What Should I Do if the Insurance Company Demands that I Try to Return to Work?
If your employer’s insurance carrier “picks up” your claim (i.e. acknowledges that you have a compensable workers’ compensation claim) they will regularly look for reasons to declare you fit to return to work and therefore no longer eligible for TTD (temporary total disability) benefits.
This “return to work” issue, by the way, is where it really makes sense to have an experienced workers’ compensation lawyer by your side. I can offer my clients perspective about when the insurance company’s return to work demand is reasonable and when it is not, and how to try to return without jeopardizing weekly wage benefits.
As a general rule, I recommend that my clients refuse to return to work without a Form WC-240 and WC-240a in hand. Why am I so insistent that the employer provide a WC-240 and WC-240a?
Returning to Work Attempt Under a WC-240 and WC-240a
The WC-240 and 204A are Georgia State Board of Workers’ Compensation forms that set out a detailed light duty job description for a light duty job. The details of the job description must come from an authorized treating physician.
Here’s how the WC-240 procedure works:
1) the insurance company adjustor will review your medical records as they are produced by the doctor (if you didn’t know this already, your medical records in a workers compensation case are not confidential – the insurance adjustor gets a copy).
2) if the adjustor believes that your condition has improved to the point where you can return to some form of work, she will contact the doctor and ask the doctor to release you to light duty work. The adjustor will ask the doctor to identify limitations that apply – i.e. you can only sit for 15 minutes at a time and need a sit/stand option, or you can only lift 15 lbs. occasionally, you can use leg controls for only 1 hour total during a day, etc. The doctor will use the WC-240a checklist form to set out these limitations
3) the adjustor will contact your employer and ask if there is a job available that fits the limitations set out in the WC-240a.
4) the adjustor will fill out the WC-240, which is an official notice of an “offer of suitable employment.” The WC-240 notice must be provided to you and your lawyer at least 10 days before you are scheduled to report
5) if you attempt to return to work under the WC-240a restrictions (and usually I recommend to my clients that they try to return) and within 15 days, you decide that you cannot perform the light duty job, you can inform your supervisor, return home and your TTD benefits will resume automatically. The employer can, of course, attempt to terminate benefits, but you continue to receive those benefits while you are waiting for your hearing. When you return to work under a WC-240, you must attempt to work at least 8 hours (or 1 scheduled work day) for the work attempt to be considered “reasonable.”
Returning to Work Without a WC-240
If, however, you return to work without a WC-240 and 240a, and you cannot perform the job offered you, and you return home, your TTD benefits will not automatically resume – instead you will have to file for a hearing, and wait two to three months for you case to be scheduled, and you will have no income benefits while you wait.
Workers’ compensation insurance companies know that if you have no TTD income benefits coming in, you will be short of money and likely willing to settle your case for less than it is worth.
In my view, this “return to work” issue is one of the more important considerations in a workers’ compensation case and one where knowledgeable legal advice is a must.