If you’ve suffered a work injury, one of the first questions you probably have is, “What will happen if I cannot do my job again?” Here are the answers. Although we have written about this issue before, it is such a common question – and the answers are complex enough – that this information bears repeating.
In Wisconsin worker’s compensation, medical restrictions and whether you have reached a medical healing plateau are key. Those two things – restrictions and whether you have finished healing – determine what happens if you cannot do your job again. Let’s discuss each in turn and how they interact.
How Medical Restrictions Can Play Out
After a serious injury on the job, you should seek medical attention and report the injury to your employer. If appropriate, your medical provider will give you temporary restrictions which you will then report to your employer. It is your employer’s duty, according to Wisconsin worker’s compensation law, to provide work within those medical restrictions if it can. Your employer does not have to make up a job for you or create undue hardship for itself, but if it is able to accommodate the temporary restrictions, it should.
Worker’s Compensation May Subsidize a Lower Wage Job Accommodation
If your employer provides alternative work but you earn less in the new role than before the injury, the worker’s compensation insurance carrier must pay you 2/3 of the difference in your wages. For example, if you made $30/hour driving a forklift before an injury, then broke your arm and moved to a desk job where you made $15/hour, worker’s compensation insurance would pay you an additional $10/hour (2/3 of the $15 difference).
Worker’s Compensation May Pay Benefits if Employer Cannot Accommodate Your Injury
If your employer does not accommodate your restrictions, or if it says it will accommodate your restrictions but the work ends up being outside of your restrictions, you are entitled to remain off work and the worker’s comp carrier must pay you temporary total disability (TTD) benefits, which is 2/3 of your gross wages previous to the injury. For example, if you made $6,000/month as a carpenter before an injury, worker’s compensation insurance would pay you $4,000/month during the period you are unable to work. You are free to find other work within your restrictions temporarily, but you must report such earnings to the worker’s compensation carrier and those earnings may reduce the TTD benefits that you receive.
Workers Do Not Receive Benefits for Denied Workers Comp Claims
What happens if the worker’s compensation carrier denies your claim? Most of the time, if your employer was accommodating your temporary restrictions, it will cease doing that. You will then find yourself off work, still seeking medical treatment and disabled, and the worker’s comp carrier will not be paying you TTD because it has denied your claim. If you are in this situation, contact us right away. If your worker’s compensation carrier has unjustly denied your claim, you will need to thoroughly build a case and begin the appeals process, which takes some time to carry out. Quality representation by a skilled worker’s compensation attorney will be important.
However, even with skilled representation and a strong case, there is often little or nothing that an attorney can do to get the denial reversed right away, or to get TTD benefits to recommence quickly. You are likely to go through a very difficult time financially unless you have sufficient savings to get you through an extended period without income. The best thing you can do is either:
- Continue seeking and following medical treatment according to doctors orders, and try to find a temporary part-time job within your restrictions, or
- Apply for unemployment benefits in order to make ends meet.
Either pathway can be a tough road. If you do eventually win an appeal claim, you may win retroactive benefits. In the meantime, we understand how hard it is, which is why we help guide our clients through this process.
When the Period of Healing Ends
The real test comes after “end of healing” has been reached, as determined by your doctor. This is the point where a doctor believes you are “as good as you’re going to get,” and any lingering injury, disability, weaknesses, etc. are permanent. If appropriate, your doctor will provide you with permanent restrictions, reflecting what you are able and unable to do. Similar to temporary restrictions, you report the permanent restrictions to your employer and the employer must decide whether they will accommodate the restrictions long-term, even if the worker’s compensation carrier has denied the claim. Again, your employer does not have to make up a job or create undue hardship for itself, but it should bring you back to work if it can accommodate the permanent restrictions.
If you sustain more than a 10% or 15% post-injury wage loss – whether that is because your employer does not accommodate your restrictions at all and terminates you, or because they cut your pay – you may be entitled to vocational retraining (schooling) benefits or loss of earning capacity benefits. Employers have 60 days after being provided with permanent restrictions to decide whether or not to accommodate permanent restrictions.
Contact Hawks Quindel right away if your employer does not accommodate your permanent restrictions, or if your permanent restrictions cause a wage loss or prevent you from doing your old job. Retraining and loss of earning capacity benefits are usually not conceded by the worker’s comp carrier, and you will need an experienced worker’s comp attorney to get these benefits and guide you in the process.