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The workers’ compensation system is designed to help workers make ends meet if they get injured on the job and need medical care or rest from work. As long as you report your injury to your boss promptly, you should be entitled to benefits. Workers’ compensation provides retroactive benefits for wage replacement as well.
However, you might wonder how long you can continue to collect workers’ comp benefits, or what happens if you lose your job while on benefits.
Understanding the rules of workers’ compensation can help you know what to expect. In this article, we’ll explain how workers’ compensation works, how long benefits last, and what happens if you’re terminated while on benefits.
How Does Workers’ Compensation Work?
Nearly 3 million workplace injuries are reported across the U.S. each year. Many of these incidents result in severe disability or even death. In Pennsylvania, the law requires all companies to have workers’ compensation insurance in place for their employees.
To qualify for workers’ comp, you must report your injury to your employer as soon as possible. It’s important to report any work-related injury, no matter how minor it might seem to you. After reporting, your employer and its insurance company have 21 days to accept or deny your claim.
Types of Workers’ Compensation Benefits
The worker’s comp system offers several types of benefits. Depending on the severity of your injury, you may be eligible for all or some of these benefits.
1. Medical Benefits
These cover treatment-related expenses. They include doctor visits, hospital stays, medical tests, medications, physical therapy, and travel to appointments. The cost of modifying your car to accommodate your injury may also be covered.
Usually, you’ll need to see a company-approved doctor for the first 90 days of your treatment. You may be able to switch doctors after that.
2. Lost Wage Benefits
If your injury causes you to miss work, you may be eligible for wage replacement benefits. These benefits generally amount to two-thirds of your average weekly wage before the injury. In some cases, you could receive as much as 90% of your pre-injury wage.
While medical benefits begin immediately, you can only claim wage loss benefits after missing seven days of work. However, with workers’ compensation, you’ll be paid for the initial seven days you missed work once your claim has been approved.
Before receiving the benefits, you’ll need to provide medical proof of your injury and condition.
3. Specific Loss Benefits
You might be eligible for specific benefits if you permanently lose a certain ability or function. This could be something like loss of hearing, vision, or a body part. With specific loss benefits, you may be paid in a lump sum.
4. Death Benefits
If a worker dies due to a work-related injury, their family may be eligible for some benefits. This includes coverage of funeral expenses and compensation for lost income.
How Long Can You Receive Workers’ Comp?
The duration of workers’ comp benefits generally depends on the severity of your injury. To some extent, your action can affect the length of your benefits payment.
How Long Can You Receive Medical Benefits Under Workers’ Comp?
There is no time limit for medical benefits under the workers’ comp. You can continue receiving benefits as long as you need treatment. However, if your doctor determines that you have reached the maximum medical improvement (MMI), your benefits may be reduced.
The MMI is the point at which the doctor determines that no further treatment will improve your condition. At this point, your benefits may focus on pain management, which could continue for the rest of your life.
How Long Do Workers’ Comp Wage Loss Benefits Last?
The length of time you can collect wage loss benefits depends on the type of your disability. There are three major disability classifications in workers’ comp.
- Temporary Total Disability: This is a situation where you’re unable to work for a limited time but are expected to recover and resume your normal job duties. In this case, you can receive wage loss benefits for up to 90 days.
- Permanent Partial Disability: This is a situation where you cannot return to your previous job but can still work with restrictions. In this case, you can collect partial wage loss benefits for up to 500 weeks, or about nine and a half years.
- Permanent Total Disability: This is a situation where the doctor determines that you can never work again in any capacity. In this case, you can collect wage loss benefits for life.
What Happens If You’re Fired While on Workers’ Comp?
As unfair as it may seem, you can actually be terminated while on workers’ comp benefits. In at-will states like Pennsylvania, your company can end your employment at any time, with or without a reason.
However, being fired doesn’t usually affect your workers’ comp benefits. You’re entitled to these benefits because you were injured on the job, not because you’re currently employed. Therefore, you should continue to receive the benefits as long as you still need assistance due to your injury.
Keep in mind, however, that if your doctor clears you to return to work and you refuse, your benefits will be stopped. Note that workers’ comp is meant to support injured workers while they recover. This means that if you can work and choose not to, you would be seen as abusing the system, and your benefits would be revoked.
Challenges with Workers’ Comp Claims
While the workers’ comp is supposed to help you make ends meet while recovering from your workplace injury, employers and their insurance companies are never comfortable paying these benefits. This is especially true where the duration of the benefits could be too long, as in the case of a permanent total disability. As a result, they can try to deny or discount your benefits before it’s time.
For example, they might have their appointed doctor declare that you’re ready to return to work when you don’t feel ready. They may also argue that your injury didn’t happen at work, or you’re responsible for the injury.
Seek Legal Guidance to Protect Your Rights
Although the workers’ comp should cover your medical expenses and lost earnings if you’re hurt on the job, securing the benefits you deserve isn’t always easy. For example, there are things that your company and its insurer may not fully explain to you, which can result in unfair decisions.
To protect your rights, consider speaking with an experienced workers’ compensation lawyer. The lawyer will guide you through the claim process, help you obtain the benefits you deserve, defend your rights if you’re fired or your benefits are unfairly discontinued.
