When Can You Go Back to Work After a Workers’ Comp Claim in Pennsylvania?

Navigating the aftermath of a workplace injury can be a highly difficult process. You may be able to recover payment for the lost income you incur during your recovery. However, it is likely that the amount of lost wage benefits you recover will only amount to a portion of your average weekly income. Accordingly, once you have sufficiently healed, you may need to return to work in order to get your life back on track.

The decision to return to work after filing a Workers’ Compensation claim in Pennsylvania will be based on your recovery progress. Once your physician has determined that you have reached the stage of “Maximum Medical Improvement” (MMI), you may be cleared to return. However, even after reaching MMI, you may still be limited in the type and amount of work you can perform. If you are permanently restricted from performing your pre-injury job duties, then you may qualify for long-term benefits.

Get support from our Certified Pennsylvania Workers’ Compensation Lawyers by calling Cardamone Law at (267) 651-7945.

Returning to Work After Filing a Workers’ Compensation Claim in Pennsylvania

Lost wage benefits provided through Workers’ Compensation offer crucial support to injured employees who are unable to earn income during their recoveries. Still, in some cases, the amount of benefits being paid out may seem insufficient when compared to claimants’ pre-injury earnings. Many clients ask our Workers’ Compensation attorneys if they may return to work so that they can sufficiently provide for themselves and their families.

As previously discussed, the decision to return to work after filing your Workers’ Compensation claim will be made by your physician. They will carefully monitor your recovery progress to determine when you have reached MMI. MMI refers to the stage at which you have reached a recovery plateau. In other words, this is the stage at which your condition cannot be improved any further.

The period of time in which you are unable to work is often referred to as your “healing period.” As outlined by § 306(c)(25) of the Pennsylvania Workers’ Compensation Act, the length of your healing period is sometimes defined by code rather that the specific circumstances of your case.

Once you have reached MMI, you may be cleared to return to work. However, it is important to remember that not all MMI designations are created equal. For example, a worker who suffers a sprained muscle may reach MMI and be fully recovered. Meanwhile, a worker who incurs a spinal cord injury may reach MMI but still have significant limitations that prevent them from performing their pre-injury job duties.

Your doctor might suggest that you can return to work before you reach MMI. However, such a recommendation will typically include specific guidelines for your employer to assign you modified or light-duty tasks that suit your physical capabilities. This approach can be beneficial if you are able to perform some level of work and potentially earn a salary that exceeds your lost wage benefits. Still, as we will discuss below, returning to work part time could also mean a reduction in the benefits you receive.

Can You Still Receive Lost Wage Benefits After Reaching MMI in Pennsylvania?

You may continue to receive lost wage benefits if you reach MMI but are still suffering from physical limitations caused by your on-the-job injury. If you are deemed to qualify for “total disability” benefits, then there is no limit to how long your benefits may continue to be paid out. However, if you only qualify for “partial disability” benefits, then your benefits must be halted after a maximum of 500 weeks, as outlined by § 306(a.2)(7) of the Workers’ Compensation Act.

In order to determine whether you qualify for total or partial disability benefits, your employer’s insurance company may send you in for an Impairment Rating Evaluation (IRE). This evaluation can only be requested after you have reached MMI and received temporary total disability benefits for at least 104 weeks. The physician performing the IRE may be selected by both you and the insurer, or one may be selected by the Bureau of Workers’ Compensation.

The guidelines for how to conduct and IRE and determine an appropriate impairment rating have been fiercely contested by various parties. However, in 2018, the Pennsylvania legislature enacted Act 111, which re-established the IRE process under § 306(a.3) of the Workers’ Compensation Act.

Under the new IRE guidelines, the examining physician must use the Sixth Edition of the American Medical Association’s Guides to the Evaluation of Permanent Impairment to determine your impairment rating. This method helps ensure objectivity in evaluating your condition. Previously, physicians were only instructed to use the “most recent” edition of the guide.

If the physician determines that your impairment rating is below 35% (previously the threshold was 50%), then the classification of your lost wage benefits may shift from “total disability” to “partial disability.” This change limits the duration of time that those benefits can be received to 500 weeks. Fortunately, anything higher than 35% will constitute total disability and will qualify you for benefits that may be paid out for an indefinite length of time.

It is important to note that while wage loss benefits may be capped, benefits for medical expenses related to your on-the-job injury are not time-restricted.

What if You Do Not Want to Return to Work After Filing a Workers’ Compensation Claim in Pennsylvania?

If conflicts emerge between you and your employer while you are receiving Workers’ Compensation benefits, or if you decide that returning to your previous role is not something you want or are capable of doing, you are not legally obligated to return. However, it is crucial to understand that choosing not to return to work when medically cleared could lead to the loss of certain benefits.

Return to Work Forms in Pennsylvania Workers’ Compensation Claims

The requirement to provide a “return to work” form is set forth by § 306(b)(3) of the Workers’ Compensation Act. Under this requirement, your employer’s insurer must promptly send you a written notice if they receive medical evidence suggesting that you are capable of returning to work in any capacity.

This notice will inform you about the perceived change in your physical condition. It will also explain that you have an obligation to search for available employment. Further, if the insurer provides proof of available employment opportunities, then your right to continue receiving benefits may be jeopardized.

Call Our Attorneys for Help with Your Workers’ Compensation Claim in Pennsylvania

Seek assistance from our Certified Philadelphia Workers’ Compensation Lawyers by calling Cardamone Law today at (267) 651-7945.