Getting Workers’ Compensation for your injury may be the best – or only – way to get medical care and lost wages covered. With sciatica, the injury often develops over time, and it is difficult to sue anyone for it. This means you might have to rely on Workers’ Comp.
Fortunately, Workers’ Comp can cover sciatica in many cases. As long as the injury developed because of your work tasks, you can get medical care and lost wages from that injury compensated through no-fault Workers’ Comp benefits.
Reach out to Cardamone Law’s Certified Pennsylvania Workers’ Compensation Lawyers at (267) 651-7945 for a free case assessment.
What is Sciatica?
Sciatica is inflammation or nerve pain in the sciatic nerve, which runs from your rear end, down your leg. This might stem from a low-back injury or impingement on your lumbar spine, or other causes lower down in your leg.
How Does it Affect Your Ability to Work?
Working with sciatica can be impossible in many situations. The pain could be severe enough to distract you, even if it does not physically interfere with your work. However, the pain may require you to sit or stand in a different position or take frequent breaks, making it harder to work.
This can affect your ability to even sit at a desk and perform sedentary/non-physical work, let alone having to rely on your legs for physical exertion.
Can Workers’ Comp Cover Sciatica?
Workers’ Comp can potentially cover your sciatica if you and your injury both qualify for coverage.
Qualifying Worker Requirements
Most employees are covered under Workers’ Comp from their first day on the job. There are certain workers – such as federal workers – that might have a different system to file through. And there are also certain workers – such as realtors and casual employees – who are not covered.
Independent contractors are not covered unless they opt in to Workers’ Comp or are actually misclassified and should be considered an employee instead. Talk to a lawyer about your status, as it is quite possible you were misclassified.
Qualifying Injury Requirements
An injury qualifies for medical coverage if it is work-related. This means that it stems from work tasks or from dangerous workplace conditions. This can include degenerative injuries or injuries over time, such as sciatica.
If the injury is disabling for at least 7 days, you can also get wage-loss benefits.
How Do You Apply for Workers’ Compensation Benefits with Sciatica?
To start your case, take these steps:
Get Medical Care
If you are starting to feel severe sciatic nerve pain, check with your employer about which doctors you should see and make an appointment as soon as you can. You have to get the injury checked out and get medical records to document the injury.
If you were injured in an acute accident that injured your lower back, just go to the emergency room. Do not worry about choosing approved doctors in an emergency.
Report Injury
You should report your injury to your employer within 21 days. If you delay this, you can still file within 120 days, but it may hurt your case.
If Denied, File a Formal Claim
Then, you have to await a decision. This should come within 21 days of your report, but insurance can choose to pay temporary benefits and give themselves up to 90 additional days to investigate.
If they deny you, file a formal Claim Petition with help from a lawyer within 3 years of the initial injury.
What Benefits Does Workers’ Comp Pay for Sciatica?
Sciatica can often receive medical benefits and wage-loss benefits, but specific loss benefits are rare.
Medical Costs
The cost of physical therapy, diagnosis, and even surgery – should it be needed – should be covered through a Workers’ Comp claim.
Lost Wages
If you miss work because of work-acquired sciatica, you should be entitled to 2/3 of your pre-injury wage (subject to caps and floors). If you can work to some extent, then you should get 2/3 of the difference in pre- and post-injury wages instead.
Specific Loss
Specific loss benefits are only paid for permanent injuries, such as amputation or total lost function. Sciatica may lead to partial lost function, but that does not typically qualify for specific loss benefits.
If you received another permanent injury in the same accident that caused the sciatica, that may qualify.
Can You Get Benefits if You Can Work with Accommodations?
Depending on what your doctor says, you may be able to go back to work with accommodations. For example, many people with sciatica who stand for their job can continue working if they have access to a stool or chair to rest on and are allowed to take additional breaks.
If this still results in lost wages, you may still get wage-loss benefits while working.
What if They Deny Your Benefits?
If your employer or their insurance carrier denies your initial claim, you can take the case before a Workers’ Comp Judge with a formal Claim Petition.
How Long Do You Have to Wait to Find Out if Your Workers’ Comp Claim Was Accepted?
Employers are supposed to answer the initial claim within 21 days of your notice of injury. If they fail to meet this deadline, you may be able to take that as a denial and file your Claim Petition.
They can also grant temporary benefits for up to 90 days and continue investigating, which would delay the final denial.
What if Your Sciatica Improves and You Can Go Back to Work?
As soon as your doctor thinks you can return to work, they will send you a Notice of Ability to Return to Work. Once you get this notice, you have to go back to work or start looking for work if you were released or fired in the meantime.
If you have restrictions on your work or need accommodations, your doctor should include that in the notice. For example, you may be released to light-duty work at first.
What if it Gets Worse Again?
If you go back to work, but the sciatica flares up again, you may miss work again. This could lead to ongoing wage-loss benefits through Workers’ Comp.
You may qualify for partial disability status, which can last an additional 500 weeks max. Those weeks do not have to be in a row.
Call Our Pennsylvania Workers’ Compensation Attorneys Today
Call (267) 651-7945 for a free case review with Cardamone Law’s Philadelphia Workers’ Compensation attorneys.
