What Happens If You’re Injured and Can’t Work?

When we talk about work and injuries, the context we tend to be discussing most often is what happens if you're hurt at work. If you're hurt at work, you report it to your boss, and you may end up filing a worker's compensation claim. 

Worker's compensation will provide wage replacement and other benefits as you recover. 

What happens, however, if you're injured outside of work? For example, maybe you were hurt while you were riding your bike or doing household chores. 

Depending on the severity of your injuries, you may not be able to work while you recover, so what happens then? We will talk more about the topic below. 

The Course and Scope Work

If you're injured participating in a hobby that is in no way associated with work, as mentioned, you don't qualify for worker's comp. 

However, there is something to be aware of here, which is called the course and scope rule. 

Under this rule, even if you're hurt outside of work, you could be eligible for worker's comp benefits. 

If you were participating in a company-sponsored event, you could be eligible for coverage, but the rules vary quite a bit between states. Questions that might be relevant in this scenario include whether you were benefitting professionally from being at an event, whether you were expected to attend, and whether the employer had you sign a waiver. 

If you were traveling out of town for work and you got injured, it gets complicated. If you were attending a business conference and you were hurt, you could qualify for worker's comp. 

If you're hurt going to or coming from work, worker's comp typically won't apply to your injuries, but if you're hurt while you're on the job but maybe not in your office, you could get benefits. 

If you can't work because of something related to your work, worker's comp should cover your medical expenses and most of your lost wages. 

You're Hurt Outside of Work

Now, back to the original scenario discussed-you're hurt outside of work. You might have a personal injury claim in some of these situations. 

If you were riding your bike and a driver hit you, or you were involved in a car accident, pedestrian accident, or slip and fall accident, you might be able to file a personal injury claim. You would have to show that your injuries and the accident were the fault of another party. 

If you're hurt outside of work, and it's someone else's fault, you could be able to recover damages for your lost wages and future earnings. You could also potentially recover past and future medical costs, damages for emotional pain and suffering, and damages for other things like loss of enjoyment of life. 

Social Security Disability Insurance 

If your injuries have nothing to do with work or another person's negligence, you may have other options available to you. 

One is Social Security Disability Insurance or SSDI. 

A lot of people assume Social Security only provides retirement benefits, but they do have programs for people who are hurt and might not be able to work over the long term. 

SSDI is available to anyone who's paid FICA taxes or self-employment taxes for a period of time. 

The maximum SSDI benefit is $3,345 currently, although most people receive significantly less. The average is $1,358 a month. 

If you're found disabled, your family might be able to get benefits as well. For example, if you have a minor child, they may be eligible for 50% of your total benefit amount, and your spouse might also. 

The downside of applying for SSDI is that it can take a long time to receive a decision. If you do get approved, you'll get back benefits from the date that you became unable to work. 

Can You Be Fired?

Unfortunately, your employer may have the right to fire you for an injury that's non-work related. Depending on your state, your employer may not have to give you a reason for firing you, either. 

Some employees might have a level of job protection if they're contract workers, or their case might be covered under federal law. 

If you are fired because of an injury not related to work or because of a medical condition, you could be eligible to receive unemployment benefits. 

If you're an at-will employee, which most people in the U.S.  are, an employer can fire you at any time and without justification as long as they're not firing you for a reason that's illegal under federal or state law. 

All states also dictate that you can be fired for an injury if the employer has a good cause.  If you're injured and can't do your job duties as a result, you can be fired. You can also be fired if you have to take a prolonged period of time off work, and it's creating a hardship for your employer or if you have excessive absenteeism. 

It does get more complicated than this, based on the facts of your non-work injury. 

If you have a disability, you might be protected under the Americans with Disabilities Act. It's illegal under this Act for your employer to fire you solely due to your disability. If you return to work with a disability, your employer has to provide what are described as reasonable accommodations. 

It may not be possible for your employer to do this, though, depending on the workplace and the nature of your job. These accommodation rules under the ADA also don't apply to businesses with fewer than 15 employees. 

You may have some protections under the Family and Medical Leave Act or the FMLA, which grants employees up to 12 weeks off from work over a 12-month period. Not every employee qualifies for this leave, though, and you don't get paid. 

If it sounds confusing, it is. There are actions that your employer can take against you if you're outside of work and get hurt, and you expect you'll have a lengthy recovery period. The best thing to do is communicate with your employer as soon as possible and potentially talk to an attorney as well to figure out your options.