The goal of workers’ compensation medical care is for the employee to return to work. Ideally, an employee will return to work at the same income-earning capacity as before. If that’s not possible, the goal is to minimize loss of earning capacity.
If you’ve been hurt at work, you need to understand NC workers’ compensation return to work policy.
What Is the NC Workers’ Compensation Return to Work Policy?
NC workers’ compensation return to work policy is that injured workers must return to work when they reach maximum medical improvement and are cleared from work restrictions. In addition, a person may not refuse suitable work that accommodates limitations. Workers’ compensation disability benefits may be terminated if an employee refuses suitable employment.
Employer Responsibilities Under Return-to-Work Policies
- Pay compensation following seven calendar days of lost work until the employee returns to work or benefits are terminated. If the worker misses 21 days or more, the first seven days become payable as well.
- If the employee has medical restrictions, the employer cannot require the employee to work in violation of those restrictions.
- The employer completes Form 28T within 14 days of the person’s return to work. They file the form with the Industrial Commission and give the worker a copy.
- Employers are encouraged but not required to offer light duty to facilitate return to work.
- Documents must state how an employee can remedy suspension of payment for failing to comply with return to work policy.
- An employer may not terminate or penalize an employee for filing a workers’ compensation claim.
- The employer must allow a return to work trial period of up to nine months. The employee can have compensation reinstated if the trial period is unsuccessful. The trial period does not apply if the employee misses fewer than eight days of work.
In addition, an employer may:
- Contact an employee directly to discuss light duty.
- Offer suitable work and request that the employee return. However, the employee may still be considered disabled because of a reduced ability to earn income in the workforce in general.
- Hold the person’s job open until they return, although they are not required to do so.
- Allow a worker to use sick leave, vacation, and other benefits during the seven-day waiting period for temporary disability pay.
- Terminate an employee for misconduct as long as they are treated the same as other employees.
The Role of Light-Duty Assignments in Workers’ Compensation
The employer doesn’t have to accommodate light duty, but it’s encouraged. Light duty is a modified duty that the injured worker can perform successfully. Light duty may mean reduced lifting, tasks that don’t require certain body movements, or limited hours. The exact restrictions that are appropriate will depend on the individual situation.
Light duty can help a person return to work. However, a person is not required to accept it if they cannot perform it successfully with restrictions.
The employer must outline the conditions of light duty and what would be expected. The employee must communicate any concerns with those restrictions.
Light duty and a finding of disability
An employer cannot argue that a person has no disability because they are willing to pay the person to perform very light duty. The question for disability is whether the person has a reduced earning capacity and not whether their previous employer generously offered to continue to pay them for an indeterminate period. An employer’s offer of what is effectively make-work is not conclusive to a finding of no disability. See Peoples v. Cone Mills Corp., 342 S.E.2d 798 (1986); Ashley v. Rent-A-Car Company, 155 S.E.2d 755 (1967).
When is a Worker Considered Fit To Return to Work?
A person is considered fit to return to work when there is suitable employment available. A person may be fit to return to work before or after they reach Maximum Medical Improvement (MMI).
If the treating physician has released the person to return to work without limitations, the person must return to work. The person may seek to have benefits reinstated if a physician determines within 45 days that the person cannot perform their work duties. Even if the person has not yet reached MMI, they have suitable employment if they can work within their restrictions.
What Happens If You Cannot Return to Your Previous Job?
If you cannot return to your previous job after reaching MMI, there is a multi-factor analysis regarding your benefits.
Whether suitable employment is available depends on your pre-existing conditions, work restrictions that remain, skills, education, and experience. There is also a question of whether work is available within a 50-mile radius. The inquiry determines whether the person can work and the extent to which they have lost earning capacity. If you can’t return to your previous job or work in any capacity, you may qualify for permanent disability benefits.
If you can’t earn at least 75% of what you made before, you may request vocational rehabilitative services.
What if I try working and it’s unsuccessful? Can I have my benefits reinstated?
Often, the answer is yes.
If the employee stops working, they file Form 28U with the Industrial Commission. They provide a copy to the insurer and the employer. A treating physician must certify the form.
When an employer receives Form 28U, and they refuse to reinstate total disability, they must state their reasons.
Legal Rights of Employees Who Dispute Return-to-Work Decisions
If you are offered suitable employment and you refuse it, your benefits may terminate. However, your refusal may be justified, and you may dispute a return to work decision.
You have the legal right to request a hearing. A lawyer can represent you. You may seek compensation for a period where your benefits were wrongfully terminated.
Tips for Navigating the Return-to-Work Process in NC
- Read any paperwork that you receive carefully.
- Discuss restrictions with your medical care provider.
- Get care provider certifications as required.
- Communicate with your employer about restrictions and return to work.
- Take the steps to contest unfavorable decisions.
- Involve a lawyer early in the process.
Contact an Experienced Jacksonville Workers’ Compensation Lawyer
At Horton & Mendez Injury Attorneys, we help people with North Carolina workers’ compensation claims involving a return to work policy. Please contact us.
