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Do workers' compensation benefits cover long-term disability?

According to one study, many injured workers settle their workers’ compensation cases before realizing that they have a disability. Specifically, a disability diagnosis may occur one or even two years after the accident. Unfortunately, once a workers’ compensation claim is closed, workers may be barred from reopening it. Accordingly, the study questions whether workers’ compensation benefits should be designed differently, in order to account for delayed post-injury symptoms.

The question merits a closer look at how the workers’ compensation system is designed. As a preliminary matter, the system is generally set up as a no fault form of compensation, with the possible exception of a negligent third party. Since fault does not have to be proven before receiving benefits, the process for filing a workers’ compensation claim is generally quicker than a personal injury lawsuit. 

However, that expediency comes at the price of a payment structure that is capped in certain instances. The damages sought in a personal injury lawsuit, in contrast, are limited only by what the plaintiff can prove and persuade a jury to award. As we note our on workers’ compensation website, medical benefits must be deemed necessary and reasonable, but generally include treatment, prescriptions and hospital services.

Workers' compensation benefits may also be available when a work injury results in partial or total disability. Temporary disability payments are usually at a rate of 70 percent of the worker’s weekly wage, but must not extend beyond 400 weeks or exceed the statutory rate set by the Commissioner of Labor and Workforce Development. Permanent disability benefits may also be available arising from a work injury or illness, but are also generally based upon 70 percent of the worker’s average weekly wage. 

Source: FindLaw, “Workers' Compensation Basics,” copyright 2015, Thomson Reuters 

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