn of such future offers; and
(C) That benefits under this section will be terminated if an employee fails to
respond to an offer of modified employment.
(4) (a) In cases where it is determined that a temporarily disabled employee
is responsible for termination of employment, the resulting wage loss shall not be
attributable to the on-the-job injury.
(b) The claimant's refusal to accept an offer of modified employment under
either of the following conditions does not constitute responsibility for termination:
(I) The offer of modified employment would require the claimant to travel a
distance of greater than fifty miles one way more than the claimant's preinjury
commute;
(I.5) The offer of modified employment would require the claimant to drive to
or from the place of employment and an authorized treating physician has
restricted the claimant from driving; or
(II) An administrative law judge determines that the claimant's rejection of
the offer of modified employment was reasonable considering the totality of the
claimant's circumstances, including accounting for:
(A) The consequences of the industrial injury;
(B) The financial hardship that would be imposed on the claimant in order to
accept the offer of modified employment; or
(C) Any other reasons that would, in the opinion of the administrative law
judge, make it impracticable for the claimant to accept the offer of modified
employment.
(c) The circumstances described in paragraph (b) of this subsection (4) are
not exhaustive.
(5) (a) Within forty-five days after an insurer or self-insured employer
terminates an employee's temporary total disability benefits pursuant to
subsection (3)(c) of this section, the employee may file an application for an
expedited hearing on any of the following issues:
(I) Who the attending physician is;
(II) Whether the attending physician gave the employee a written release to
return to regular employment; and
(III) Whether there is a difference of opinion between authorized treating
medical providers regarding whether the employee is released to return to regular
employment.
(b) If an administrative law judge finds there is a difference of opinion as
described in subsection (5)(a)(III) of this section, the employee has the burden of
proving by a preponderance of the evidence that, as a proximate result of the
claimed injury or disease, the employee is unable to return to regular employment.
If the employee meets this burden, the administrative law judge shall reinstate the
employee's terminated temporary total disability benefits back to the date of
termination.