What Happens If You Get Caught Working While on Workers Comp In Pennsylvania

May 26, 2021
Stern & Cohen
injured philadelphia worker

Oftentimes when a worker is injured, they want to know if they are allowed to work while receiving workers’ compensation benefits. This really depends on the status of your case. There are some circumstances in which you may be able to work in a limited or part-time capacity if you are partially disabled, but this will have an impact on your benefits. There are strict rules with how this must be reported. If you are caught working without reporting it to your insurance carrier, there are serious consequences to your workers’ compensation claim, and there may even be criminal penalties.

What Is Workers’ Compensation?

To recap, workers’ compensation is composed of two types of benefits: medical and wage loss. if you are currently getting workers’ compensation wage loss benefits, that means that the insurance carrier has recognized that you were injured at work and that the injury has rendered you “disabled”, i.e., unable to perform your pre-injury job duties. Thus, an injured worker is not permitted to be receiving total disability benefits under workers’ compensation and be working and earning wages on top of that. This follows the same rationale as how a person cannot collect unemployment and work a job.

However, if your work injury has not interfered with your ability to work and you are only receiving medical benefits in relation to your work injury, then yes, you are able to and should continue working.

Since there is no way to determine exactly how long an injury will last, workers’ compensation benefits only last as long as the disability from the work injury lasts. When the disability ends, so do the workers’ compensation benefits. As such, by returning to your full-time, full-duty position, you are indicating that you are no longer “disabled” under workers’ compensation laws.

Are You Allowed To Work While Collecting Workers’ Compensation?

While you are allowed to work while receiving workers’ compensation benefits, remember, there are strict rules of reporting it. If you are injured at work and cleared by a doctor to return to work light-duty, you must report this to the insurance company. Even if you are going to start working light-duty for your pre-injury employer, you should still inform the insurance company. If you are able to find a job with a different employer within your restrictions and start earning wages, you must report your income to your pre-injury employer’s insurance company.

If you are earning less than you were prior to your injury, you will still be entitled to partial wage loss benefits. However, it is important to understand that the amount you were receiving while completely out of work will be reduced. The amount you will receive through workers’ compensation will be calculated based on the difference between your pre-injury wages and the wages you are now earning working in a modified capacity because of your work injury. It is always worthwhile to have an attorney review the amount you are being paid to make sure it is accurate. We can easily do this by reviewing your paystubs. Also, if you have to come out of work completely again because of your work injury, your checks are supposed to be reinstated to full wage loss benefits. However, this may require litigation as often times the insurance company will try to fight this.

If the job you want to start will pay you the same as or more than the wages you earned prior to your work injury, payment for lost wages will be suspended. This means your wage loss checks will be stopped temporarily. However, your medical benefits will be ongoing. When this happens, you will likely be sent a document by your insurance company notifying you that your checks will be stopped. It is important to have an attorney review this document to make sure you understand what rights you are giving up and that your benefits should, in fact, be temporarily suspended. Even while “suspended”, you will still be entitled to medical benefits.

It is extremely important that you report any income you have while out of work with your employer on workers’ compensation benefits. Failure to do so can result in workers’ compensation fraud and lead to a loss of benefits, regardless of whether you are medically entitled to partial benefits and your disability is ongoing. To be safe, it is always best to consult with an attorney before returning to work in any capacity, because it helps to know your obligations and what impact your actions will have on your benefits. Furthermore, if the job you are seeking to start is physical in nature and outside of your restrictions, your employer can use this as evidence to stop paying your benefits. They will try to argue that if you are capable of doing the new physical work, you should have been capable of returning to your pre-injury job, and thus, you are no longer “disabled” under the Act.

What Happens If You Get Caught Working?

If you are receiving full workers’ compensation benefits and are working without reporting it, there are serious repercussions. Although we rarely see this with our own clients, unfortunately, some people try to get away with this. As noted in a previous blog (HERE), insurance companies have the right to conduct surveillance on the activities of an injured worker that is making a workers’ compensation claim. Remember, if you are in public, you have no expectation of privacy under the law. Moreover, investigative companies are able to search through your social media and can uncover evidence showing that you are currently working. Thus, if you are caught working while receiving full benefits, not only will you likely lose your workers’ compensation benefits, but you could be subject to criminal prosecution. This is why honesty and transparency are always the best policy.

Contact The Experienced Attorneys At Stern & Cohen

If you are unsure of whether you can or should return to work in some capacity, it is always best to contact an attorney to understand the impact it may have on your claim. There is nothing wrong with contemplating returning to work. However, there are strategic considerations as well as legal considerations that many injured workers are not aware of. By contacting us, you can make a fully informed decision.