Labor Code 4656 104-Week TD Cap

What the Cap Means

Temporary disability is not open ended in many claims. The law can limit the number of weeks paid. The cap issue often appears after a worker has been off work for a long time.

The worker should not rely only on the adjuster’s count. Payment weeks should be checked against the actual checks and doctor notes.

The cap does not mean treatment must stop. It is a wage replacement issue. Medical care may involve different rules.

What to Check

Start with the first temporary disability payment. List each period paid. Count weeks carefully. Do not count a week unless it was actually paid or clearly included in a payment notice.

Compare the payment list with doctor notes. The doctor note should show whether the worker was off work or had restrictions for that period.

If the carrier says the cap is used up, ask for its payment printout. Compare that printout with your log.

Records That Help

Save pay stubs, time sheets, schedules, work-status notes, and every payment notice. Keep a copy of each check stub if one is provided.

Make a payment log. List the period paid, the amount, and the date the check arrived. Mark missing weeks. Mark short checks.

Ask for the calculation in writing. A written rate explanation is easier to compare with wage records than a phone summary.

Questions to Ask

Ask what wage period was used. Ask whether overtime or other earnings were included. Ask what doctor note supports the payment period.

If a check stops, ask for the stop reason in writing. The answer may involve a doctor note, a cap, a return-to-work offer, or a dispute about the injury.

Bring the wage file and payment log to any consultation. Those records help show the problem quickly.

Common Problems

Common problems include counting the wrong weeks, missing gaps, treating partial weeks incorrectly, or confusing medical treatment time with paid disability time.

Another problem is a stop notice with no clear payment history. The worker should ask for the records behind the stop.

When the Record Is Incomplete

Sometimes the worker does not have every check stub or every doctor note. Start with what is available. Then ask the claims administrator for the missing payment history.

If the employer has the wage records, ask for copies. If the worker has direct deposit, bank entries can help show when payments arrived, but they do not replace the carrier's calculation.

Do not mix regular wages with disability checks. Keep them in separate lists. Regular wages show what the worker earned before or during modified duty. Disability checks show what the claim paid.

If the worker returned to modified duty, save the offer, schedule, and pay records. A return to work can change the disability analysis.

If the worker later went back off work, save the new doctor note. A new work-status period should be tied to a medical record.

The goal is a clean timeline. A clean timeline helps show whether the dispute is about wages, dates, the cap, or the medical work status.

What a Lawyer Checks

A lawyer checks the wage base, the doctor notes, the payment periods, and the carrier's written explanation. The review also looks for missing weeks, wrong dates, and notices that do not match the checks.

If the math is wrong, the next step may be a request for correction, a benefit printout, or a WCAB filing. The right step depends on the records.

Bring every payment notice you have.

Small date errors can change the cap count.