Workers’ Compensation

Workers' Compensation was started in the United States in the 1920s. Many workers were injured due to unsafe working conditions. When this happened, workers were discarded like used up parts in a machine. Many people went homeless and due to a lack of medical care and finances, many died. Soon, trial lawyers came to the rescue of some of these people and started suing the big industries for unsafe conditions and negligence on the work site.

What the Injured Employee Should Know:

  • Workers' compensation coverage is paid by your employer at no cost to you.
  • It is your responsibility to report a work-related accident as soon as it happens.
  • This coverage will pay for reasonably necessary medical care you need if you get hurt or get sick because of an injury on your job.
  • Your employer or its workers' compensation insurance carrier has the right to choose the doctor who will treat you.
  • Workers' compensation coverage will also replace part of your lost wages if your doctor says you must be off work for a certain length of time because of a work-related injury or illness.

How to get medical care and benefits:

  • For you to begin getting benefits, your employer must report the injury to its workers' compensation insurance carrier by completing a First Report of Injury or Illness.
  • Go to the doctor chosen by your employer or your employer's workers' compensation insurance carrier.
  • Be sure to do everything possible to cooperate with your employer and its workers' compensation carrier. If you do not, your benefits may be stopped or delayed. Be sure you:
  • Complete all workers' compensation forms in a timely manner.
  • Keep all appointments.
  • Report any earnings you get after your injury to the workers' compensation carrier.
  • Get approval from the carrier before receiving treatment. If you are not satisfied with the doctor first assigned, ask your claims handler or carrier to approve another doctor. You may also write to the Commission to request a Change of Physician.
  • Return to work as soon as the doctor says you can.
  • Keep all records in a safe place for future reference.
  • Be aware that your right to receive benefits and medical care may end if there has not been payment made or necessary medical care provided for a one year period.

What type of benefits can you get?

Medical Benefits

Workers' Compensation insurance pays for all reasonably necessary medical care related to your on-the-job injury or illness including:

  • visits to an approved health care provider
  • surgery
  • hospital care
  • physical therapy
  • prescription drugs
  • braces and crutches
  • other medical supplies when ordered by your approved physician

Before being treated, be sure you have the approval of your employer's workers' compensation carrier. You are not responsible for the doctor bills as long as the carrier approves the doctor you are seeing. If you see a doctor without the carrier's approval, you may be responsible for the bill. When you receive approved treatment, the doctor will bill the insurance carrier directly. If you are billed, send the bill to your employer or the carrier.

Payment for Lost Wages

If you have to miss work because of a work-related injury or illness, you may be eligible to receive some cash benefits (indemnity benefits). The waiting period for these benefits is seven (7) calendar days and must be at the direction of your approved doctor.

These payments can help you through the period of time you are disabled from your workplace injury or illness. Your coverage begins on the eighth day of partial or total disability. You will be paid for the first seven (7) days only if you are disabled for more than fourteen (14) days. These days do not have to be continuous calendar days.

Mileage is paid to the employee when he is required to submit to treatment outside of the local or metropolitan area.

Lost Wages are paid by the employer following strict guidelines. A waiting period applies before any lost wage benefits are paid. In order to receive any payment for lost wages, you must be disabled for three consecutive days. If you are disabled for more than fourteen consecutive days, the original three day waiting period will then be paid.

Temporary Total Disability results from an injury that keeps an employee from working temporarily. These benefits are calculated at 66 2/3% of the injured employee's average gross weekly wage. There are maximums which are set by the state and the employer/insurer is not required to pay more than this maximum amount. These benefits, subject to a waiting period, are paid until the employee is released by the doctor to return to work.

Temporary Partial Disability refers to an employee who is able to work on light duty at less than full pay. These payments are calculated at 66 2/3% of the difference in what the employee made before the injury and what he/she is making on light duty.

Permanent Partial Disability refers to a permanent disability that does not prevent a person from returning to some type of employment. In the event that a person is determined to have a permanent partial disability, they may receive a lump sum settlement based on the percentage of disability.

Permanent Total Disability refers to a person who will never be able to work a regular full time job again. Moreover, an attorney will be able to advise you if a lump sum offer fairly compensates the worker for the life benefits he or she would have received.

Funeral Expenses and Death Benefits are paid when an on the job injury results in the worker's death.

Call Andrew today for your free consultation at 800-491-4103.