When you are injured on the job and have a worker’s compensation claim, your claim really has two aspects: the medical portion, and the indemnity portion. The medical portion is where the employer or their insurance is required to provide you reasonable and necessary medical care that tends to provide cure and relief and lessen the period of disability. The indemnity portion is where the employer or their insurance is required to pay you compensation for your time out of work. The two portions are interconnected in many ways, but are also largely separate and distinct. So it is certainly possible for an employee to quit their job and still receive workers’ comp benefits. However, the benefits may become limited if you quit your job.
Here’s an Example That Will Apply to North Carolina Injured Workers
Take a truck driver who hurts his back on the job. The worker’s compensation doctor tells him to go to an urgent care center in their network, and that doctor refers him to physical therapy and tells him to remain out of work for the next 6 weeks. The insurance company pays for the therapy and begins paying the injured worker 2/3 of his wages while he is out of work. The wages are not taxed, but the employer tells him that if he wants to continue to receive health insurance while he is out on work comp, he will need to pay for it at the COBRA rate, which is very expensive. The injured worker decided that he is not totally disabled, and that there are some things he can do. So he takes a part-time job working for a friend. The job pays less than his old job, but it is less physical, and it provides health insurance. What happens to our worker’s work comp claim?
The fact that he left his job and took a new one should have no effect on his entitlement to medical care. His new job is not aggravating his back, and it is not preventing him from attending his physical therapy sessions. So the worker’s compensation adjuster should have no problem continuing to pay for the medical care. And if more medical care is needed, and the worker ends up needing to see an orthopaedist or getting an MRI, the insurance company should pay for this as well.
The other aspect of the injured worker’s claim, however, will be impacted. Now that he is receiving wages, he certainly will see a reduction in the indemnity benefits he was receiving. Those weekly checks that were $300 a week might drop to $100 a week now, since he is receiving wages from a new job. He might even see the checks stops completely if, for example, the employer claims that they would have offered the employee a temporary light duty job at his pre-accident wage rate if he had not resigned.
Resigning his job may also hurt the injured worker when it comes time to settle his claim. Many insurance companies prefer that a settlement agreement include having the injured employee resign his job. Obviously, we take a strong stand for our clients in this regard and when clients don’t want to resign their jobs we try very hard to take that option off the table. In addition, a good portion of their settlement value may be based on their interest to have the employee separate from the jobsite so he cannot re-aggravate his injury. A good portion of their settlement valuation will also be based on how much they are paying out on this claim, so the employee receiving $100 a week and costs them relatively little might see considerably lower settlement offers.
The other thing to consider is that insurance companies often tend to drag their feet on approving medical care, and they especially do so when they are not paying someone weekly checks. When they know they are going to be paying a claimant until he recovers, they have more motivation to give him the medical care that will get him back to work.
Given all the factors that go into a worker’s compensation claim, it is wise to consult with an attorney before taking steps that might impact your worker’s compensation claim. Our firm includes two Board Certified Specialists in North Carolina Worker’s Compensation Law, and we offer free consultations.
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