- Workers’ compensation is for people who get hurt at work, and short-term disability is for injuries or illness that are deemed non-work related (car accidents, sickness, or diseases).
- If you file for workers’ compensation and get denied, you can then file for short-term disability.
- If your employer tells you to file for short-term disability instead of workers’ compensation after you’re hurt on the job, your employer either may not know the difference or save the company money.
- If you get on short-term disability and you should have been receiving workers’ compensation benefits, you will have to pay back the short-term disability benefits later on.
Common Questions About Workers’ Compensation vs. Short-Term Disability
- “What is the difference?”
- “Which one should I apply for?”
- “Why is my employer telling me to file for short-term disability if I got hurt at work?”
- “I have been denied for workers’ compensation benefits, now can I get short term disability?”
- “Does it affect my workers’ compensation case if I get on short-term disability?”
The above are the most common questions I hear when injured workers are caught between short-term disability benefits (STD) and workers’ compensation benefits. Read on for some clarity on the two different types of insurance and how they affect one another.
Difference Between Workers Compensation and Short Term Disability
The big difference is that workers’ compensation is for people who get hurt at work and short-term disability (STD) is for injuries or illness that are deemed non-work related (car accidents, sickness, or diseases). Likewise, short-term disability policies typically do not cover work-related injuries. If you have a STD policy, you are usually paying for this. This is money taken out of your check, just in case something unforeseen should happen to you.
Your employer pays for the workers’ compensation insurance, so that way if an injury does occur on the job, the insurance is there to handle the situation (kind of like you and I pay for car insurance – just in case!). Workers’ compensation and STD policies typically have very different time limits associated with them as well.
Applying for Short Term Disability vs. Workers’ Compensation
This can be confusing. Generally speaking, if you got hurt at work, you should be applying for workers’ compensation benefits. However, if workers’ compensation benefits are denied (if it is a repetitive injury, for example), you could then file for short term disability benefits (depending on the terms of your policy).The difficult situation is when the two insurance companies deny the claim and point the finger at the other and you are stuck in the middle not getting any benefits.
Why is my employer telling me to file for short-term disability if I got hurt at work?
The answer may be one of two things: 1) Your employer may not be aware of the difference between the two types of benefits OR 2) Your employer could be trying to pull the wool over your eyes – by having you make a claim under your personal STD policy (remember YOU pay for this and it is usually much less money and no medical benefits), instead of filing a claim for workers’ compensation benefits against the company’s insurance policy (the policy the employer pays for) it saves the company money (filing a claim will increase their premiums).
I have been denied for workers’ compensation benefits, now can I get short-term disability benefits?
In most cases, yes; however, short-term disability policies vary greatly so you may have to pull out your policy and read over the terms and conditions to be sure.
Does it affect my workers’ compensation case if I get on short-term disability?
The short answer is, yes. If you get on STD and you should have been receiving workers’ compensation benefits, you will have to pay back the STD later on.
For example: Your workers’ compensation claim is initially denied and you start collecting STD benefits. Then you hire a workers’ compensation attorney to go to a hearing and fight for your workers’ compensation benefits. The attorney wins your benefits and you are paid workers’ compensation wages for the time you were out of work. Now you have been paid twice, once from STD and once from workers’ compensation. Now you would have to pay back the money you collected while getting STD to the STD company because workers’ compensation has now paid you and you cannot collect both. No double-dipping!
Also, in most cases to get on STD, you have to say that the injury that is preventing you from working is not work-related. If you are still seeking workers’ compensation benefits, any statements of this nature could be VERY HARMFUL to your case!
Make sure you understand the difference between the two types of insurance, how they affect each other and how they could affect you.
There Are Other Ways To Ruin Your Workers’ Comp Claim As Well
If you have a workers’ compensation claim based on a personal injury in the workplace in Virginia, you are most likely seeing a workers’ compensation approved treating doctor. These doctors have typically the system before, so they know how the insurance companies operate and the things the insurance companies may be looking for. Dealing with your workers’ comp doctor is a large and extremely important part of your claim.
In all workers’ compensation cases, we try to emphasize the importance of not making these 5 mistakes that could severely hurt your workers’ compensation insurance case. Just because you suffer a workplace injury doesn’t guarantee that you will receive disability benefits.
Waiting to Seek Medical Care
Insurance companies and Commissioners believe that if you are not injured badly enough to seek medical attention, you are not injured badly enough to be entitled to workers’ compensation benefits. You should ALWAYS seek medical care after an injury; even a minor injury can get worse if untreated and, as I have stressed so many times before, DOCUMENTATION is KEY!!
Not Being Honest With Your Doctor
When you discuss your injuries with the doctor, the insurance company (and the Commissioner) will see his or her notes. It is important that you are completely honest with the doctor about your prior medical history, how your injuries happened, your pain levels, symptoms, and your personal habits.
- Prior Injuries – Any prior injuries you have will show up in your medical history so you need to be transparent about this. Omitting prior injuries or surgeries from your statements to your doctor or the insurance company can cost you in the end.
- How your injury happened – These need to be consistent from your first accident report to how you report the injury to the doctor and the insurance company. Consistency is extremely important
- Symptoms and pain levels – You need to have your symptoms and pain levels properly documented by your doctor at each and every appointment. Underreporting things to your doctor in the beginning can be problematic if your recovery takes longer than anticipated. It could even give the impression to the insurance company that you are exaggerating your pain now when you reported feeling fine at your last 3 appointments. Some folks hide their symptoms from their doctors in an effort to be released back to work; while I know you want to be able to return to work and put this whole mess behind you, this is not the way to do it. Once a doctor releases you to go back to work, they are typically very reluctant to take you back out. If you really want to return to work, but your injury has not fully healed, ask your doctor and your employer about the possibility of returning with work restrictions.
Conflicting and inconsistent information will also destroy your credibility and this can be devastating to your case!
Failing to get all of your injuries and pain levels properly documented.
Saying you are in pain is not the same as having it documented in your medical records. You can say you are in pain all day but the doctor has to be the one to document your pain and relate your pain complaints to the work injury. This is why I tell people to keep a log or diary of their pain – when it is the worst, what makes it better, or what makes it flare-up – that way you can share this information with your doctor at your appointment and be sure these issues are part of the conversations you are having with him or her.
Medical reports from the emergency room or your medical provider after a workplace accident will become a central point when the time comes to negotiate your workers’ comp benefits with your employer’s insurance company.
Showing up late or missing a doctor’s appointment.
When you “no show” for an appointment with the doctor or are so late that the doctor can’t see you, typically all that is in the medical record is that the appointment was missed and you did a “no show.”
The doctor’s office does not make your reason or excuse for missing the appointment part of the document so when the insurance carrier or the Commissioner sees this in your file, they could easily assume that you didn’t make it to the appointment because it was not a priority for you and this can cost you in a big way. It can give the impression that you are not committed to getting better and the insurance carrier may say that you are refusing medical treatment which can cause benefits to be cut off. I always advise injured workers to keep all of their appointments but if one absolutely has to be missed for some reason, call in advance to reschedule the appointment or let them know you are running late.
This is especially important if you are asked to undergo an independent medical examination. You may generally deal with your own doctor, sometimes referred to as the treating physician, but the insurance company has the right to ask you to see one of their doctors and undergo an independent medical examination (IME) so they have a second opinion and can make sure that their doctor’s opinion is in line with yours.
Not following the doctor’s instructions on the course of treatment or medications.
When the doctor tells you to participate in physical therapy or to take a certain medication and you don’t do it, the insurance company, and sometimes the Virginia Workers’ Comp Commission, might assume that you are not taking your recovery seriously or purposely delaying the healing process because you simply want to collect benefits and not return to work.
Remember, there is a reason why doctors prescribe a particular type of medication for a particular time period. You should follow your doctor’s recommendation until your doctor tells you something different. If you think a medication is making your muscles ache or your stomach hurt, say so; side effects are not rare, and your doctor can usually switch you to another drug. The same goes for your treatment plan. If a particular treatment is not helping or even making things more painful, you need to report this to the doctor as he or she is the only person who can make changes to this.
Don’t put yourself in the position where you have to admit that you chose not to follow your doctor’s advice. This can be devastating to your worker’s comp claim.
Speak With A Virginia Workers’ Comp Attorney
At Injured Workers Law Firm, our team does nothing but help those who have suffered a work-related injury. We don’t take any other types of personal injury cases. Our workers’ compensation attorneys are dedicated to helping injured employees navigate the Virginia workers’ compensation system and getting them the full and fair benefits to which that are entitled. We understand what it takes to get the best results for your workers’ compensation claim.