I Threw My Back Out at Work. Can I Get Disability?

In most states, when we say “disability,” there are a number of different possible policies and programs you could be talking about.  When it comes to back injuries, however, there is likely one that will apply over others: Workers’ Compensation.

Workers’ Comp is the go-to policy to cover injuries sustained in the course of your work, and it covers all kinds of injuries that keep you from returning to work.  There may be other disability programs and insurance policies that could overlap with this, potentially paying you additional money, but Workers’ Comp is usually the core program you will apply through.  Getting coverage for throwing out your back usually has a particular process, though it may vary from state to state.

Workers’ Compensation vs. Other Disability Programs

Workers’ Comp is often the best way to get benefits for a back injury at work because it is usually quite universal, it is likely to apply to your injury, and your injury is likely to qualify for benefits.  There may be other policies and programs you can apply to at the same time, but they might not apply, depending on the situation.

Broad Workers’ Comp Coverage

First, Workers’ Comp is usually required for all employers.  Some states do have laws that allow employers or employees to opt out, but most employees are covered whether they know about their employer’s Workers’ Comp policy or not.  For example, the rule that our Philadelphia Workers’ Comp lawyers encounter requires all employees with even one employee who could be injured in Pennsylvania to have insurance to cover their employees’ potential work injuries.

Workers’ Comp vs. Long-Term and Short-Term Disability

Employers sometimes have other policies and benefits that they give you that might cover additional damages for injuries, such as short-term disability and long-term disability insurance.  With these, there is always a question of whether a back injury is the type of injury covered under these policies.

If you only have long-term disability benefits, a short-term back injury might not qualify, and the reverse is also true of short-term disability benefits.  However, back injuries are one of the most common work injuries people face, and Workers’ Comp is designed to cover these kinds of injuries even if they ultimately go on for longer than you might expect or if they end sooner than you planned for.

Workers’ Comp vs. Social Security Disability

Lastly, some disability programs need very severe injuries for coverage.  For example, Social Security Disability Insurance (SSDI) – the Social Security Administration’s main disability program – requires an injury that is likely to last over a year or ultimately end in your death.  This means this program is best for very severe conditions like cancer or heart failure.  It also requires a very low ability to work.  Because back injuries might not last long enough and might allow you to still work to some extent, you simply might not qualify for SSDI with a back injury.  That leaves Workers’ Comp as your best option anyway.

Applying for Workers’ Comp After a Work-Related Back Injury

The process is a bit different from state to state, but in our home state of Pennsylvania, Workers’ Comp cases for a back injury usually go a little something like this:

Applying

Your initial application actually goes to your employer by providing them notice of your injury.  They then file a claim with their insurance carrier, and either the insurance carrier or the employer might have a problem with the claim and deny it.  In rare circumstances, they might accept your claim, but you should typically be prepared for a denial and a fight.

Going to Court/Appeals Boards

From that stage, different states make the next step an application with the state’s Work Comp board or a petition to a Work Comp Judge.  Pennsylvania cases go to a judge with a petition to grant the benefits, and then if there are issues with that case, you can appeal to the state appeals board.

During this stage, the judge will hear arguments and evidence from both sides in a hearing, where the judge will make the final decision about whether your injury is sufficiently disabling to get you wage-loss benefits and whether the injury was work-related in the first place.  Often, if the insurance carrier or employer had no good reason for denying your claim, we may be able to get attorney’s fees and punitive damages through the case.

These cases are also often resolved with a settlement, which the judge has to sign off on before benefits can be granted.  Sometimes, these settlements involve ongoing benefits as a result, but more often, they are simply paid as a lump sum.

Getting Benefits

If you sign a compromise and release agreement, your benefits are usually paid in one lump sum, and your case is over – there is nothing else to do!  Otherwise, if you are granted ongoing benefits, you should start receiving them quite soon after the hearing.

Ongoing wage-loss benefits can be paid for a back injury to cover any time you have to take off at work.  If your back injury allows you to work to some degree, the benefits will often cover 2/3 of the difference between your old and new wages instead, making up some of the difference.

As long as your case is still open, any ongoing medical treatment you need – such as therapeutic massages, chiropractic adjustments, and physical therapy – should be covered to help you try to get back to 100%.

Getting Workers’ Comp for a Back Injury

Although other disability benefits might be available and might overlap with Workers’ Comp, this is often the main way to get benefits for a back injury at work.  When you receive these benefits, you will often need a lawyer’s help to file a petition and get you the benefits you deserve, given that insurance carriers and employers often fight to shut down claims.