Whether you have work restrictions affects you and your employer’s rights and responsibilities under the Occupational Safety and Health Act (OSHA), Family and Medical Leave Act (FMLA), unemployment, Social Security disability, and workers’ compensation laws.
Work restrictions come from physicians, whom government agencies, insurers, employers, claimants, and attorneys ask to complete papers describing what their patients can do at work but should not. These work status reports certifying your abilities and restrictions and how judges, attorneys, and parties interpret them may determine your eligibility for benefits or how much you receive through a workers’ compensation settlement.
But, as you will see in this article, providing work restrictions is more art than science.
Further, the American Medical Association (AMA), insurers, and employers encourage physicians to keep patients at work or release them to light-duty work as soon as practicable. This philosophy may force you to return to work before you are ready or accept a lower lump sum because your permanent restrictions are less limiting than you feel they should be.
Fortunately, a skilled work injury lawyer can help you handle return-to-work issues and discussions with your physicians, so an early release to return to employment before you are ready does not delay your physical, mental, or financial recovery.
Continue reading to learn more about work restrictions and physician decisions on work abilities and limitations.
And call my firm at (804) 251-1620 or complete this form if you have worker compensation questions. We help injured employees throughout the Commonwealth of Virginia and want to see you get every medical treatment and penny you deserve.
A medical restriction is a communication from any company or treating physician stating your current environmental, mental, and physical limitations and capabilities because of your work-related 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.
Medical work restrictions can be permanent or temporary.
Physicians start with temporary restrictions on work, except when a work-related head injury causes traumatic brain injury (TBI) or coma or a spinal cord injury results in paralysis.
In most cases, the doctor continues to ease the work restrictions, permitting you to do more until you reach maximum medical improvement (MMI). Then, when you reach MMI, your doctor will issue permanent work restrictions or refer you to a functional capacity evaluation (FCE) to help decide any permanent limitations or impairment rating (an exam you need to obtain permanent partial disability benefits).
You must have written work restrictions from a treating physician to prove your entitlement to wage loss benefits (temporary total disability, temporary partial disability, or permanent and total disability payments) or keep them under a workers’ compensation award order.
Countless court holdings state that as the injured employee seeking benefits, you bear the burden of proving disability and the periods of your disability.
Further, the law does not presume you will remain disabled indefinitely once you prove disability. You must, therefore, ask your treating physician for a letter addressing your work status at each office visit. Otherwise, you risk losing cash payments that can keep you and your family financially afloat while you recover.
Yes.
You must get your treating doctors to put your work restrictions from the occupational injury in writing to give yourself the best chance of winning benefits at a workers’ compensation hearing.
The format of your written “off-work” slip does not matter. Your doctor can put the restrictions in an office visit note or a separate letter, email, text message, form, or questionnaire response.
Oral communication – such as the doctor or their staff saying you cannot do your regular job during a clinical examination or phone call – is not good enough for several reasons.
First, the insurance claim adjuster will not offer an agreement form unless you have written restrictions. I know this based on handling thousands of claims.
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 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 weight to testimony on this issue unless you have papers from your doctor supporting your testimony.
It can be.
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. This lack of training leaves doctors feeling unqualified to discuss specific work restrictions.
Second, some physicians want to avoid taking part in litigation at all costs. They fear depositions and court testimony. Instead, they want to focus on diagnosis and treatment.
I get this. But a hands-off or avoidance approach to work status can harm a patient. Refusing to provide medical work restrictions to a patient increases the risk of the Workers’ Compensation Commission denying wage loss benefits or the insurer refusing to authorize ongoing treatment for the work-related injury. Both scenarios cause stress and impede healing.
Third, the physician might not be familiar with the workers’ comp claims process or understand an injured employee’s responsibility under the 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. This lack of familiarity means your doctor may not understand the importance of writing work restriction letters for your claim.
Your doctor has two goals.
First, to diagnose your injury.
Second, to treat your injury so that you have the best possible outcome and recovery.
Re-injury or too much stress on the injured body part too soon impedes recovery.
Remind your doctor of this. Then ask your physician for proper work restrictions after providing a written job description for the position where you suffered an injury and explaining all the tasks you performed pre-injury.
Ask your doctor or nurse practitioner for a written letter describing your work restrictions at each appointment. Make two copies: one for your employer and one for your attorney.
In the next section, I will explain the factors your doctor may consider when deciding whether to give work restrictions.
Use this knowledge to explain to the doctor why you hesitate to return to work.
The AMA published a book titled A Physician’s Guide to Return to Work that recommends physicians think about three concepts when asked about a patient’s work ability: risk, capacity, and tolerance.
Your doctor may not follow this guidance. But knowing that your physician may have read this publication can help you discuss return-to-work issues during medical appointments.
Let’s look at each term.
Risk means the chance that you will suffer re-injury or some other harm if you perform a specific work activity.
Capacity means your ability to perform specific strength, flexibility, or endurance activities.
Your capacity may change during your recovery, for better or worse. For example, an occupational injury that requires surgery may lead to deconditioning and reduced ability.
Tolerance is how long you can sustain a work activity at a certain level.
When assessing your ability to return to work, your doctors should evaluate your ability to handle physical and mental tasks and environmental settings.
Let’s take a look at these three categories of work restrictions.
Depending on the type of injury you suffered, ask your doctor to address your work restrictions for:
If you experience chronic pain from an occupational injury or have developed a mental health condition because of a work-related incident, ask your doctor to address any work restrictions involving the following:
Those of you who suffer from work-related CRPS, heart disease, or pulmonary conditions should ask your doctor to address work restrictions related to your physical surroundings, including the following:
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 is vital in determining whether you must accept a light-duty job offer if the employer makes one and whether you must look for light-duty work (market your residual functional capacity) to receive workers’ comp payments.
Call 804-251-1620 if you have concerns about returning to the job after an injury and want to know how to discuss work restrictions with your doctor. My law firm has helped thousands of injured employees navigate conflicts and disputes over work ability and resolve their claims successfully.