Temporary Disability Indemnity Payments will begin when the injured workers’ compensation claim is approved by San Joaquin County’s Third Party Administrator (TPA). The TPA will have a period of time in which to accept, deny or delay the claim. This period of time is the “Determination Period”, the claim is being reviewed, and documentation from the treating physician is being collected and/or forwarded to the TPA.
Claims involving loss time from work, workers’ compensation law requires a three day waiting period before the start of Temporary Disability Indemnity payments. If an injured worker is off work more than 7 days or requires immediate hospitalization the waiting period will be waived.
During the “Determination Period” the injured worker will have the option of using leave accruals in the following manner:
For an explanation of benefits for each increment of hours, see NOTICE OF LEAVE OF ABSENCE FOR TEMPORARY DISABILITY INDEMNITY PAYMENT (FORM 29).
Risk Management will coordinate disbursement of the Temporary Disability Indemnity payments once approved. The TPA determines the TDI amount and the period of benefits (including retro periods).
The TPA determines the amount, which is based on the Average Weekly Wage (AWW), reported by the County.
Doctor’s work status reports, and disability notes will determine the length of the workers’ compensation leave period upon approval of the TPA. In order to prevent any interruptions or benefits due the injured worker, it’s the injured worker’s responsibility to provide any and all doctor’s reports, disability, leave from work notes to their Manager/Supervisor.
Questions concerning the injured workers’ compensation benefits, contact the Risk Management Department, Workers’ Compensation Team. See Contact Information