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Getting a severe injury while working can become a complex legal process that people must assess immediately. Injured workers can file a 'Workers' Compensation Claim' and get the appropriate medical assistance and after-care without spending their money.
In most cases, the victim's doctor or medical expert is responsible for telling them when they can go back to work. However, there may be some cases in which the injured employee may still not feel ready to go back after a work-related injury.
It's vital to note that an injured worker may not return to perform their job duties if they still don't feel fully recovered. In these cases, the person must seek help from a workers' compensation lawyer immediately. Experienced workers' compensation attorneys can help the injured worker find a second opinion so that they can recover from their workplace injury more efficiently and go back to their former job duties, if possible.
The following article covers the workers' compensation benefits and what injured workers can do when they feel they can't go back to their job duties yet.
What Is a Workers' Compensation Claim?
Workers' compensation is a system that pays money to people who got an on-the-job injury or became disabled while they were working due to an accident. Overall, it's an insurance type that people are entitled to get in case they suffer from an accident as a result of their employment.
It's vital to note that people who get workers comp insurance waive the right to sue their employer after a workplace injury. Typically, workers' comp offers partial or total coverage for medical fees, although some cases may also cover lost wages, physical therapy, and other factors.
In essence, a workers' compensation attorney is going to work toward getting their client as much coverage from the insurance company as possible, especially in cases of total disability. A workers' comp claim may vary depending on the work injury, so the victim needs to assess all the information as soon as possible with their workers' comp attorney.
How Can Injured Workers Benefit from Workers' Compensation?
Specifically, workers' compensation can pay for workplace injuries immediately. Some of the most common cases involving receiving workers compensation benefits include the following:
Medical fees
Temporary total disability benefits
Temporary partial disability benefits
Permanent partial disability benefits
Permanent total disability benefits
Fatality coverage
Medical Coverage
This is the most common case that a workers' compensation lawyer works with. Here, workers' compensation benefits cover 100% of medical costs for the victim. Moreover, the insurance company coverage also pays cash benefits for any lost work time after seven days.
Temporary Disability
There are two types of temporary disability: partial and total. In the case of partial disability, the victim may return to work at less than a pre-injury wage. However, people who suffer from total disability get paid when the accident temporarily prevents them from returning to work at all. Still, most people who suffer from physical limitations due to a work accident recover fully after some time.
Permanent Disability
Permanent disability is a bit more complex to discuss since it may involve irreversible damage to the person. If the person gets a permanent injury that leaves them with some impairments even after they've reached maximum medical improvement, they may be eligible to receive workers' compensation benefits.
Fatalities
If the person dies after the workplace accident, a workers' comp program may also pay death benefits. These benefits include burial and funeral expenses, as well as some cash benefits for the person's family. If the victim didn't have any family or dependents, the benefits only cover funeral and burial fees.
Who Decides If the Person Is Ready to Go Back to Work?
Perhaps you cannot go back to work because you are hurt—but who decides if you are ready?
As mentioned before, the person responsible for determining if the victim is ready to return to their previous job duties is the independent medical examiner or the person's own doctor.
In most cases, the insurance company is going to try its best so that the victim gets back to work as soon as possible. However, they may not return until the doctor decides they've recovered enough.
In some cases, the victim may be able to return to work before reaching maximum medical improvement, which is when the doctor concludes the patient is not going to improve further with treatment.
Getting Released
Overall, the victim may work with light or modified duty or work with no restrictions. It's important to note that insurance companies are allowed to review the victim's medical records, meaning they may try to contact their physician and question their treatment in an effort to get them released sooner.
If the company's HR department or insurance company is pushing too much to get the victim released, they may try to request an independent medical examination to get a second opinion on the person's current status.
On the other hand, it's vital to note that an employer may not force the victim to get back to work until they're medically released. If they engage in that behavior, they may be violating the state's workers' comp law.
What If the Victim Doesn't Want to Return to Work After Reaching Maximum Medical Improvement?
In some particular cases, the victim may not feel ready to even perform limited job duties after the doctor cleared them off to do so. Unfortunately, if the doctor decided to release the person to work, the victim has limited options to go through.
Typically, if the person refuses to go back to work, the insurance carrier may decide to stop paying compensation benefits and close the case. Moreover, if the victim fails to report to duty on the set date by the doctor, they may risk losing their job since the employer may take it as abandonment.
While the person has the right to request a second opinion, they may have to pay for that consultation. In these cases, the best thing to do is contact a workers' compensation attorney to assess all the available options.
Can Someone Get Fired After Getting a Job-Related Injury?
In most states, it's illegal to fire an injured person in retaliation for filing a workers' comp claim. However, an employer may be entitled to legally fire an employee after they got injured, under particular circumstances.
If the person refuses to go return to work after the doctor decided they're able to go back, the employer is legally allowed to fire them; this is known as being fired for cause.
On the other hand, if the injury causes financial pressure or general hardship for the company, the employer may also be able to fire the person. In these cases, however, the victim may still receive workers' comp benefits until they are cleared to return to work.
As long as the victim wasn't fired for cause, they may also get unemployment insurance coverage while they look for another job. It's also important to note that the employee may cover the victim's work restrictions according to the company's availability.
Legally speaking, an employer may not be required to keep the victim in the company if they can't perform their previous work duties (even if it involves light-duty work) or if there isn't any other job available for them.
Timeline of a Work Injury and Getting Workers' Compensation Benefits
While most work injuries follow a slightly different scenario, here's a general timeline these accidents may follow:
Accident: It may be either a traumatic accident or an occupational illness.
Initial Diagnosis/Treatment: Depending on the case, it may involve studies and tests to assess the person's condition. In severe cases, it may involve emergency injury care.
Notification to the Company: The employer gets a notification regarding the time, place, and conditions surrounding the injury. This must happen as soon as possible.
Filling Out a Workers' Comp Claim: The victim may talk to someone in a law office to file this claim before the state-mandated deadline. Otherwise, the claim could get rejected immediately.
Follow-Up Treatment: Here, the person gets a final evaluation to determine whether the person can return to work with medical restrictions or not. It's vital to note that someone with temporary or permanent total injuries may not be released.
Once all of these events happen, there may be two outcomes, which involve the following:
Release with Work Restrictions: The victim may be able to return to work under light-duty or seated-only duties. In other cases, the victim may be able to work for a shorter amount of time.
MMI: Here, the doctor decides that the victim may not improve further with treatment, meaning they can determine the person may be able to return to work with no restrictions or if they ended up with a permanent disability.
Following an Appropriate Return to Work Plan
Not all injuries may involve an instant transition to going back to work. Generally, the employer and employee must work together with a return to work policy so that the victim may return to work smoothly and safely, whether that's with or without work restrictions.
It's vital to note that a return to work plan may only apply if the victim's injuries aren't work-related. These plans are applicable for those who suffered a disability from a job injury, and they may include a few work restrictions. The goal of a return to work strategy is for the person to keep being a productive employee.
Generally speaking, a return to work plan may include several factors. First, it must have a written note describing confirmation that the employer understands the victim's injuries and that those may involve some physical limitations.
Moreover, the policy must include reasonable accommodations for workers returning to a particular position. These accommodations must ensure that the person doesn't experience unnecessary discomfort or pain while working.
Here, there must be open and transparent communication between the victim, the employer, and the physician so that every part of the process gets done smoothly. Moreover, if the victim is working with a workers' comp attorney, they may include them in this plan.
In order to ensure safe vocational rehabilitation, the victim must follow the work restrictions ordered. Some people may try to perform duties that they haven't been cleared off for, or they may try working longer hours.
If the doctor clears the person to work with some restrictions that place them in a lower-paying position, workers' compensation benefits may be able to pay a portion of the pay difference unless the person refuses to accept the new position.
Finally, the victim needs to notify their employee when they're cleared to work so that they can close the claim. If the person doesn't send the notification and keeps receiving benefits, they may have to reimburse the insurance company for overpayments.
What Happens if There's No Available Job for the Victim?
In the case the employer doesn't have an adequate job position to give the injured person right away, workers' comp may still pay for benefits until they get fully recovered. However, some insurance carriers may decide not to pay benefits if the person stays home.
Typically, employers may find anything to accommodate the victim's needs. If they find something for the person to work with, and they refuse, the employer may be able to terminate their benefits. These situations can be complicated, which is why the victim needs to talk to a Columbus workers compensation lawyer to clear the issue as soon as possible.
Why Would Someone Need a Workers' Compensation Lawyer? | Bottom Line
Experiencing an injury at work can be devastating for some people, especially for those who work with employers that aren't prepared for these situations. If the employer doesn't have an appropriate position for the victim, a workers' compensation return policy may be applicable.
While workers' compensation may be excellent, some insurance companies don't care about what the victim wants or not; they may only want to stop paying the benefits. In these cases, the victim must contact an attorney immediately through a reputable law firm.
An attorney that can develop a great attorney-client relationship may be able to provide the victim with all the assessments they may need through these hard times. Moreover, they can do their best to ensure they get as much compensation as possible from insurance carriers.
In these cases, the Larrimer & Larrimer firm in Columbus, OH, is full of experienced lawyers that may help accident victims get the compensation they deserve. Those who want further information may request a free consultation from the legal experts in this law office.
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