The expected duration of absence from work after a work-related injury, illness, or medical procedure influences how long you receive disability benefits through workers compensation and your case’s settlement value.
Despite this importance, few medical professionals, workers comp adjusters, nurse case managers, claimants’ lawyers, insurance defense attorneys, or adjudicators understand how to estimate disability duration for specific occupational injuries or surgeries based on all the relevant factors.
Indeed, the American Medical Association’s (AMA’s) publications admit this lack of knowledge is prevalent:
Most physicians have not been trained in work ability assessment. Multiple physicians often give contradictory answers to questions of work ability if tolerance of symptoms is what limits work performance. There is little good science on work risk assessment.
So does The Medical Disability Advisor – Workplace Guidelines for Disability Duration by Presley Reed, M.D., Second Edition, 1994, at Preface, a treatise published by a group founded “to provide proprietary research on [medical disability, absenteeism, and employee morale] to other Fortunate 500 Organization”:
The vast majority of people with disabilities have minimal objective findings on careful medical evaluation and appear to the outside observer to be “whole.” Pain for example, the most common disabling condition, is impossible for another person to observe or measure directly.
…. …. …. ….
Managing medical disability by [using] disability duration guidelines based [on] diagnosis or procedure is, admittedly, an imperfect approach …
Despite these admissions, medical doctors often make return-to-work decisions for injured employees with open workers compensation claims.
These disability duration judgments determine the settlement value of your workers comp claim and whether you and your family can continue to count on wage loss payments (such as temporary total disability and temporary partial disability benefits). Indeed, a doctor’s letter saying you can return to work may cause your workers compensation benefits to stop.
But many physicians are uncomfortable making these decisions. They lack the knowledge, training, or confidence to assess work ability. Therefore, they often defer to other sources to determine medical work restrictions or cave to the nurse case manager who wants you to return to work before you feel ready.
These other sources include functional capacity evaluations (FCEs) and industry disability duration guidelines.
This is what employers and insurers want.
They know the data shows the longer you are out of work on disability, the higher the likelihood you will never return to work. And lengthy periods of absenteeism lower the profits of workers comp insurers such as Travelers, The Hartford, Liberty Mutual, and others.
Persuading doctors to rely on guidelines for disability duration based on a pro-return to work as soon as possible philosophy or written for groups that benefit from shorter disability periods helps insurers make more money.
We have reviewed some of these disability duration guidelines.
And we disagree with them based on the thousands of injured employees we have represented. Indeed, we think longer periods of disability are warranted, particularly because many employers coerce employees to exceed their work restrictions.
This disagreement isn’t surprising. We represent injured employees, car crash victims, and people applying for Social Security disability, and we want them to take every step that helps them heal. In comparison, the first chapter in the AMA’s A Physician’s Guide to Return to Work, edited by James B. Talmage, MD, and J. Mark Melhorn, MD, (2005), is titled, Why Staying at Work or Returning to Work Is in the Patient’s Best Interest.
This article gives a claimant’s attorney’s estimates on disability duration based on what our law firm has seen with injured employees’ recoveries over the past 14 years.
We hope you consider this information when negotiating return-to-work issues with your doctor after an occupational injury and when looking for answers to these types of questions:
Our opinions on recovery times and when you may be able to return to work for your specific occupational injury are just that – opinions – and do not substitute for your lawyer’s or doctor’s advice.
But our thoughts can help you prepare for discussions with your physician when you feel unready to return to work after a work-related accident and the employer, insurer, doctor, or nurse case manager presses you to.
So keep reading to learn more.
And call us at (804) 251-1620 or (757) 810-5614 for a free consultation with a top-rated workers compensation attorney. We represent employees in Richmond, Virginia Beach, Newport News, Norfolk, Roanoke, Harrisonburg, Fairfax, Baltimore, Hagerstown, and elsewhere in Virginia and Maryland. And we want to resolve your case so you can move forward with your life.
Disability duration estimates the time needed for an injured employee to return to work after their specific work-related injury or illness.
These disability duration guidelines are not rules or laws for when an injured employee must return to work (full duty or light duty) or when workers compensation benefits stop. Indeed, workers comp can last much longer than these periods.
Instead, insurers and claim administrators (such as Sedgwick, Gallagher Bassett, ESIS, or Corvel) may use disability duration guidelines to determine when to scrutinize claims.
For example, the insurance company may send you to an independent medical examination (IME) if its guidelines estimate you can return to work five weeks after a broken bone, but your orthopedic surgeon disables you months later.
No.
Disability duration, the time it takes to reach maximum medical improvement (MMI) for a work injury, and total healing or recovery time are different concepts.
Typically, disability duration is shorter than total healing time because your physician may release you to return to light-duty work before you reach MMI or heal completely. And some of you may never recover fully, instead receiving permanent restrictions (such as for a spinal fusion or total knee replacement).
Multiple factors influence the length of disability from work after an on-the-job injury.
These factors include the following:
Generally, the older you are, the longer the disability duration of your work injury may be and the more difficulty you may have returning to work.
There are several reasons for this.
Your age may contribute to the severity of your injury, the course of treatment recommended by your doctor, and the prognosis for healing.
In addition, you may have a harder time finding employment if you are over 40, despite the Age Discrimination in Employment Act (ADEA).
Further, the older you are, the more trouble you may have acquiring new job skills.
The research and data supporting this statement explains why the Social Security Administration’s (SSA’s) Medical-Vocational Guidelines (also called the “Grid Rules”) make it easier to qualify for Social Security disability insurance (SSDI) benefits or Supplemental Security Income (SSI) when you turn 50, 55, or 60.
The availability of compensation payments, such as Social Security disability insurance (SSDI), Supplemental Security Income (SSI), long-term disability, short-term disability, VRS work-related disability, or workers compensation (for example, having an Award Letter), may result in longer disability duration.
The rationale is simple: You are less likely to risk reinjury or put yourself in a dangerous situation if you have financial security.
At least one study found a correlation between disability duration and the unemployment rate in the locale where injured employees live.
Disability from work-related injuries likely lasts longer in cities, counties, and towns with weak economies and fewer job opportunities.
A medical complication is an unfavorable result of an injury, disease, or treatment.
For example, common postoperative (post-surgery) complications include deep vein thrombosis (DVT) and infection.
If you develop one of these complications, you may take longer to heal and return to work.
Your doctor may prescribe medication to treat the initial work injury or the consequences of the acute trauma.
For example, you may take muscle relaxers, hydrocodone, or opioids for a work-related back injury. Or your doctor may prescribe selective serotonin reuptake inhibitors (SSRIs) for post-traumatic stress disorder or depression arising from the incident.
These medications may cause side effects (drowsiness, fatigue, headaches) that prevent you from working around heavy machinery or driving commercial vehicles. Indeed, the Federal Motor Carrier Safety Administration’s (FMCSA) regulations say a driver is medically unqualified to operate a commercial vehicle such as a tractor-trailer when taking some medications.
Heavier people may take longer to heal from work-related injuries involving weight-bearing joints.
Preexisting physical (osteoarthritis, degenerative joint disease, past concussions, fibromyalgia, CRPS, etc.) or psychological conditions (depression, anxiety) may lengthen disability from an occupational injury.
This extended absence from work remains the employer’s responsibility.
Both tort law (negligence and intentional torts) and workers compensation law recognize the egg-shell-skull doctrine.
This doctrine says the defendants (including employers and insurers) take the plaintiff (or claimant in workers comp) as they find them. That an incident caused harm because the employee had a preexisting condition that increased their susceptibility to injury does not help the employer avoid liability.
The following psychosocial factors may affect how long you remain disabled after a work-related accident:
Returning to work before you are medically cleared or ready may cause reinjury, which prolongs the time missed from work.
Research shows that smokers may take longer to recover from occupational injuries, particularly those requiring surgery.
At least one study found that low-wage earners have longer periods of disability than high wage earners.
The length of disability from an occupational injury or illness may vary based on these job factors:
During settlement negotiations, some employers and workers comp adjusters will argue for a lower value because they have seen other employees with the same injury in the same job return to work sooner than the employee we represent.
We can easily explain the differences in periods of disability using the general factors discussed above and these injury-specific factors:
The chart below estimates how long before you can return to work for some of the most common work-related injuries and conditions.
The lower end of the range is how long it takes to return to sedentary or light exertional level work.
The upper end of the range is how long it takes to return to heavy or very heavy work.
We base these disability duration estimates on the following:
Remember – your length of disability from a work-related injury depends on many factors and may fall outside of these ranges.
| Injury Type | Return to Work Range |
| Acetabulum Fracture | Three months to six months |
| ACL Tear | Two weeks to nine months or more |
| Achilles Tendon Rupture | Four weeks to nine months or more |
| Adhesive Capsulitis (Frozen Shoulder) | Six weeks to twelve months or more |
| Amputation | One week to twelve months or more depending on the body part |
| Ankle Fracture | Six weeks to four months or more |
| Aortic Aneurysm | Three weeks to twelve months or more |
| Arthritis | Zero days to six months or more |
| Arthroplasty (Joint Replacement) | Two months to ten months or more |
| Arthroscopy | One week to three months or more |
| Back Pain (Lumbago/Lumbar Strain) | Zero days to two months or more |
| Biceps Tendonitis | Zero days to four months or more |
| Black Lung Disease | Two weeks to one year or more (depends on the disease's progression) |
| Brachial Plexus Injury | Three weeks to four months or more |
| Bruises (Contusions) | Zero days to four weeks (for bone bruises) |
| Burns | Three weeks to twelve months or more if you need skin grafts |
| Bursitis | One week to 12 weeks |
| Calcaneus Fracture | Two weeks to twelve months or more |
| Carpal Fracture | One week to 12 weeks |
| Carpal Tunnel Syndrome | Zero days to three weeks or more |
| Cervical Spine Fusion | 10 weeks to six months or more |
| Chondromalacia Patellae | Zero days or four months or more (if surgery is needed) |
| Chronic Pain (including CRPS) | Zero days to 12 months or more |
| Clavicle Fracture | Zero days to 12 weeks |
| Coccyx Fracture | One week to 12 weeks |
| Post-Concussion Syndrome | Zero days to 12 months or more |
| Contact Dermatitis | Zero days to two weeks or more |
| Coronary Artery Disease | One week to three months or more (and possible career change) |
| Degenerative Disc Disease of the Spine | Zero days to six months or more |
| Degenerative Joint Disease | Zero days to six months or more |
| Dental Injuries | Zero days to three weeks or more |
| Depression | Zero days to six months or more |
| De Quervain's Disease | Zero days to three weeks or more |
| Dislocations | One week to five months or more |
| Dupuytren's Contracture | Zero days to four weeks or more |
| Elbow Fracture | Two weeks to ten months or more |
| Epicondylitis (Lateral and Medial) | One week to 12 weeks or more |
| Eye Contusion | Zero days to six weeks or more for heavy work |
| Femur Fracture | Six weeks to eight months or more |
| Fibula Fracture | Two weeks to three months or more |
| Foot Fracture | One week to six months or more |
| Frostbite | One week to two months |
| Hand Fracture | Zero days to six months or more |
| Heart Attack | One week to six months or more |
| Heat Exhaustion and Heat Stroke | One day to three weeks |
| Hernia | Zero days to three weeks (if you need surgery to repair it) |
| Herniated Disc | Zero days to three months or more (if you need surgery) |
| Humerus Fracture | One week to six months or more |
| Jaw Fracture | One week to eight weeks or more |
| Joint Pain | Zero days to three weeks |
| Lumbar Spine Fusion | 10 weeks to six months or more |
| Meniscus Tear | Zero days to three months or more |
| Neck Pain (incl Cervical Radiculopathy) | One week to eight weeks |
| Nerve Damage/Neuropathy | Zero days to six months or more |
| Open Wounds | Zero days to four weeks or more |
| Patellar Fracture | One week to four months or more |
| Pelvic Fracture | One month to eight months or more |
| Post-Traumatic Stress Disorder (PTSD) | Two weeks to three months or more (you may need to change your work environment) |
| Pulmonary Embolism (DVTs) | Two weeks to six months or more |
| Radius Fracture | One week to six months |
| Radius and Ulna Fracture (from the same incident) | One week to eight months |
| Rib Fracture | One week to four months or more |
| Rotator Cuff Tear | Zero days to four months or more |
| Scapula (Shoulder Blade) Fracture | Two weeks to six months or more |
| Sciatica | Zero days to three months or more (if you are a surgical candidate) |
| Skull Fracture | Two weeks to five months |
| Spinal Cord Injury | Three months to twelve months or more (incl. paralysis) |
| Sprains and Strains | Two weeks to 16 weeks |
| Sternum Fracture | Two weeks to 12 weeks |
| Subdural Hematoma | Four weeks to six months or more |
| Talus Fracture | Two weeks to one year or more |
| Thoracic Outlet Syndrome | Zero days to four months or more |
| Tibia Fracture | Four weeks to one year or more |
| Traumatic Brain Injury (TBI) | Ten days to twelve months or more |
| Trigger Finger or Thumb | Zero days to six weeks |
| Ulna Fracture | One week to five months |
| Vertebrae Fracture | Six weeks to six months or more |
| Wrist Fracture | Two weeks to eight months or more |
Our personal injury law firm helps injured employees get the benefits, lifetime medical treatment, and lump-sum settlements they deserve for workplace injuries and illnesses.
No matter your company’s size, we can help. From the smallest construction company to the world’s largest employers (Amazon, Wal-Mart, Kroger, Target, Lowe’s, Home Depot), our experience and skills can help you after an on-the-job injury.
Contact us today to start.