No one—including the insurer, the insurer’s examiner, or your employer—can tell you that you must return to work. This decision is up to you and should be made carefully after discussions with your doctor. The only exception to this rule is if the Department of Industrial Accidents orders an impartial physician and he or she determines that you are capable of returning to work. A report by an impartial physician is crucial to your claim because he or she has the authority to determine the extent of your injury or illness and your right to continued compensation.
Once you do return to work, you are provided a trial period of 28 calendar days to make sure that you are fully capable of meeting all of your job responsibilities. If you find that you are not able to continue working, you must give your employer and the insurer notice within 21 days thereafter. If you appropriately report your inability to continue work, your benefits will begin again without you having to file a new claim. If the insurance company does not reinstate your compensation, they will face severe penalties under the law.
If your condition worsens after you return to work, it must be determined if your worsened condition is due to natural deterioration associated with your original injury (tied to original claim) or if the injury was aggravated by a new incident (requires new and separate claim). If you suffer an aggravated or new injury, you will most likely receive limited benefits. In this complicated situation, a lawyer with workers’ compensation expertise should be sought out immediately for advice.
If you are able to return to work, but you are not able to earn as much money as you did prior to the injury based on lingering pain or disability, you are eligible for partial incapacity compensation. If you were injured on or after December 23, 1991, your partial compensation rate is calculated by subtracting your new average weekly wage from your old average weekly wage and multiplying by 60%. So, partial compensation for a person injured on or after December 23, 1991, would be ($600-$300)60% = $180. An additional limitation states that partial incapacity benefits cannot be more than 75% of the employee’s total compensation. So, if an employee’s total compensation rate is $500, and 60% of the difference between the old average and the new average results is more than $375 (75% of $500), then the maximum amount received in partial compensation is $375.
If you are able to return to work but you are left with a permanent loss of function or a scar as a result of your injury or illness, you are eligible for specific compensation benefits. These benefits cover the total and partial loss of bodily functions or senses as well as scarring to the face, neck, or hands. Receiving specific compensation payments does not settle your claim and you maintain the right to receive weekly benefits and payment for medical expenses.
In some instances, an injured worker may be cleared for light duty only when their only experience is in heavy employment. For situations like this, it is important that every injured worker who has been incapacitated for any significant period of time meet with a counselor from the Department of Industrial Accidents’ Office of Education and Vocational Rehabilitation. These counselors can decide if you are in need of vocational rehabilitation assistance and direct you to the appropriate agencies or authorities. However, because these counselors are so busy, the decision regarding rehabilitation should first be made in consultation with your workers’ compensation lawyer after reviewing all relevant factors. If an Office of Education and Vocational Rehabilitation counselor contacts you, you must cooperate with them or your benefits can be reduced by 15% per week for the entire duration of your claim.