Very Little Job Security After a Work Accident

Q: What happens if my work injury prevents me from being able to do my old job?

A:  If your treating doctor releases you with permanent work restrictions that are not compatible with the physical requirements of your job, one of three things is likely to happen:

1) your  employer may offer you a  permanent light duty position , or

2) if your  employer doesn't offer permanent light duty,  you will be eligible for vocational rehabilitation benefits and/or services, or

 3) you can try  to get your permanent work restrictions lifted so that you can stay in your  job.

Q:  Doesn't  my employer have to provide me with a permanent light duty job?

A:  No, your  employer is free to say that it does not want to offer a permanent modified position.  While the  Americans with Disabilities Act, if applicable to your employer,  may be helpful in securing an accommodation and keeping you employed, Nevada workers' compensation law  does not provide job security to injured workers.

Q:  What if I am released full duty and my employer has given my job to someone else or simply won't rehire me? 

A:  Workers' comp law provides that benefits are not payable  if the injured worker is released full duty and the pre-accident job is no longer available.   An employer is not required to hold an  injured worker's job position open indefinitely.  If applicable, the Family Medical Leave Act, may require an employer to hold the job open for up to 12 weeks.   Many injured workers need to file for unemployment benefits when they are able to work.  No recourse can be taken against an employer for not rehiring the injured worker unless it can be proven that the employer is retaliating against the injured worker for filing a workers' comp claim.

Q: What is the best way to keep my job after an injury?

A:  Because an employer is not obligated to offer permanent light duty, the safest way to secure your job is to have your treating doctor release you full duty, without work restrictions.  (You can still be rated for impairment and receive a PPD award even if you have a full duty work release.) Of course, you need to be able to do your old job if you intend to convince your treating doctor that it is safe and reasonable to send you back to work full duty.  If you are unsure, then ask your doctor to give you a trial of 2 weeks or 30 days of full duty, with a follow-up appointment.  That way, if you really cannot work full duty, you will get permanent work restrictions at the follow-up visit,and be entitled to vocational rehabilitation.  Keep in mind that if you do have a full duty work release, your employer has a right to expect full duty work performance from you.   You want to be a valuable employee, and don't want to give your employer any excuses to look for reasons to terminate your employment.

Q:  What else can I do to keep my job even if I have restrictions?

A: From the moment your doctor and you think that you may have permanent work restrictions, you can start strategic planning  on how to keep your job.  Devise a plan for showing your employer how you can remain a valuable employee.  Refuse to be a victim, and focus on what you are still qualified to do.  Put yourself in your employer's shoes, and think creatively about how to best use your skills.  Keep in contact with supervisors and human relations reps so that you are aware of positions that may be opening within the company.  Ask whether you would be qualified for other positions with a short course of retraining.

Getting Medication After Claim Closure

 

Prescription BottlesWhen the adjuster sends a letter, either scheduling a rating evaluation, or simply closing the claim, No additional medical treatment will be authorized.  That means that the insurer will also stop paying for any medication refills, and will not authorize return visits to the doctor for more medication.  If the injured worker's treating doctor reports that the patient will need ongoing medication, then this issue needs to be discussed and resolved with the adjuster before the appeal time (70 days) runs on claim closure.  Additionally, if an injured worker accepts a permanent partial disability award in a lump sum, any appeal the injured worker has filed on claim closure to obtain ongoing medication will be dismissed.

Nevada statutes and regulations governing workers' compensation claims do not address what the insurer's obligations are to provide ongoing medication after the treating doctor recommends that that claim be closed. The best way to deal with this issue is to negotiate with the adjuster to reach a reasonable agreement.  Assuming the treating doctor makes it very clear that ongoing medication is necessary, many insurers are willing to pay for medication for at least a year after the claim is closed and are agreeable to letting the injured worker receive his PPD award also. Insurers are usually only willing to do that when the injury is very serious.  If the insurer agrees to ongoing medication for a year, the insurer will want to make a new determination after a year after asking the doctor whether more ongoing medication is necessary. 

Other insurers take a more obstinate stance and refuse under any circumstances to pay for any medication or doctors' visits after claim closure. The injured worker can appeal the claim closure letter, and try to persuade a hearings or appeals officer  to order the insurer to provide ongoing medication.  While it is possible to obtain such an order, the problem is that this appeals process takes months.  Again, the injured worker can not take his permanent partial disability award in a lump sum while the claim closure/medication issue is being litigated.  Many injured workers cannot afford to let their award money sit with the insurer while trying to get ongoing medication through the appeals process.

Obtaining ongoing medication after claim closure is difficult, and most injured workers will be unable to obtain it without an attorney.  If the injured worker is able to obtain it without an attorney,  it is essential that any agreement obtained from the adjuster be in writing.  Adjusters change frequently, and an oral agreement will not be enforceable. 

 

Average Monthly Wage, Fiscal Year 2011

Maximum total disability benefits, payable when an injured worker is off work, are determined each fiscal year by the Nevada Department of Employment, Training, and Rehabilitation, Employment Security Division.  Maximum benefits are 66 2/3 of this maximum average monthly wage.  (If the wage earned on the date of injury is less than the maximum average monthly wage, the benefit is 66 2/3 percent of the actual earned wage.)  For the first time, the maximum average monthly wage for injuries is less than the prior year's maximum average monthly wage.  The maximum average monthly wage for injuries occurring 7/1/10- 6/30/11) is $5,179.05.  The maximum bi-weekly compensation is $1,588.02.

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How Concurrent Wages Affect Benefits

If an injured worker is holding two jobs at the same time he or she has a work accident  (or files a claim for an occupational disease), that worker is said to have concurrent employment.   Concurrent employment is not the same as consecutive employment.  Consecutive employment occurs when a worker has a job with one employer, terminates that employment, and then has a job with a second employer.  There are special rules that entitle an injured worker to increased benefits where the injured worker has a concurrent employment at the time of his industrial accident or occupational disease claim.

Even though the worker is injured on one job only, the worker is entitled to give information to his adjuster showing the amount of wages earned  with the second, concurrent employer  in the 12 weeks or full period of employment before the job accident.  Those concurrent wages can then be combined with the wages earned from the first employer when the adjuster calculates the injured worker's average monthly wage before paying compensation benefits.   Including those additional wages from the second employer can often bump up the average monthly wage to the maximum allowable benefit, and this can also greatly increase the amount of the permanent partial disability award.

If an injured worker can return to only one of his jobs as a result of the work injury, he may be entitled to the difference between what he earns after taxes on the one job and what his compensation benefit would be if he were unable to work at all.  In that case, the injured worker should send in a copy of the wage stubs and ask his worker's compensation adjuster to pay the difference.

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