Washington, DC's system of workers' compensation is compulsory, meaning that employers are required to provide workers' compensation insurance to their employees. Workers' compensation insurance may be provided through private insurance carriers or self-insurance. Waivers are not permitted.
Exemptions from coverage may apply to certain employees, including domestic employees.
Medical Benefits are provided to employees entitled to workers' compensation benefits, with no limit on necessary medical care.
The employee makes the initial choice of treating physician. The mayor may order a change of doctor.
Indemnity benefits are payable to injured workers to help make up for lost income. There is a waiting period of 3 days before a worker is eligible for indemnity benefits, but if the worker's disability lasts more than 14 days indemnity benefits become retroactive to the date of the injury.
Benefits available to injured workers include the following:
Temporary Total Disability (TTD)
Temporary total disability (TTD) benefits are paid to workers who are unable to work due to injury, but who are expected to make full or partial recovery such that they may return to work. Benefits are based upon 2/3 of the worker's average weekly wage, subject to a cap, and continue for up to 500 weeks with the worker eligible to petition for an additional 167 weeks of benefits.
Permanent Total Disability (PTD)
When a worker is not expected to recover from a total disability caused by a work-related injury, and as a result suffers a total loss of earning capacity, the worker becomes eligible for permanent total disability (PTD) benefits. In the District of Columbia, PTD benefits are calculated based upon 2/3 of the injured worker's pre-injury weekly wage, subject to a cap, and may continue for 500 weeks, with the worker eligible to petition for up to another 167 weeks of benefits. Benefits are periodically adjusted for inflation.
Permanent Partial Disability (PPD)
Once an injured worker has recovered to the maximum possible extent, the worker may be able to return to employment but nonetheless remain partially disabled, and may potentially qualify for permanent partial disability (PPD) benefits. In the District of Columbia PPD benefits are determined based on a statutory schedule and 2/3 of the injured worker's average weekly wage. Unscheduled injuries may qualify for PPD benefits with a 500 week limit for all disability benefits received; the injured worker pay petition for up to an additional 167 weeks of benefits.
Temporary Partial Disability (TPD)
When a worker suffers an injury that limits his ability to return to work, resulting in a reduction of income as a result of reduced hours or wages, the injured worker may be eligible to receive a benefit based on the difference between the worker's pre-injury earnings and their reduced, post-injury earnings. In Washington, D.C., TPD benefits are paid based upon XXX of the difference between the injured worker's pre-injury and post-injury wage, subject to a cap.
For some, more serious injuries, workers' compensation indemnity benefits may be paid according to a statutory schedule, instead of following the standard model of the weekly benefit based on the duration of the disability. Scheduled injuries include such injuries as the amputation of an arm, the loss of a dominant hand, the loss of a leg, the loss of a foot, the loss of an eye, or loss of hearing in an ear.
Coverage may be available for disfigurement, and for occupational hearing loss.
When a worker dies as the result of a work-related injury, workers' compensation pays additional benefits, including a burial allowance, and benefits for a surviving spouse and dependents. Survivor benefits are calculated based on 50% of the worker's average weekly wage, subject to a cap in amount. Benefits may continue for minors until the age of 18, the age of 23 if the dependent is a student, or indefinitely in the event of disability. Spousal benefits end upon remarriage.
Attorney fees are not to exceed 20% of the benefits obtained for the injured worker.
This article provides a quick overview of the benefits available to injured workers, but the full formulas used for assessment of benefits, coordination of different types of benefits, and assessment of injuries and disability ratings can quickly complicate the determination of benefits. Also, states frequently revise their workers' compensation laws. Most workers who suffer a significant injury or wage loss as the result of a workplace injury will benefit from consulting a workers' compensation lawyer.
The state agency responsible for workers' compensation is:
District of Columbia Department of Employment Services
Labor Standards Bureau
Office of Workers' Compensation
4058 Minnesota Avenue, N.E., 3rd Floor
Washington, DC 20019