How to Ask Your Doctor for Work Restrictions After a Workplace Injury and Negotiate Your Return to a Light Duty Job

 

What You Need to Know About Light Duty Work Restrictions and Limitations After a Workplace Injury

 

Receiving light-duty work restrictions is a significant milestone in the workers compensation claims process.

 

And the return-to-work issues that arise after a light-duty release are a frequent area of disagreement between injured workers, employers, insurers, third-party administrators such as Sedgwick and Gallagher Bassett, and doctors. 

 

On one side is you – the injured employee. You likely want to return to work after your workplace accident but only when it is safe for you to do so without risk of re-injury and in a position that accommodates your new reality.

 

On the other side are your employer and its insurer. They want you to return to work as soon as possible because every dollar you earn reduces their liability for payment.

 

And in the middle is your doctor, who probably has little to no formal training in assessing a patient’s work capabilities. But who is likely being pressured by the claim adjuster, nurse case manager, or defense attorney to encourage you to work as part of your treatment.

 

Whether you win these disputes depends on the specific work restrictions given by your doctor, your health care providers’ opinions on whether you can return to work, and your job description.

 

This article aims to help you educate your doctor on the importance of medical restrictions in workers comp. In addition, it gives tips on negotiating return to work issues with your medical providers. And how to respond to job offers from your and employer (and its insurer) when released to light-duty so that you protect your right to benefits and put yourself in the best position to get a reasonable workers comp settlement.

 

Have more questions? Call now for a free consultation with one of Virginia’s best work injury lawyers: (804) 251-1620 or (757) 810-5614. We are ready to help.

 

What are Medical Work Restrictions?

 

A medical restriction is a communication from any treating physician stating your current environmental, mental, and physical limitations and capabilities because of your work injury or occupational disease. 

 

Your work restriction letter can come from any medical provider treating you for a workplace injury or occupational illness, including your orthopedic surgeon, pain management doctor, neurologist, psychiatrist, psychologist, cardiologist, pulmonary specialist, or chiropractor. 

 

What is Light Duty under Workers Compensation?

 

A light-duty job is any work that is physically or mentally less demanding than the job you had when you were injured.

 

It may even be your regular job, with the employer stating you are exempt from performing tasks you cannot do because of the injury and disability.

 

Under workers comp law, you are restricted to light duty when you cannot perform each task your regular job required because of medical work restrictions related to your workplace injury – even the functions you rarely do. Therefore, it does not matter if you can perform all but one of your job duties or if the work function you cannot do is one you infrequently perform (for example, once per month).

 

You may also hear the terms “modified duty,” “temporary alternative assignment,” “transitional work,” or “selective employment” after receiving work limitations from your doctor. These terms are used interchangeably with “light-duty.”

 

Does the Light Duty Work Restriction Have to be in Writing?

 

Yes – to give yourself the best chance of winning your case.

 

The medical restriction should be in writing – either as part of your office visit note (treatment report) or as a separate letter, form, or response to a questionnaire.

 

An oral communication – such as the doctor or their staff telling you that you cannot do your regular job – is not good enough for a couple of reasons.

 

First, the insurance claim adjuster will not offer a Workers Comp Award Agreement form unless you have restrictions in writing.

 

The adjuster will not offer a Workers Comp Award Agreement form unless they see the restrictions in writing.

 

Second, you will not be allowed to testify about what the doctor told you about restrictions if your workplace injury case goes to trial. This type of testimony – saying what someone else told you – is hearsay evidence, and it is usually not admissible in court.

 

Your attorney, however, can ask questions about your understanding of your restrictions at the hearing. But the judge may not give much weight to testimony on this issue unless you have papers from your doctor supporting your testimony.

 

Is a Medical Diagnosis Good Enough to Prove I Have Work Restrictions? 

 

No. 

 

Workers compensation will not infer specific work restrictions based on your medical diagnosis.

 

Medical diagnosis is the term for the process of determining which condition or disease explains your symptoms. Usually, your physician makes a diagnosis based on the history you give, a physical examination, your response to conservative treatment such as prescription medication and physical therapy, and diagnostic procedures such as MRIs, CT scans, and EEGs. 

 

Your diagnosis determines the next steps for treatment. 

 

However, medical work restrictions do not depend on your diagnosis, though the diagnosis may help your physician decide your work capabilities. 

 

Why is it Difficult to Get Accurate Work Restrictions from Your Doctor – Or Any Restrictions at All? 

 

Many doctors hesitate to give their patients work restriction notes. 

 

There are three reasons for this. 

 

First, most physicians have not received training in assessing a patient’s ability to work after an industrial accident or car crash. Therefore, they do not feel qualified to discuss specific work restrictions. 

 

Second, some physicians want to avoid participating in litigation at all costs. Instead, they would rather focus on diagnosis and treating. 

 

This is understandable. However, such an approach can cause a patient harm. A lack of medical work restrictions could result in the denial of wage loss benefits (temporary total, temporary partial, etc.) and even the insurer’s refusal to authorize ongoing treatment. 

 

Third, the physician might not be familiar with the workers comp claims process or understand an injured worker’s responsibility under workplace injury law. 

 

I see this frequently happen in psychiatric (PTSD, depression, etc.) and occupational disease claims (heart disease, lung disease, Legionnaires, etc.). 

 

The physicians who focus on these illnesses do not treat as many workers comp patients as orthopedic surgeons, neuropsychologists, or pain management specialists. Therefore, they do not understand the importance of writing work restriction letters. 

 

Why are Work Restrictions Important under Workers Comp?

 

Medical restrictions impact your rights and responsibilities under workers comp law and what you must prove to recover or keep wage loss payments.

 

For example, work restri

 

Work restrictions serve as the basis for many of the benefits available under workers comp, including temporary total disability and temporary partial disability payments.

 

When you submit a workers comp claim seeking wage loss replacement benefits, you should include copies of your medical records including work restriction notes. Without documents from doctor or their nurse practitioner or physician’s assistant stating that you have job restrictions because of your workplace accident, the Workers Compensation Commission is unlikely to award you cash benefits.

 

Similarly, work restriction notes are critical to keeping your wage loss replacement benefits if you are already receiving them under a Workers Compensation Award Letter. Once your employer and its workers compensation insurance carrier or third party claim administrator (TPA) find out that your doctor is no longer restricting you from work, they may file an application to stop your payments. This pleading is called an Employer’s Application to Suspend Benefits. Or they may request that you attend an Independent Medical Examination (IME), which I call a Defense Medical Examination because there is nothing “independent” about it. The IME may result in unfavorable evidence that can be used to reduce your claim’s value.

 

Work restrictions also affect the insurance company’s rights in workplace injury litigation.

 

 

For example, a physician’s release to light-duty permits the insurer to start vocational rehabilitation efforts or the employer to try to force you into a job you do not want. And if you refuse to cooperate with these efforts, the insurer can apply to stop benefits.

 

How Do I Get Work Restrictions?

 

You ask your doctor for them.

 

Your doctor has two goals.

 

First, to diagnose your injury.

 

And second, to treat your injury so that you have the best possible outcome.

 

Doctors are not trained in or experts on return to work issues. And many of them are uncomfortable with making a determination on whether an employee can return to work and, if so, with what job restrictions. This may explain the increase in use of functional capacity evaluations (FCEs) to determine permanent work restrictions when a person reaches maximum medical improvement (MMI).

 

Some doctors, especially orthopedic doctors who treat a lot of workers comp patients with back, neck, knee and shoulder injuries, do a decent job of providing work restrictions regularly. But others don’t. I recommend asking your doctor or nurse practitioner for a written letter describing your work restrictions at each appointment. Then make two copies: one for your employer and one for your attorney.

 

What Should Work Restrictions Include? Different Examples of Work Restrictions

 

Work restrictions are often classified as physical, mental, or environmental in nature.

 

Let’s take a look at each.

 

Common Physical Work Restrictions

 

Depending on the type of injury you suffered, ask your doctor to address your job restrictions involving:

 

• The amount of weight you can lift or carry, both frequently and occasionally throughout the work day.

 

• The number of hours you can sit in an eight hour work day.

 

• The number of hours or minutes you can sit at one time before taking a break.

 

• The number of hours you can walk or stand in an eight hour work day.

 

• The number of hours or minutes you can walk or stand at one time before taking a break.

 

• How far you can walk without stopping.

 

• Whether you need an assistive device such as a cane, crutch, walker, or wheelchair.

 

• Whether you will need to lie down during the day and, if so, how often.

 

• How often you can reach above your shoulders with one or both arms (overhead reaching).

 

• How often you can reach down to waist level with one or both arms.

 

• Whether you are able to handle objects and, if so, how often (gross manipulation).

 

• Whether you are able to use your fingers for handling smaller objects and, if so, how often (fine manipulation).

 

• Whether you will have difficulty with postural activities such as bending, squatting, and kneeling and, if so, how often you can do each of these activities.

 

• Whether you are able to turn your head or move it up and down, especially if you suffered a head injury resulting in post concussion syndrome or a whiplash injury.

 

• Whether there are any limitations on your driving ability and, if so, what those are. For example, if you are an injured truck driver make sure your doctor addresses whether you can drive a tractor-trailer, which more difficult than a normal vehicle.

 

• Whether you need to elevate your legs to reduce swelling, especially if you suffered an ankle injury or torn ACL.

 

• Whether you are capable of protecting yourself physically in emergency situations. This is especially important for those of you who have jobs that expose you to workplace violence and dangerous situations, such as nurses, police officers, firefighters, and security guards.

 

Common Mental Work Restrictions

 

If you experience chronic pain from your work injury or have been diagnosed with work-related PTSD or depression, ask your doctor to address any limitations involving:

 

• Medication side effects

 

• Your ability to remember different locations and work-like procedures.

 

• Your ability to understand and remember short and simple instructions.

 

• Your ability to understand and remember detailed instructions.

 

• Your ability to maintain attention and concentration for extended periods.

 

• Your ability to maintain regular attendance and show up to work on time.

 

• Your ability to perform your work without special supervision.

 

• Your ability to work with or close to others without being distracted.

 

• Your ability to make simple work-related decisions.

 

• Your ability to complete a normal work day or work week without interruptions.

 

• Your ability to interact with members of the general public.

 

• Your ability to accept criticism from supervisors.

 

• Your ability to get along with coworkers and supervisors.

 

• Your ability to work in a fast-paced environment, such as warehouses owned by Amazon, Walmart, or Target.

 

• Your ability to handle normal work stress.

 

• The number of days you would need to miss each month because of your work-related psychiatric injury.

 

Common Environmental Work Restrictions

 

Those of you who suffer from work-related Complex Regional Pain Syndrome (CRPS), heart disease, or pulmonary conditions should ask your doctor to address work restrictions related to:

 

• Your ability to work in extreme temperatures.

 

• Your ability to work in plants and factories that expose you to strong smells, gases, or dust.

 

• Your ability to look at a computer screen. For example, those of you with traumatic brain injury may develop headaches or migraines if you look at a computer for too long.

 

• Your ability to be exposed to loud noises or bright lights.

 

• Your ability to operate heavy and moving machinery.

 

Other Types of Work Restrictions

 

In addition to the physical, mental, and environmental restrictions described above, you should also ask your doctor to address the number of hours you can work each day and the number of days you can work per week.

 

This information plays an important role in determining whether you have to accept a light duty job offer if one is made and whether you have a duty to look for light duty work to receive workers comp payments. This duty is also referred to as marketing your residual work capacity.

 

Understanding the Five Physical Exertion Levels Found in the Dictionary of Occupational Titles: A Good Starting Point But Not the Whole Story

 

If your treating doctor evaluates your ability to perform each of the mental, environmental, and physical tasks described above, you should receive work restrictions that give an accurate picture of what you can and cannot do.

 

Unfortunately, many doctors and physical therapists follow the Social Security Administration’s (SSA’s) lead and give vague work restrictions that do not address each and every task you had to perform in your pre-injury job.

 

When deciding Social Security Disability claims, both those for Social Security Disability Insurance (SSDI) benefits and Supplemental Security Income (SSI), the SSA classifies work into five different levels: sedentary; light; medium; heavy; and very heavy.

 

These physical exertion classifications, which are described below, are a good starting point for determining your job restrictions. But they are just that – a starting point. I recommend asking your doctor to go into more detail so that you are not offered a light duty job that you are unable to perform or released to full duty when you are not capable of performing all the tasks of your pre-injury job.

 

Sedentary Work

 

A job is considered sedentary if it requires standing or walking no more than two hours total in an eight hour work day, and involves lifting no more than 10 pounds occasionally.

 

Many sedentary jobs require you to use your hands and fingers constantly. So if you suffered a work-related hand injury or carpal tunnel syndrome, or experience numbness and tingling in your hands because of spinal cord trauma such as a herniated disc, you may be unable to perform sedentary work even though you can stand or walk for extended periods or lift a lot of weight.

 

Examples of sedentary jobs include receptionists, administrative assistants, and dispatchers.

 

Light Work

 

A job is considered light work if it requires you to stand for up to six hours in an eight hour work day and lift up to 20 pounds occasionally and 10 pounds frequently.

 

Many jobs that are classified as light work require you to push or pull arm and leg controls during the day.

 

Examples of light jobs include cashier and security guard.

 

Medium Work

 

A job is considered medium work if it requires you to stand up to six hours in an eight hour work day and to lift 25 pounds frequently and 50 pounds occasionally. Many jobs that are classified as medium work also require frequent postural movements such as kneeling, climbing, or squatting.

 

Many nursing and construction jobs are considered medium work.

 

Heavy and Very Heavy Work

 

A job is considered heavy or very heavy work if it requires you to stand up to six hours in an eight hour day and to lift up to or more than 100 pounds.

 

Many of you who work in construction or as delivery drivers have “very heavy” jobs.

 

What is Light Duty Work?

 

A job is considered light duty if it is a modified version of the job you had when you were injured or a new job with fewer physical, mental, or environmental demands.

 

For example, a job lifting 80 pounds at one time may be considered light duty if your pre-injury job required you to lift more than 100 pounds.

 

Does My Employer Have to Offer Light Duty Work?

 

Under the Workers Compensation Act, no. Employers are not obligated to offer light duty work to employees seeking to return to work after an on-the-job injury.

 

But other state or federal laws may require employer your employer to accommodate your light duty work restrictions or to protect your job while you have work restrictions.

 

For example, the Americans with Disabilities Act (ADA) requires certain employers to provide reasonable accommodations if your work injury results in “a physical or mental impairment that substantially limits one or more major life activities.” And the Family and Medical Leave Act (FMLA) provides up to 12 weeks of job protection, though this leave may be unpaid depending on your employer’s policy.

 

Refusing to offer light duty work creates a new obligation for your employer or its insurance company: vocational rehabilitation. If you have suffered a compensable injury and your employer is unable or unwilling to accommodate your light duty work restrictions, you have the right to ask for vocational rehabilitation services, which include job coaching and retraining, at the employer’s expense.

 

Do I Have to Look for Light Duty Work While Receiving Workers Compensation Benefits?

 

If you are under an open Award, which means you have an Award Letter providing ongoing wage loss benefits, then you do not have to look for a light duty job if you are released from being totally disabled to partially disabled with work restrictions.

 

But if you do not have an open Award and your workers comp claim is pending, you need to look for light duty work. The Workers Compensation Commission has Guidelines on the type and scope of job search you should conduct.

 

Can I Refuse a Light Duty Job Offer from My Employer and Continue to Receive Workers Comp Checks?

 

It depends.

 

The general rule is that you have the right to refuse an offer of employment with light duty work restrictions if any part of that job falls outside of your work restrictions and your treating physician has not signed off on the light duty job.

 

If your physician clears you to return to the light duty job that is offered or if the job is clearly within your work restrictions, then you risk losing workers comp benefits by refusing the light duty job offer.

 

Can I Refuse Light Duty Work If I’ve Taken Leave under the Family and Medical Leave Act (FMLA)?

 

Refusing light duty work while on FMLA leave puts your workers comp benefits at risk.

 

The FMLA provides certain employees with up to 12 weeks of unpaid, job-protected leave each year. You can refuse a light duty job offer without losing your right to FMLA benefits.

 

But you cannot use your rights under the FMLA to ignore or overcome the requirements of the Workers Compensation Act. If you refuse a light duty job that your treating physician thinks is within your work restrictions, you will likely lose certain workers comp benefits even though you were out on FMLA leave.

 

For more information on this topic, read my article: The Interaction Between the FMLA and Workers Comp.

 

Will I Make Less Money if I Return to Work Under Light Duty Restrictions?

 

Maybe.

 

The Workers Compensation Act does not require your employer to pay you regular wages if you return to a light duty job. Some employers will pay your regular wages. But others will pay you a lower wage because you’re not performing the same tasks that you were performing at the time you were injured.

 

If you are earning less in the light duty job, either because it pays a lower salary or less per hour or because you are working fewer hours, you may be eligible for temporary partial disability benefits. These cash benefits are paid at two-thirds of the difference between your pre-injury average weekly wage and post-injury average weekly wage.

 

What Can I Do if I’m Unable to Perform the Light Duty Job that My Doctor Said I Could?

 

This is a common situation.

 

After being out of work for weeks, months, or years because of an on-the-job injury, your doctor sends you back to light duty work even though you are deconditioned and have not worked in some time.

 

Within a few days or weeks of returning to light duty, you realize that you simply can’t do the job even though it is easier than your pre-injury job.

 

When this happens, make a follow up visit with your doctor to discuss the specific problems you are having despite your light duty work restrictions. And ask the doctor to provide updated work restrictions that take into consideration the problems you are now having.

 

If your treating physician is unwilling to update your work restrictions, then consider getting a second opinion.

 

What Can I Do if My Employer Offered a Light Duty Job But is Now Asking Me to Exceed My Work Restrictions?

 

Work restrictions have a purpose. They are designed not only to keep you safe and to help you avoid re-injury but also to keep your coworkers and the people you interact with at work safe.

 

Unfortunately, some employers forget this and pressure injured employees to perform tasks outside of their work restrictions even though they promised they would accommodate the employee’s light duty work restrictions.

 

If this happens to you, I recommend doing two things.

 

First, make an appointment with your treating doctor. Explain that your employer is refusing to accommodate your light duty job restrictions and give specifics. If your physician has treated many workers comp patients then they have probably seen this situation before and will be willing to take you out of all work or to provide additional work restrictions making it clear that what your employer is asking you to do is not acceptable.

 

Second, you should file a motion with the Workers Compensation Commission asking it to order the employer to stop asking you to do things outside of your work restrictions. This puts the Commission on notice of potential problems with your employer should it argue that you refused light duty work at a later date.

 

Does My Employer Have to Reinstate My Regular Position if My Doctor Removes the Light Duty Work Restrictions?

 

No.

 

Your employer cannot terminate you solely because you filed a workers compensation claim. This type of employment retaliation is unlawful.

 

But your employer is not required to reinstate your position under the Workers Compensation Act.

 

If you think you have been discriminated against or have a wrongful termination claim, contact an employment lawyer immediately. You can pursue a labor or employment law claim while receiving workers comp.

 

Will Being Released to Light Duty Affect How the Employer and Insurer Defend or Value My Workers Comp Case?

 

Yes.

 

If you are released to light duty work before receiving a Workers Compensation Award Letter, then your employer and its insurer may decide not to offer an Award Agreement form right away. Even though they know your injury is covered by law.

 

The reason employers and insurers do this is to force you to satisfy all the procedural requirements to receive wage loss benefits. Specifically looking for work within your light duty restrictions.

 

If you fail to conduct a good faith job search that the Workers Compensation Commission considers adequate, you may not receive wage loss benefits even though there is no dispute that you are unable to perform your pre-injury job because you were hurt at work.

 

Receiving light duty work restrictions also affects the settlement value of your claim. As a general rule, the more job restrictions you have the more difficult it will be for your employer to accommodate you and for your employer or its insurer to find a light duty job that you’re capable of. This increases the amount of time you may be out of work, which increases the settlement value of your claim.

 

Get Help Protecting Your Workers Comp Benefits When You Have Light Duty Work Restrictions

 

Some studies show that light duty work has benefits. It can speed up the physical recovery process and have a positive impact on your mental health. Having a job can provide fulfillment and motivate an injured employee to continue to battle against their injuries.

 

Some companies, however, create and offer degrading and mind-numbing light duty jobs that have one purpose only: to make you show up. Employers know that if you do not show up to a light duty job within your restrictions then they can fire you or cut off your wage loss benefits.

 

It’s important that you protect yourself throughout the workers comp process – even when your employer and its insurer have accepted liability. Complex return to work issues come up often. And resolving these issues favorably is the only way to protect your financial well being and livelihood.

 

Call today for a free consultation: (804) 251-1620 or (757) 810-5614.