A caller to our office wanted to know if they should be getting workers’ compensation benefits or long term disability benefits through a policy their employer provided.
They were injured on the job in Chicago and filed a workers comp claim with their employer. Although there was no basis for it, the insurance company denied the case saying it was not work related. As a result he filed for long term disability (“LTD”). That too was denied because on the application it asks if you were hurt on the job. He answered honestly and sad yes, so he didn’t get LTD either.
Although it sounds like it burned him, the reality is that by answering honestly, this worker will end up with work comp benefits. His case was denied without reason. Had he filled out a form stating that his injuries weren’t work related, he would have created a defense to his case. Once he gets a lawyer to file his work comp case, he should immediately get paid and have his medical treatment covered.
The point of this post though was should you file for work comp or LTD? It’s actually a simple question.
You can’t get both. If you were injured on the job, you should file for workers comp. First off, it’s the truth as to why you can’t work. Second, unlike many LTD policies, there is no cap on benefits and usually you get paid more. Third, it covers your medical care. Fourth, you will get a settlement at the end.
On the flip side, if you weren’t really hurt at work or don’t know (e.g. a repetitive trauma situation), you should file for LTD until a doctor states that your problems are work related. That said, if you think it might be work related, you should make clear on your application that you aren’t sure.
If you do start to get LTD and then it turns out that it’s work comp, the work comp insurance would have to reimburse the LTD insurance.
On the other hand, if you go to trial or in some other way it’s determined that you didn’t have a work injury, you should be able to get short or long term disability.
Whatever you do, we recommend two things. One, be honest. It’s people that lie for short term gain who lose in the long run. Two, don’t sign anything or fill out a form without having an attorney look at it. By doing this you protect yourself and give yourself the best chance of a great result in the end.