Getting Your
Benefits Paid
If you have been
injured at work, or suffer from an occupational disease, your entitlement to
worker's compensation benefits is clear. Notice should be given to your employer
as soon as possible following your injury. You have the right to obtain a copy
of the Employer's Basic Report of Injury that is required to be filled in your
state. Once you make a claim for benefits, the employer or its insurance company
has a duty to promptly investigate your claim and make a decision within thirty
days regarding your entitlement to benefits. You should submit proof of your
injury including the names and addresses of your physicians as soon as possible
to your employer. You should make sure that your employer reports this information
to the insurance company immediately after your injury. If benefits are not
paid within thirty days, certain penalties may apply depending upon the circumstances
of the delay. You have every right to know the status of your claim, and you
should stay in constant contact with your employer and its insurance company
to make sure your claim is being properly handled.
Hiring an Attorney
The decision to
hire an attorney in a worker's compensation claim is a very important one. An
attorney experienced in worker's compensation law can provide valuable assistance
to an injured worker by advising them of their specific rights and responsibilities
under the law. An attorney that specializes in worker's compensation will be
able to effectively communicate with the employer or insurance company to make
sure all of your benefits are paid. In some states, the law provides that attorney
fees can only be charged to an injured worker when the attorney's services result
in the payment of workers' compensation benefits to an injured worker. The attorney
fee charged to you is subject to maximum fees set forth in the workers' compensation
law. If an attorney is successful in obtaining a voluntary payment of workers'
compensation benefits on your behalf, or an award from a magistrate, the maximum
fee chargeable is 30 percent of your past due benefits. The attorney will most
likely forward expenses associated with handling the case, which are reimbursable
out of any past due benefits or award before computing the fee. If an attorney
is successful in obtaining a settlement on your behalf, different fees apply.
A workers' compensation settlement is known as a redemption. Attorney fees on
redemptions workers' compensation the first $25,000 obtained, and 10 percent
of any amount above $25,000, after first subtracting the expenses. If a person
is receiving benefits on a voluntary basis at the time of the settlement, and
no dispute exists, then the maximum attorney fee is 10 percent. If a workers'
compensation case proceeds to trial, and proofs presented in the case are complete,
then the attorney can charge a fee of 20 percent of the amount of any settlement.
All attorney fees are subject to approval by a magistrate. An experienced workers'compensation
attorney should be able to provide you with advice and may not charge you a
fee unless workers' compensation benefits are obtained on your behalf.
Lost Wage Benefits
If you have been
injured at work or suffer from an occupational disease, and are off work for
more than eight days, your employer or its insurance company is responsible
for paying you for your lost wages. Your lost wage benefits are determined by
averaging the highest 39 weeks of your earnings for the 52 weeks prior to the
date of your injury. If you worked less than 39 weeks for the particular employer
where you were injured, then your average weekly wage is based upon the total
number of weeks that you've worked. Your employer is required to supply this
information to their insurance company or make the necessary calculation. The
benefit rate to which you are entitled is typically 80% of your after tax wages,
subject to a maximum benefit rate that is tied to the state average weekly wage.
Your weekly benefit rate will increase if you have dependents such as an unemployed
spouse, or children under the age of 18. For injuries occurring in 1996, the
current maximum benefit rate is $524. Your weekly wage loss benefits are payable
for as long as you remain unable to work. There is no limitation on how many
weeks of benefits you could receive if you became permanently disabled. Wage
loss benefits are not subject to any local, state or federal taxes. Your weekly
benefits are also exempt from attachment or garnishment, but for court ordered
child support or alimony payments. You should always contact an experienced
workers' compensation attorney for a detailed explanation of all of your rights
under the law.
General Overview
If you have been
injured at work, or suffer from an occupational disease, you are entitled to
benefits. There are three basic types of benefits -- lost wages, medical and
vocational rehabilitation. These benefits are aavailable to any employee regardless
of who was at fault for causing the injury or making a pre-existing condition
worse. The lost wage benefits are based upon your average weekly earnings for
the year prior to the injury and the value of any discontinued fringe benefits.
These benefits are payable weekly and represent approximately 80% of your after
tax wages subject to a maximum benefit for 1996 of $524. Your are also entitled
to reasonable and necessary medical treatment with a physician of your choice
within ten days after an injury. Medical expenses must be paid within 30 days
after proper proof of the expenses have been submitted. The company does have
the right to send you for treatment to their doctor within the first ten days
of an injury. If you become unable to return to your past employment because
of your health conditions, you are entitled to professional assistance in finding
suitable employment, retraining, or education. You should always contact an
experienced workers' compensation attorney for a detailed explanation of all
of your rights under the law.
Your Right to
a Hearing
Most workers' compensation
claims are paid voluntarily by an employer, or their insurance company. However,
disputes often arise regarding a person's right to receive the benefits or to
continue to receive benefits once a claim has been paid. Your employer or their
insurance company can stop your benefits for a variety of reasons. They may
also deny you certain benefits such as medical care or vocational rehabilitation.
You have the right to request a hearing and be represented by an attorney. The
hearing process is started by filing and Application for Mediation or Hearing
with the Bureau of Workers' Compensation. Mediators are employed by the Bureau
to try and resolve disputes informally. These informal hearings are conducted
at various county offices on a daily basis. The mediator has no authority, however,
to order the payment of benefits. A formal hearing is required when workers'
compensation bbenefits have not been properly paid, or are improperly discontinued.
Attorneys that specialize in workers' ccompensation provide valuable assistance
to injured workers by presenting your case to a magistrate. Your employer, or
their insurance company will be represented by their attorneys. The workers'
compensation hearing is conducted by presenting the testimony of an injured
worker, witnesses, and presenting medical evidence. It is not unusual for there
to be long ddelays in obtaining a formal hearing date due to crowded court dockets.
Only a workers' compensation magistrate can order the payment of compensation
benefits to an injured worker that has the force of law. You should always contact
an experienced workers' compensation attorney for a detailed explanation of
all of your rights under the law.
Medical Care
If you have been
injured at work or suffer from an occupational disease, your are entitled to
reasonable and necessary medical treatment. Typically, within the first ten
days after an injury, an employer will send you to a company clinic or preferred
hospital for treatment. You should cooperate with your employer by attending
any appointments, and then choose a physician of your own within ten days of
your injury. You must give written notice to your employer of the name and address
of the physician with whom you intend to obtain treatment. The employer or insurance
company should send a letter of authorization to the physician so that you can
obtain prompt medical care. The insurance company must pay your medical expenses
within 30 days of receipt of the bill. Your physician must send copies of all
medical records and occasionally write medical reports to support their treatment.
Finally, your employer will have the right to have you examined by a physician
of their choice from time to time during your disability. Many persons experience
an interruption in their wage loss benefits or right to receive medical care
of suffer other consequences from such an examination. You have the right to
challenge the opinion of any physician who might examine you at a workers' compensation
hearing. You should always contact an experienced workers' compensation attorney
for a detailed explanation of all of your rights under the law.