Economic Ramifications of a “Full Duty Release to Return to Work”

In North Carolina, treating doctors often release an injured worker to return to work “full duty, no restrictions” before the worker has returned to full function of the injured body parts.  Lack of function of an injured body part, often referred to as an “impairment,” can make returning to work without restrictions quite difficult.

But there is also an insidious economic risk to a full duty release.  If the doctor has released the worker to return to work with some restrictions, even a small restriction, under NC law that worker has some protection from job loss.  If the employer of injury cannot accommodate the restriction and put the worker back to work earning wages, then the worker is entitled to continue receiving his weekly disability check from the workers’ compensation insurance carrier.  The worker is obligated, most of the time, to perform a reasonable and diligent search for “suitable employment” when he is restricted but not working.  So long as his restrictions remain in place and he does the diligent job search (which he needs to document as well as possible),  he is entitled to continued TTD (temporary total disability) payments while he looks for work.

But with a “full duty, no restrictions” release, the employer can terminate the injured worker and the worker has no financial recourse!  This is because a “full duty release” is viewed as a medical statement that the injured worker has no impairments that might adversely affect his ability to get a job.

The truth may well be different—for example, a work comp case I tried this week involved a lady in her 60’s who had a severely comminuted fracture of her wrist.  The doctor bolted it back together in an ORIF surgery and she healed up without complications.  But her range of motion and grip strength are approximately half of what they are on the other, non-injured arm.  The doctor, after she was healed, sent her back to work “full duty no restrictions.”  She testified that the impairments due to the injury prevent her from safely walking up and down stairs, since she cannot grasp the handrail with any strength or confidence.  Many jobs require one to use stairs.  So even though she has a physical impairment that affects her ability to take some jobs, she has no medical restrictions.  Her employer fired her.  Her only remedy was to sign up for unemployment, because under the work comp law, she was no longer entitled to TTD benefits.   And, of course, her employer fired her along about the time the doctor released her full duty.

Doctors do not intend to hurt their patients, but a full duty release often does hurt the patient economically.  It often results in a job termination from the employer of injury.  Employers will not fire an injured worker before the full duty release, because employers know that doing so may cost them more money in TTD benefits paid out.  But those case nurses that employers send to medical  appointments with injured workers are always pushing the doctors for a “full duty release.”  Why?  Because a “full duty release” permits the insurance company to stop the TTD checks, and it permits the employer to fire the employee without much economic backlash in the comp case.

For these reasons a “full duty no restrictions release to return to work” is often a raw deal, economically, for the injured worker.  This is especially true in times such as 2012 when unemployment is high and jobs are not plentiful.