When workers’ comp wants to end benefits but you aren’t better


Getting hurt on the job can mean that you aren’t able to keep working until you recover. You may require surgery, physical therapy or other expensive medical care. Beyond that, the time off of work can also have a substantial financial impact.

Workers’ compensation benefits will cover your treatments and some of the wages you don’t earn until you can get back on the job. However, some workers find themselves in the awkward situation where their employer or the insurance administrator overseeing the claim wants them back on the job before they feel capable of returning to work.

What are your options when the insurance company wants you back at work but you don’t feel physically up to it yet?

Talk openly with your physician about your concerns

The doctor overseeing your workers’ compensation claims should have frequent communication with the insurance provider or your employer, in addition to communicating with you.

If you downplay or don’t acknowledge your symptoms during treatment, they may overestimate the speed of your recovery. Talking to your doctor about how you respond to treatment and the symptoms you continue to experience in your day-to-day life will help ensure that their records match your experience.

Ask to see a qualified medical evaluator

It isn’t that unusual for an individual beneficiary and the insurance company to disagree with when is the best time to go back to work. The state of California already has a system in place to address such disputes. They certify qualified medical evaluators (QMEs) for this exact reason.

These specialized medical professionals can perform an in-depth examination to determine the extent of the impact that an injury has on an individual. Seeing a QME can help establish that your complaints are valid and that it is not yet time for you to go back to work.

Ask for accommodations from your employer

If your employer, your doctor or the insurance company wants you back on the job while you still have some symptoms, you have the right to ask for support. Accommodations ranging from differing job responsibilities to assistive technology can make it easier for you to get back to work after an injury.

Dealing with the disagreement with the insurance company or your employer can put a lot of extra pressure on you at a time when you already feel bad enough stress. Having adequate support while navigating a complex workers’ compensation claim frees up your mental energy to focus on your recovery instead of paperwork and red tape.

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