Your Workers’ Comp Case: Chapter 2 – Treatment Phase

• Jun 19, 2025
• Blog
• Michael Burgis & Associates, P.C

Welcome to Chapter 2 of our series, “Navigating Your Workers’ Comp Case with MB&A.” I’m Michael Burgis, a founding and managing attorney at Burgis Law Firm. Today, we’ll look at numerous details related to the treatment phase of your worker’s compensation case. This phase sets the stage for your recovery and makes sure you receive the medical treatment benefits you need after an industrial injury.

Transcript: 

Hi. My name is Michael Burgis. I’m the founding and managing attorney of MB&A.

Your Workers’ Comp Case Step Two: Treatment Phase

This video is to talk about Chapter 2 in your litigation path. Remember that there’s the Welcome, there’s Chapter One, which is the delays associated with getting a case set up and getting to a doctor. Chapter 2 is the treatment phase. So in workers’ compensation, this video is going to be addressing Chapter 2, which is the treatment phase.

Once your case is accepted and treating with a doctor, what does that entail? Let me be clear. Workers’ comp pays essentially a few benefits. The first one is medical treatment to get you better, in fact, to cure and relieve the effects of your industrial injuries. Then there’s compensation for temporary disability. And then once you’ve reached your maximum medical improvement, and you’re what’s called permanent and stationary, that would be Chapter 3. That’s the settlement side. But Chapter 2 is the treatment phase.

Treatment with an Insurance Company Medical Provider

Now, if the case is accepted, we are legally obligated to treat in an insurance company’s medical provider network.

Keep in mind that these doctors don’t work for me, they get paid for by the insurance company. So sometimes they are not our friends. Sometimes they’re beholden to the insurance companies. I want to make this clear. Everybody has the right to switch their primary treating physicians in the medical provider network. If you don’t like that doctor, you can switch. There is no limits to how many times you can switch.

We should make sure that you are comfortable with a primary treating physician. Hopefully that is reasonably geographically located to where you live. And again, sometimes there’s therapy, medications, injections, surgery.

You Choose Your Doctor within the Medical Provider Network

I want to be clear. I don’t tell my clients who’s a good doctor, who’s a bad doctor. Good doctors can have bad days. Bad doctors can have good days. And I don’t ever want my client saying, “Well, I had surgery with the doctor you told me and now I’m worse.” It is you and you only who decide who your primary treating physician is. And you should find one that you’re comfortable with. And if it’s a surgery that’s being done, you should be comfortable with your surgeon.

Temporary Disability

Next, that treatment phase. Temporary disability.

Accepted Case

If a doctor, your primary treating physician who’s your quarterback, says that you are totally temporary disabled and can’t work, guess what? You should receive two-thirds of your salary, subject to a max and a min.

Denied Case

If your case is denied, and a lien doctor is seeing you, and that lien doctor is certifying that you’re totally temporary disabled, again because the claim is still denied, the insurance company won’t pick up that temporary disability. But if you paid into state disability—EDD—you can collect up to a year from state disability. Again, while a doctor is certifying that you’re totally temporary disabled and cannot work.

Temporary Work Restrictions

There’s also, you can receive total temporary disability when a doctor gives you a temporary work restriction. So you can receive total temporary disability without being certified totally temporary disabled under the following circumstance.

When a doctor feels like you can work, but there are temporary work restrictions, like you have a back injury and you are temporarily precluded from lifting more than ten pounds.

Communicate with Your Employer

Now, what you need to do whenever you are… if a doctor is saying you can’t work or a doctor saying you can work with temporary work restrictions, you do need to communicate with your employer. So let me be clear about this. Chapter 2, you need to actively communicate with your employer—what is called engaging in the individual interactive process.

You shouldn’t talk to the workers’ comp insurance. That’s why you’re represented. But you should actively communicate with your ability to work with your employer.

If a doctor gives temporary work restrictions and the employer says, “You know what, we can accommodate that,” you have two options. You can go back to work under those work restrictions or you can say, I don’t want to work. But if you don’t work and they can accommodate that, you are not entitled to temporary disability.

Now, if there are temporary work restrictions and the employer says, “You know what, I can’t accommodate that right now, it’s unduly burdensome.” What that means is if the employer cannot accommodate the temporary work restrictions, you’re legally entitled to total temporary disability.

Temporary Disability Pays 104 Weeks

Again, if your case is denied, you should be able to get that through state disability, EDD. If your case is accepted, should be through the worker’s comp care. Temporary disability, they pay for 104 weeks. So it’s basically two years.

After two years It doesn’t matter if you have surgery and you’re totally temporary disabled for another ten years. Two years is the maximum they will pay, period, statutorily. Not fair, not just, but the laws are what the laws are.

Apply for EDD

Now, another important thing is if your case is denied, or even if your case is accepted, I recommend that you apply for EDD. Here’s why. If ultimately you get temporary disability, EDD won’t pay you. You can’t double dip. You can’t get temporary disability from two pots. But if you apply for EDD and then they pay you it, EDD will stop. But now you’ve reserved the money in your account.

Understand that when you pay in the EDD, that money, if you claim it and reserve it, if they do pay the remaining two years of temporary disability and you’re still temporary disabled, if you’ve reserved that money on that account, you have another year of temporary disability.

So it’s important. I do recommend you apply for state disability even if the insurance company is paying you, because if you anticipate receiving more than two years of temporary disability, you could reserve one year in EDD and get a third year of temporary disability.

Now, there will be a credit offset on your workers’ comp case, but don’t worry about that. So that’s the treatment phase and that’s temporary disability.

Denied Medical Treatment

During this phase, there’ll be a lot of denied medical treatment issues. It’s going to be frustrating. Insurance carriers don’t care. They don’t do the right thing. You know, they just minimize liability. So if there is a delay or denial of medical treatment, I have a completely separate video breaking all of that down. Watch that video.

Maximum Medical Improvement (MMI)

But assuming that you’ve had sufficient treatment and you’re at your plateau—so, sometimes a doctor might say you’re surgical, but you say, “I don’t want surgery.” Well, then you’re at your plateau. Or if surgery is not recommended and you’re at your plateau, the doctor will issue what’s called an MMI report or a PNS report. Alphabet soup here at workers’ comp.

But MMI —Maximum Medical Improvement—or what’s called permanent and stationary. Now, at that point, that doctor will address whether you’ve had a full recovery or have residual… what’s called permanent disability. Remember that the worse you are on paper medically, the more the value is on your workers’ comp case, because your compensation is based on permanent disability.

Permanent Disability

Now, a lot of my clients freak out. Well, wait a minute. I don’t want to have permanent disability. Keep in mind the phrase permanent disability is a legal abstract. It doesn’t mean anything. It’s literally to determine how much money you’re entitled to. You can Google this.

There’s money charts, typically paid at $290 per week. The greater the disability, the longer the duration of those payments. We do want to lock in the greatest amount of permanent disability because that’s the greatest compensation to you.

But understand, if a doctor said you had 10% permanent disability, doesn’t mean anything, doesn’t mean you’ve lost 10% of your functional capacity, doesn’t impact on your ability to work for this employer or the next employer. Ultimately, the doctors address work restrictions. There’s a difference between work restrictions and disability.

It is possible to have very high work restrictions and no disability, or inversely, no work restrictions and high disability. The only thing that affects your ability to work at this job, or potentially the next, is work restrictions.

Let me be clear. It is up to you to communicate with your doctors as to what you believe is your ability to work. It’s up to the doctors to determine medically what they feel you can do without further aggravating you. And it is up to your employer and you as to whether there are reasonable accommodations that you’d be able to do going forward. That is outside of my control.

Temporary Work Restrictions vs. Permanent Work Restrictions

Now, when that final report is issued, there’s a difference between temporary work restrictions and permanent work restrictions. This is going to get into Chapter 3. But I want to quickly end on telling you that when there’s a final report and that doctor is finding permanent work restrictions, if the employer can’t accommodate those permanent work restrictions, they essentially lay you off and you can collect unemployment while you look for a better job or one that can accommodate your disability. But keep in mind that you’ve got to anticipate this.

We usually like to do a plan of action where we anticipate, is this an exit claim or do you want to try to go back to work? Because I can advocate to minimize work restrictions. At the end of the day, we do a tailored custom plan for our clients as to what their goals are. And some clients are like, “I never want to go to work for this employer, this is an exit plan.” Or, “I’m going to retire. This is an exit plan.” Or, “I’d like to keep my options open.”  Or, “I love my job and I just want to get back to work.”

And sometimes I literally had to reduce the value of cases and reduce the disability, sometimes to reduce the work restrictions, to get them back to work. But at the end, we want to accomplish what you want to accomplish, right?

Conclusion: Chapter 2 – Treatment Phase

So again, this is Chapter 2. This is the treatment phase. You should get medical treatment to cure, relieve the effects of your industrial injury by a doctor of your choosing in their network.

Temporary disability. If a doctor is certifying that you can’t work, or there are temporary work restrictions the employers’ not accommodating, at the end there’s a permanent and stationary report or MMI report. If that report addresses permanent and finds permanent disability, that’s the start of Chapter 3, which is the settlement phase.

Contact Our Workers’ Compensation Law Firm

If you have any questions or concerns, we can absolutely set an in-office appointment.

But again, this was just to sort of educate you as to what to anticipate going forward. And the Chapter 3 settlement should be a ‘happily ever after’.