What happens when workers’ comp ends before you’re better?

Workers’ compensation is a crucial lifeline for those who get hurt on the job or develop a medical condition due to work. Workers can count on receiving 100% coverage for necessary medical care and the partial replacement of their wages through disability benefits for as long as their medical condition affects their ability to work.

Short-term disability benefits can help you if you will be able to quickly recover and go back to work within a few months. There are also permanent disability benefits for both those with the total inability to work and those who have limited job function because of the permanent consequences of an injury.

Most of the time, workers, their employers and the doctor overseeing their care are in agreement about when a worker is ready to return to work. What happens when you aren’t ready to go back but the doctor says you are?

You may need to provide details about your job responsibilities

Typically, there should be open communication between you, your employer and the medical care provider overseeing your treatment. That should mean that the doctor understands the physical demands of your job.

In some cases, due to assumptions or improper communication, a doctor might believe a patient can return to work because they don’t understand the actual physical mechanics that their position requires.

You may need to dispute the decision

When the insurance company ends your benefits because they deem you fit to return to work, you can dispute their decision. You can send a letter advising them that you disagree and asking for reconsideration. You will have 20 days to send the letter if you have an attorney representing you and 30 days if you do not have legal representation.

You may need to request a second opinion

In situations where the doctor doesn’t believe your self-reported symptoms or seems to think that you should work through significant levels of pain, it may be time for you to talk to a different physician. You have the right to ask for a second and even a third opinion about the care you receive. 

Your employer may need to adjust your job

Sometimes, especially if you will have persistent pain or lasting limitations due to a work acquired medical condition, you need different job responsibilities or other accommodations. You may need to ask your employer for support to get back to work.

Learning more about your rights as a workers’ compensation claimant can help you navigate this complex benefit system more easily.