Return-to-work issues seem to involve the blind leading the blind, even in the best circumstances. Doctors, especially general practitioners, are unsure what exact work restrictions are needed for an injured employee. Employers may not always have a good idea, assuming they are acting in good faith, what the requirements for the job are as well.
This can be further complicated if an employee attempts to come back to work part time from temporary disability. Not only do you have to navigate the issues of whether the job is appropriate, but you also have to deal with how much you get paid for what is called temporary partial disability.
What is temporary partial disability?
Temporary partial disability represents two-thirds of the difference between what you are making and your pre-injury average weekly wage. Though this seems simple in theory, it can be complicated for many reasons. Here are five things that employees can do to ensure they are being paid the proper amount of temporary partial disability:
Keep track of your pay stubs: Temporary partial disability is difference between your pay and your average weekly wage. So you need to know your pay in order to determine that amount. Sure employers can do this, but sometimes employers, especially if they are self-insured, have incentive to drag their feet. Also, many companies will outsource their payroll so that information may not be readily available to them. The best solution is to have that information on hand yourself. Having your pay stub will also allow you to know your pay period, which is also important.
Keep track of your hours on daily basis and/or get a copy of time card: Temporary disability is usually paid weekly. Many employers will pay every other week. The pay periods between your paycheck and your disability check might also vary. Sometimes checks will get delayed because an insurance company legitimately has to investigate what benefits have to be paid for one week. You can simplify this for them by providing your time card. The U.S. Department of Labor has a good app for this that you might want to use that tracks hours worked.
If your job is too hard to do physically, make a doctor’s appointment right awayto see if you can get your restrictions changed: Delaying a visit to the doctor may not only damage your health; it can also cost you money. An employer can attempt to deny and delay payment between the time where you stopped working at a “light duty” job and when a doctor took you off work and you start receiving temporary total disability again. You may not be able to recover this money, short of going to court, but you do have some control over keeping these gap periods as short as possible.
Turn in your time cards and time sheets to your workers’ compensation attorney or insurer: Don’t assume that your employer is turning over your hours to their workers’ compensation insurer. Be sure that you (or your lawyer) are turning in that information to ensure prompt and full payment.
Make sure that you know your average weekly wage: Workers’ compensation benefits are generally some percentage of your average pay over a time period. Employers will often turn over this information to their workers’ compensation insurer for them to determine how much you should be paid. If you think you are getting shorted, ask the insurer for the basis of their calculations and run it by an experienced workers’ compensation lawyer in your state or the state where your claim has been filed.
This blog post is the third in a series that examines the basics of workers’ compensation.
To be a covered workers’ compensation claim, an employee’s personal injury must be caused by an accident or occupational disease, but what does that mean?
The Nebraska Workers’ Compensation Act defines accident as: “an unexpected or unforeseen injury happening suddenly and violently, with or without human fault, and producing at the time objective symptoms of an injury. The claimant shall have a burden of proof to establish by a preponderance of the evidence that such unexpected or unforeseen injury was in fact caused by the employment. There shall be no presumption from the mere occurrence of such unexpected or unforeseen injury that the injury was in fact caused by the employment. …” Nebraska Revised Statute 48-151 (2)
Of course, many workers’ compensation injuries are not as simple or as clear as a broken arm that was the result of a fall. Some injuries are caused by repetitive motion or cumulative trauma on the job. In those cases, the injuries are still considered workers’ compensation “accidents” under the definition above, even though the injuries did not truly occur “suddenly and violently” as required by the statute.
As for an occupational disease, the Workers’ Compensation Act defines it as “a disease which is due to causes and conditions which are characteristic of and peculiar to a particular trade, occupation, process, or employment and shall exclude all ordinary diseases of life to which the general public is exposed.” Nebraska Revised Statute 48-151 (3) Examples to think about would be mesothelioma for asbestos workers or black lung for coal miners.
In sum, pretty much any injury or illness that an employee receives from work can fit into the definition of “accident” under the Nebraska Workers’ Compensation Act. However, proving the injury is much more difficult and may require the help of a lawyer.
Workers’ compensation law covers a very broad spectrum of cases. Each year, one of my favorite blogs publishes its top 10 most bizarre workers’ compensation cases. This year’s list, written by attorney Thomas A. Robinson, is interesting reading.
I appreciated Robinson’s empathetic approach to the cases, which he explains in this quotation.
“One thing we always kept in mind: one must always be respectful of the fact that while a case might be bizarre in an academic sense, it was intensely real. The cases mentioned below aren’t law school hypotheticals; they affected real lives and real families.”
In addition, as is stressed on a regular basis in the firm’s blog and social-media posts, workers’ compensation laws vary between states. The variety of states represented in this list included the two where attorneys from Rehm, Bennett & Moore practice, Iowa and Nebraska, and also North Carolina, New York, Wisconsin, Washington, Florida and Pennsylvania.
Today’s post comes from guest author Thomas Domer from The Domer Law Firm in Wisconsin. Below is an article discussing the fear of retaliation many injured workers around the country feel when they are faced with the decision of whether to report a work-related injury or not. The rules vary from state to state, and as the article discusses, the fear often depends on a number of different factors.
In Nebraska, if your employer terminates your employment because you reported a work-related injury, you may be entitled to additional compensation due to your employer’s retaliatory actions. This type of claim is referred to as a retaliatory discharge claim. Retaliatory discharge claims are considered an exception to Nebraska’s at-will employment doctrine. This is because the Nebraska Supreme Court determined that allowing the type of fear of retaliation for filing a claim discussed in the article below undermined the very important purpose of the Nebraska Workers’ Compensation Act, which is to relieve injured workers from the negative economic effects caused by a work-related injury. All that being said, though, a retaliatory discharge claim requires very specific facts and will not apply to every situation because it is an exception to the rule of at-will employment. In fact, a large amount of potential claims will not fit the criteria needed for a retaliatory discharge claim. That is why it is important to speak with an experienced attorney about your potential case.
Workers often fear retaliation if they report a safety violation or work injury related to a violation. Concerns about being fired or other forms of retaliation by employers permeate the process of worker’s comp claims filing. Studies have indicated that retaliatory fear prompts many workers not to file either OSHA or workers’ comp claims. Workers also don’t want to be perceived as careless or complaining. In a Government Accounting Office (GAO) study of OSHA reporting, occupational health providers often reported to workers’ fear of retaliation as a reason for underreporting. Fully 2/3 of health providers “reported observing worker fear of disciplinary action for reporting an injury or illness.”
Pressure from co-workers also prompts failure to report safety violations and comp claims. Safety incentive programs (sometimes called “safety bingo” ) create incentives not to report, since non-reporting leads to a reward for a work group. If one worker reports his injury, the entire crew may pay the price. The GAO survey found this peer pressure to be a troubling factor contributing to underreporting to OSHA. (Anecdotally, I remember a worker who cut off his finger on a Friday, wrapped it in a hankie and put it in his pocket , rather than report the injury and disappoint his fellow employees looking forward to a case of beer reward for “100 consecutive safe work days”).