Burns or other soft tissue injuries can leave you with a lifetime of scars, both physically and emotionally. Treatment for burns can take years to repair the damage that has been caused to the skin and muscles. Some injuries will allow you to return to work under certain restrictions, but in other cases, you might be able to return to work for a period of time. Patients who find themselves unable to work because of severe burns may qualify for long term disability (LTD) benefits. The insurance company will review their claim to see if they qualify under the conditions of that plan.
Do Burns Qualify You For Long Term Disability?
Maybe. You will need to check your long term disability policy to determine what is covered. Most employers have some group policy that covers you as long as you are employed there. If you are self-employed and have an individual policy, check to see what is included. You can request a copy of your policy from your human resources department. It’s recommended that you request a copy in writing so you can start the documentation process. Some HR departments may try to delay sending you the policy or forms because they know you intend to file.
Residual Functional Use
A component of your long term disability claim is to determine your capacity to work. A residual functional capacity evaluation determines this. The insurance claim examiner will rate your residual functional capacity (RFC) to determine what level of work you are capable of doing. To do this, claims examiners will go through each category addressed on the RFC. They will look at the following information:
- How much can you lift, and how often? For example, if you can lift 25 lbs frequently and 50 pounds occasionally, you will be assigned a medium RFC rating. If you can only lift 10- 25 lbs frequently, you will be given a light RFC rating;
- How long are you able to sit or stand? For example, if you have a knee injury, you might not be able to stand for long periods. Or, if you have suffered a lower back injury, it may be too painful to sit all day;
- How well can you reach out or overhead? Injuries or illnesses like degenerative disc disease and arthritis can make it hard to reach out or overhead;
- How well can you bend down, crouch, or stoop? Many manual labor jobs require bending, stooping, or crouching low. If you cannot perform these functions, your job choices will be limited;
- How well can you grasp objects or use your hands? People who are suffering from burns or other soft tissue injuries will have a hard time grasping tools or typing all day because their fine motor skills are not as good as they were previously; and
- How well can you hear and see? Hearing and vision are critical to success in the workplace as well as life. If your disability has impaired your hearing, vision, or both, it will be very hard to work.
Should I Resign If I Plan to Be Out of Work For a Long Time?
The simple answer is not until you consult an attorney. After an extended period, most employers will ask that you resign from your position. From the employers’ standpoint, they are trying to accomplish two things: (1) The job requires a non-disabled person to work the vacant position, and your resignation will allow them to hire someone to replace you and (2) If you do not word your letter carefully, they may be able to interpret your letter as an “I quit” and will be off the hook when it comes to paying your disability claim and any other benefits like FMLA, retirement, health insurance, etc.
When you use the term “resign,” you are telling your employer that you quit. Resigning your position is not the same as not being able to work your job due to your disability. This is why the correct language in your letter is so important. The best practice is to consult a disability attorney before you submit your letter to human resources.
Consult An Attorney
Working with an experienced disability attorney will give you the best chance of getting the benefits you deserve for your burn. Even if you have been denied benefits, that does not mean your fight is over. Many people are denied benefits the first time they apply. You have the right to file an appeal and try to get more information that may help your case. Getting expert help is often the difference between being denied and being approved for benefits.
While the process can be daunting, your experienced disability attorney will be able to guide you through the process. They do not get paid until you win your case. You can seek help without worrying about upfront costs or unexpected bills.
The Ortiz Law Firm has successfully represented people in disability cases across the United States. If you would like to talk to an experienced disability lawyer about your burn and its impact on your ability to work, call us at (888) 321-8131. We would be happy to evaluate your case and to discuss how to help you through the appeal process.