First Quarter 2018
By: Tracy Thompson
Question: In an otherwise compensable claim, when does an employer have to pay for pre-surgical testing/treatment and pay TTD benefits while such testing/treatment occurs?
Short Answer: Employers in Indiana are required to pay for pre-surgical testing and treatment expenses. Pre-surgical testing and treatment has no bearing on the payment of TTD benefits. The employer must pay TTD starting on the eighth day of disability regardless of the employee’s treatment status.
Discussion: In Indiana, if a claim is determined to be compensable the employer must pay for all related medical treatment until the employee reaches maximum medical improvement. This includes any pre-surgical testing or treatment. However, under IC §22-3-3-4, the employer chooses the treating physician, not the employee. Treatment must be authorized by the employer, although there are limited circumstances in which an employee may seek unauthorized treatment, such as in an emergency or if the employer fails to provide treatment.
As for TTD, the Indiana Worker’s Compensation Act provides that compensation for TTD can begin on the eighth day of disability after an injury. Under I.C. §22-3-3-7, the first seven days are only compensable if the disability continues for longer than twenty-one days. TTD must be paid to the employee if the employee cannot work due to the employee’s disability regardless of whether the employee is testing or treating for the employee’s injury at the time.
Practice Tip: If a claim is determined to be compensable, we recommend that an employer pay all medical bills for authorized treatment, including pre-surgical testing or treatment, in a timely manner up until the plaintiff reaches maximum medical improvement. If there is a question on compensability, the employer should still pay any outstanding bills for care authorized by the employer. Additionally, TTD should be paid to an employee starting on their eighth day of disability, regardless of the employee’s treatment status or if they need to undergo pre-surgical testing/treatment.