When Does Workers’ Comp Pay Start?

Lost wage replacement benefits don’t begin on the first missed day. The average waiting period, which varies in different states, is about seven days. Waiting periods reduce employer costs. If injured workers go back to work before the waiting period expires, the resulting “medical only” claim is about 70 percent less than a full workers’ compensation plan.

The waiting period is partially or mostly retroactive in some states. For example, Texas has a seven-day waiting period. If victims miss at least fourteen days of work, the insurance company pays lost wage benefits for the initial seven-day period.

Here’s how this game works, especially in states that force injured workers to see company doctors. A worker files a claim and the company doctor quickly clears the victim medically. If the injury isn’t fully healed, the initial claims deadline has usually passed, so the victim cannot refile. Even if refiling is possible, most Claims Examiners quickly reject subsequent claims. They may even accuse these victims of fraud.

Temporary Disabilities

The waiting period rule works a bit differently if, as is often the case, doctors clear victims to go back to work part time. If that happens, workers’ compensation pays two-thirds of the difference between the pre-injury and post-return incomes.

Assume Jake, who is a warehouse worker, hurts his shoulder. He cannot lift, but according to his doctor, he can sit. So, Jake’s boss gives him parking lot attendant duty. Parking lot attendants earn a lot less than warehouse workers. This time, however, there is no waiting period. Jake’s new benefits begin immediately, at least in most states.

Permanent Disabilities

The waiting period rule usually doesn’t apply in permanent disability cases. Whether the disability is temporary or permanent, over the long haul, the victim will miss a lot more than seven days of work.

The eggshell skull rule, on the other hand, often applies in workers’ compensation disability cases. Many people have pre-existing or non-work conditions which increase the probability and/or severity of injury.

Assume Linda, who is a lifeguard supervisor, is pregnant. Part of her job includes working with toxic pool cleaners. Usually, chlorine and other fumes aren’t dangerous. However, to pregnant women, these fumes are often disabling. They’re even more dangerous to their unborn children.  If Linda or her baby gets sick, the insurance company cannot use Linda’s pregnancy as an excuse to reduce or deny benefits.

On a related note, despite federal laws which prohibit the practice, pregnancy discrimination is very common.

Some companies flatly refuse to hire pregnant women. Others unilaterally reassign people like Linda to other, lower-paying positions to prevent toxic exposure and other conditions. This call might be the right call. However, the decision to transfer belongs to Linda and her family, not to Linda’s boss.

Pregnancy discrimination victims usually have legal options, sometimes under state, federal, and local law.

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