Some workers’ compensation cases are straightforward. A worker needs stitches or a cast to protect a broken bone. They make a full recovery with treatment and return to work quickly. Workers’ compensation pays for their care and replaces a portion of their wages until they are fit to work.
Other times, the injured employee may face a long road to recovery. Injuries and medical conditions that can create lasting symptoms may require more extensive treatment. The physician overseeing the workers’ compensation claim may recommend surgery, physical therapy or even home exercises as part of their overall treatment plan.
They may also impose functional restrictions on the injured worker that limit what they can do for their employer and in their free time. Workers typically either need to comply with treatment plans or work to adjust them. If they fail to do so, in some cases, their benefits could be at risk.
Fault usually doesn’t affect benefit eligibility
For the most part, workers’ compensation provides no-fault coverage. It doesn’t matter if the employee made a mistake that caused their injury. Fault does not factor into their rights to claim benefits. They can receive benefits even if they are to blame or if there is no proof that their employer is at fault.
However, a refusal to follow medical instructions may limit their eligibility for ongoing benefits. When a worker directly causes their medical challenges, that can affect their benefits. If they refuse to attend physical therapy sessions and cannot improve lost function due to that choice, the doctor overseeing their care may determine that additional treatment is inappropriate.
The physician may assert that any additional may not improve the worker’s condition without their completion of a physical therapy regimen or willingness to follow the doctor’s instructions. In such cases, medical coverage for ongoing care may end because the worker has prevented their own recovery.
A refusal to follow a doctor’s instructions might also impact eligibility for disability benefits. Workers who question the necessity of certain interventions may need help asserting themselves. They could seek out a second opinion or appeal an unfavorable medical determination.
Getting assistance when navigating a workers’ compensation dispute or appeal can help an employee protect themselves. Those who have someone advocating for them are less likely to make mistakes that can affect their eligibility for ongoing medical and disability benefits.