What Happens If You Can't Return to Work After an Injury?
June 15, 2023 · 9 min read
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Atticus offers free, high-quality workers' compensation advice to those injured at work. Our team of Stanford and Harvard trained lawyers has a combined 15+ years of legal experience, and help thousands of Americans get the benefits they deserve each year.
If you got injured on the job, it might be tempting to use a few sick days or tough it out to avoid missing work. But what happens if you can’t get back to your normal work activities even with a brief recovery window?
That’s where workers’ comp comes in. It’s designed to protect employees who get hurt on the job and almost all states require employers to have it. But getting the benefits you’re entitled to isn’t always easy. Laws vary by state and there are multiple deadlines to juggle — missing one could mean losing benefits.
To help you navigate the road ahead, let’s dig into workers’ compensation (and your options if you can’t get coverage).
What to do after a work injury
Any work injury that requires you to miss a few days of work or more could qualify you for workers’ comp, which is a type of insurance coverage you get through your job.
Workers’ comp covers offers two key benefits:
It covers medical expenses for the care you need to recover.
The key here is that workers’ comp only covers injuries that you get while working. So if you get into a car accident on your way to work, but you’re not technically on the clock yet, workers’ comp won’t cover your injury.
However, time is of the essence when it comes to workers’ comp. Depending where you live, you may need to notify your employer (including your boss or shift supervisor) within a few days of the injury. If you miss that window, you won’t qualify for benefits even if it’s a serious injury or gets worse over time and one day becomes bad enough that you need to take more time off work.
You might be tempted to “tough it out” after a workplace injury. We get that you may not want to miss work or lose a paycheck, but this isn’t an area to prove your toughness. If you’re injured and can’t work or can’t do all of your normal work, you can qualify for workers’ comp benefits (and weekly payments). You’re better off looking into workers’ comp and realizing you don’t actually need it than trying to push through only to find out later that your injury is more serious than you thought but you no longer have access to benefits because you didn’t act quickly enough.
You should get the medical care you need after your injury, but then you should notify your employer of the injury as soon as possible.
Requirements vary by state, but you generally have anywhere from a few days to a month to report your workplace injury. If you don’t notify your employer within that time, you won’t be able to file a workers’ comp claim.
The big takeaway here: Notify your employer as soon as possible after you get hurt on the job, even if it’s a minor injury. Maybe you won’t end up missing any work time, but this way you’re covering yourself in case your symptoms escalate.
As long as you notified your employer in time and your injury has already kept you out of work for some time (more on workers’ comp waiting periods here) you can file a workers' comp claim. Until you file a claim and it’s approved, you won’t get weekly benefit payments and your medical expenses won’t be reimbursed or covered by your employer’s workers’ comp insurance.
Workers’ comp will pay for the medical care you need to help you recover from your injury. Your employer may have a list of approved workers’ comp doctors but you may be able to choose your own (this varies by state).
You’ll also receive weekly payments to cover some of the wages you’re losing because you can’t work. In most states, your benefits are worth up to two-thirds of your pre-injury pay, but you can see the exact rate in this state-by-state guide to workers’ comp payments.
4. Return to work once you’ve recovered
The goal of workers’ compensation is to give you the time and money you need to recover so that you can get back to work and move on with your life. So once you’ve recovered, your benefits will expire and you can return to your job.
If you’ve recovered as much as possible but still can’t return to work, you can qualify for long-term workers’ comp benefits. There are also federal disability insurance programs that pay monthly benefits and offer free health insurance if you can’t work because of an injury or medical condition.
Long-term workers' comp benefits
If you've recovered from your injury as much as possible, meaning you've reached maximum medical improvement, but you still can't return to work, you may be eligible for long-term workers' comp benefits.
There are two main types of long-term workers' comp benefits: permanent partial disability (PPD) and permanent total disability (PTD).
How much you get and how long your PPD or PTD benefits last will depend on your impairment rating. That's determined by your treating physician and it represents your ability to work or function compared to before your injury. For example, a 50% impairment rating after a hand injury would mean you've lost half of the functioning in your hand, and a 100% rating would mean you no longer have use of your hand.
Where you live also matter here because each state sets its own payments lengths and amounts for permanent disability recipients. Injuries to central parts of your body, like your brain, spine or nervous system, are likely to pay more than injuries to your extremities, like your limbs or fingers.
If you think you're going to need long-term benefits, consider finding with a workers' comp lawyer. They can help you negotiate with your state to ensure you get payments that are worth enough to cover the cost of living and any ongoing medical care you'll need.
Do all workers qualify for workers’ comp?
If you’re a full or part-time employee and your employer takes taxes out of your paychecks then you almost definitely have access to workers’ compensation benefits. However, your injury must have happened on the job and you still need to have reported the injury in time.
If you’re an independent contractor, things are a little less clear. Contractors generally don’t qualify but there are exceptions. Some states require employers to extend workers’ comp coverage to specific seasonal workers (like farmworkers) or those in certain industries (such as transportation or construction). You’ll need to check with your state’s workers’ comp board to see if you could qualify.
Unsure whether you’re an employee or a contractor? Check your pay stubs to see if your employer is withholding income taxes. If so, workers’ comp likely covers you. Another sign you’re an employee is if you get a W-2 form during tax season.
Some employers also mischaracterize workers as contractors so even if your job title is contractor, it’s worth double-checking your state rules.
Injuries that can qualify
An injury or illness can generally qualify for workers’ comp coverage if it happened while you were doing your job, regardless of who was at fault for the accident. It could have resulted from a specific event or from exposure. Workers’ comp also applies to new injuries as well as the worsening of a pre-existing condition.
Really, the key here is less about what your injury is and more about two things: Did it happen in the course of your work duties and does it impact your ability to work moving forward?
Illness from exposure to chemicals or other harmful substances
Getting caught in work equipment
Injuries that result from years of doing a repetitive motion
What to do if your workers’ comp claim is denied
If you file a workers’ comp claim and it’s denied, it is possible to appeal the denial. At this point, you can likely benefit from talking with a workers’ comp lawyer. They will know your state’s laws, so they can help you appeal and fight for the payments or medical coverage you need so you can properly recover and get back to work.
You might benefit from working with a lawyer if your claim is denied for one of these four reasons:
Your employer mischaracterized your employment type, like by saying you’re an independent contractor even though they withhold taxes from your paychecks.
Your employer said you never reported your injury but you did (especially if you have proof).
Your employer said your injury didn’t happen on the job, especially if you have proof that it did.
Your employer offered you incentives not to file a claim.
In some cases, you might actually want an employment lawyer, not a workers’ comp lawyer. This applies if you got injured because of negligence on your employer’s part, if they threatened you or your job when you said you wanted to file a workers’ comp claim, or if they discriminated against you or even fired you because of your claim (which, by the way, is illegal).
Your options if you don’t qualify for workers’ comp
While there aren’t a lot of options if you don’t qualify for workers’ compensation, one thing to consider is disability benefits.
And if it looks like your injury will impact you for a year or longer, you could qualify for federal disability insurance programs like Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). These programs require that you’re unable to work at all and will require you to present clear medical evidence of your health condition.
If you were hurt at work and you’re having trouble making your way through the workers’ comp process, a workers’ compensation lawyer can likely help. To find out if this might be a good fit for you and to get connected to a lawyer quickly, start with our quick workers’ comp quiz. We’ll reach out to learn more about your situation and match you with a lawyer from our network. Getting matched is free, you don’t have to use our lawyers if you don’t want to, and you’ll never pay anything until after you get your benefit payments or a settlement.
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Frequently asked questions about workers’ comp
How does workers’ comp work?
The workers’ comp process starts when you report your work injury or illness to your employer. Then you have to file a claim within a certain amount of time so you can qualify for weekly payments and reimbursement of your medical bills while you recover.
Can I get workers’ comp if the injury was my fault?
Yes. You can qualify for workers’ comp no matter whose fault the injury or illness was, as long as it happened while you were doing your job. Our guide to qualifying accidents and injuries will help you see if you could get coverage.
Do all workers qualify for workers’ comp?
You're probably eligible for workers’ comp if your employer withholds taxes from your paychecks. Independent contractors don’t usually qualify, but states may offer coverage to certain contractors, volunteers, or seasonal workers. Check with your state workers’ comp board to see exactly who qualifies in your area.
Not everyone needs to work with a lawyer, but a workers’ comp lawyer can especially help if your claim is denied, if you get a settlement offer, or even if your claim just lasts for more than a few months. Here are some situations when a lawyer can help you.
No, workers’ comp benefits aren’t taxable. That's true whether you get weekly payments, a lump-sum settlement, or a settlement with a structured payment plan.
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Victoria Muñoz is an attorney on Atticus’s Workers' Compensation team. She’s a licensed attorney, a graduate of Stanford Law School, and has counseled hundreds of people seeking workers' compensation. In her free time, she enjoys hiking and spending time with her pup.
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