Workers' compensation benefits are supposed to pay for medical bills and provide wage benefits for injured workers. Once you are able to return to work, the benefits will generally stop. In some cases, you may receive partial benefits if you can only return to light work or modified work duties.

Eligibility for workers' comp benefits varies according to state law. Each state has its own process for collecting workers' compensation and what workers can do if their claim is denied. If you have questions about your workers' comp case or want a free case review, talk to an experienced workers' compensation attorney in your state for advice.

What if the Employee Returns to Work?

For workers who are injured on the job, the most common way to get medical benefits and payments is through workers' compensation insurance. State workers' compensation laws provide benefits to employees injured or disabled in a work-related injury. However, there are strict workers' comp rules and regulations that must be followed in order for you to make a workers' compensation claim to receive benefits.

If you can return to work or are cleared to work by the treating physician, your eligibility for benefits may change under the worker's compensation system. If you return to work without disclosing it, you could lose your benefits or even face workers' compensation fraud charges.

Can I Do Part-Time Work or Temporary Work?

When an injured employee is ready to return to work, they must immediately notify their state workers' compensation department. This includes any temporary work, part-time jobs, a second job as an independent contractor, or self-employment. When workers are cleared by their doctor to return to work, their temporary total disability benefits will generally stop.

Can I Return to Light Duty or Modified Work?

If a worker is injured and cannot return to their usual job, an employer may be able to offer modified job duties or an alternative position so the worker can continue working at their previous workplace. However, this change in position can come with reduced pay because it is not the same position.

In some cases, when the worker returns to a modified job or light-duty work, they may still get partial workers' comp benefits for primary jobs that don't pay as much as before the injury. When wages are less than the old job because of the ongoing job injury, they may still be eligible for continuing temporary partial disability benefits. When an employee receives wages equal to or greater than those earned prior to the accident, workers' compensation benefits are typically ended.

What Does Workers' Compensation Cover?

In general, workers' compensation is intended to cover workplace injuries that occur regardless of fault. However, because of the workers' compensation system, injured workers usually cannot file a personal injury claim against their employer for wage loss, medical expenses, or pain and suffering, except in minimal circumstances.

Workers' comp insurance may not cover some workplace injuries. For example, if a worker was injured while under the influence of alcohol or drugs, they may have their workers' comp claim denied. The state may also deny benefits if the workplace injuries were self-inflicted or caused because the employee was violating the law or company policies.

What Are the Benefits of Workers' Compensation?

Most employees who are injured on the job are entitled to benefits that are used for:

• Medical care needed because of the illness or injury
• Replacement income based on a percentage of the average weekly wage
• Costs for retraining after the injury
• Compensation for lost income following a permanent injury
• Benefits to the surviving family members in the event of a workplace death

Most people think of workers' compensation benefits after they have experienced a sudden incident on the job that has caused injury. Still, these payments are also given for occupational illnesses and injuries that are developed over a long period of time. For example, workers who develop carpal tunnel syndrome or respiratory issues from repetitive motions or prolonged exposure to certain chemicals can also apply for workers' compensation benefits.

Who Is Covered Under Workers' Compensation?

Most employees are covered under some form of workers' compensation insurance. Employers can purchase workers' compensation insurance through a private insurance company, state workers' comp coverage, or be approved for self-insured coverage.

Depending on the state, some workers are not required to have workers' compensation. For example, in Connecticut, sole proprietors, seasonal employees, and part-time employees are required to have insurance but casual employees and employees working in a private home less than 26 hours a week are not. However, in New York, casual workers are required to be covered, but sole proprietors are not.

Other workers, including federal employees and railroad employees, may have their own workers' comp system.

When Should I Contact a Workers' Compensation Lawyer for Help?

Workers' comp programs are supposed to assist injured workers, but they may be wrongly denied benefits. If your employer denies your claim or the insurance company no longer pays for your medical care, you have the right to appeal. You can appeal the employer's decision through the state workers' compensation board. You can also request a hearing.

There is a limited amount of time to request a hearing from your state workers' comp agency. If you wait too long, you may be denied benefits. For example, in Wyoming, workers must file a written request for a hearing within 15 days after the date the notice of final determination is mailed.

Contact a workers' comp attorney if your employer denied your claim or you are not getting the benefits you were promised. A workers' compensation lawyer may also be able to give you a case evaluation of your workers' compensation case.