When does workers’ comp start paying? That is the question I'm asked quite often. Of course in many cases the question should be stated a bit different. The one above vs when should workers’ comp start paying?

Okay great question for today. These are two rather interesting questions that should, but don’t have a simple answer. Let’s try and answer the second one first. Injured workers should start getting paid after they are out of work for 3 or more days following a work related injury. If you’re out of work for 10 days or more then they are supposed to catch you up and pay those 3 initial days off of work.

More porridge sir?

But should and does are two different things leading to what I call wiggle room. The answer in each case is not the same because the concepts are not entirely clear under the law. It seems the insurance industry and the employer understand the nuances of the law and how to exploit a concept called delay. Shall we promote the float?

First if your claim is disputed you are for all practical purposes screwed; because the insurance industry will simple say ‘no joy’ and refuse to pay; which under the law they have every right to do. If it appears your claim is covered, but the adjuster sees any question in coverage they will delay pending an investigation. After all they do realize if sometime later your claim is found not to be covered, then it's good luck getting the money back from the injured worker. You can’t get blood out of a turnip and they know that to be the case. If on the other hand they start paying, and can later cut off the payments until things get cleared up, then they will do it every time. But for purposes today let’s make the assumption your case for payment is clear and they start paying. In some cases I've seen the insurance company start paying the first day and then again in some instances others don’t pay those first three days. It all really depends on the seriousness of your injury and if common sense tells us this type of injury will require you to be out of work longer than 10 days.

As an example say you have a soft tissue strain that may or may not require long term care? Well then you’re probably not going to get paid until you're out for more than 3 days and then they will wait for you to be out 10 days before they make up those initial three days.

Or say you break your leg and you’re an over-the-road trucker who has to unload cargo. Chances are you’ll need to see the orthopedic surgeon, do follow-up and then participate in physical therapy. With an injury this serious it’s unlikely you’ll be back to work before the cows come home in a month or two. Wanting to save themselves time they will start paying on day Uno knowing this is going to take a while before you’re back in the truck. The same could be said for a waitress, a cop, a nurse, a doctor, oops not a lawyer, a factory worker, a deliver driver and any other worker requiring a lot of walking and being up on your feet all day.

Hopefully that answers your question but if not see a lawyer, including this one.