What is a Workers Compensation Case?
A workers' compensation claim is a legal process which occurs when an employee is injured while on the job. It is designed to safeguard the worker from loss of income and to help pay for medical treatment and rehabilitation.
In the course of a workers' compensation case it is possible for an injured worker to receive medical treatment or wage loss compensation and even an settlement.
1. Medical Treatment
Workers' compensation insurance covers a majority of medical costs for employees who are injured at work. This includes the initial emergency treatment , such as an ambulance ride, and then regular care, which includes physical therapy, medication, as well as other expenses.
The injured worker is also entitled to travel reimbursement for trips to and from doctor's appointments. This is especially useful for those who must undergo surgery.
In most states, the employer has the option of contracting with preferred provider plans or managed care organization to treat employees' work injuries. This is a means for both the employer and insurer to lower costs by regulating the quality of medical care.
It is essential to select the right medical provider for your treatment. Your doctor can also recommend you to specialists for further testing and evaluation.
The office of your doctor will usually give you an approved list of Board-certified providers to choose from, though there are exceptions. You should make sure your doctor is on this list before starting treatment.
It is essential to follow the instructions and guidelines of your doctor once you have found one. Inadequate follow-up could affect your claim of workers compensation benefits.
Additionally the Workers' Compensation Board regularly updates its Medical Treatment Guidelines. This is dependent on the latest information and advice from doctors. These changes can sometimes be detrimental to injured workers. An experienced attorney can help know how these changes affect your case.
Getting proper treatment is essential in a workers compensation case to show that you suffered an injury that is related to work and are eligible to receive the benefit of lost wages. workers' compensation attorney lakewood must confirm that your symptoms are related to your job. You are not able to return to your previous job or engage in any other activities, unless special work restrictions have been imposed on you.
It is also important to remember that in certain states, your employer has to pay for diagnostic tests, such as ultrasounds and x-rays. These tests are designed to determine if your ailments are related to the workplace and assist you in understanding the severity of your medical condition and the appropriate way to take care of it. Your doctor will suggest that your employer pay for any necessary and reasonable surgery, implantations, or injections to aid in the recovery process from your injury.
2. Wage Loss
The loss of wages or the ability to replace lost income as a result of an on-the-job injury is among the most significant workers compensation benefits. You may be entitled to up to two-thirds (depending upon where you work) of your earnings prior to injury.
Your age and severity of your injury will impact the amount you'll receive. In addition, many jurisdictions place an upper limit on the total amount of wage loss per week you can receive while you receive workers compensation.
A good way to ensure that you're getting the most benefit from your claim is to submit your claim as quickly as possible. Also, you must adhere to deadlines and notify your employer promptly.
The best way to determine whether you have an appropriate claim case is to consult with an experienced worker's compensation attorney. This will ensure that you receive the maximum amount of benefits allowed by the law, such as those for lost wages and medical bills. For instance, you could be eligible for an increase in the amount of benefits when you prove that you've been actively searching for a job after you were injured or sustained injuries in your accident. This is particularly applicable if your injuries caused you to be unable to work or you have significant medical limitations that prevent you from returning to work. The most appealing aspect is that you don't have to pay any fees or out-of-pocket expenses!
3. Litigation
The Claim Petition is the first step of the litigation timeline. This brings your case before the court system, and thus begins the litigation process. The petition will provide the details of the injury date, time and other information. The Employer or Insurance Company may or not respond to this petition however, if they do it is placed at the discretion of the judge who will decide the amount of benefits you can receive and for how long.
Some issues can be resolved by the Workers Compensation Board on a casual basis, without a hearing. These include disputes regarding whether the injury is related to work or not, the degree of impairment, the amount of financial awards payable to you, and which medical treatment is appropriate.
More complex disputes require an official hearing before a Workers Compensation Law Judge. The judge will take both sides' arguments and then make a decision on the amount of benefits you are entitled to.
The attorneys will both present written arguments to the judge during the hearing. These arguments will explain the evidence they have gathered as well as their position on the issues.
If the judge agrees with the arguments of both lawyers, they will issue an written Decision that outlines the results of the hearing and concludes your workers' compensation claim. You will receive a copy the Decision via mail.
When your employer or its insurance carrier disagrees with the claim investigation and request an independent medical examination (IME). This is a medical examination that your employer will pay for in order to check you and gather evidence.
The IME is an essential part of the litigation timeline as it provides vital medical evidence to your employer. The IME will look over your medical records, and make a report on your injuries and treatment.
Usually, once your IME has been completed, your employer will engage an attorney to represent their side of the claim. This is a lengthy process that requires several legal experts as well as plenty of time on the part of your employer.
Panelists suggested that injured workers who are taking painkillers as part of their treatment should be monitored closely during litigation. They can be susceptible to addiction if they're taking too often or taking the wrong drug.
4. Settlement
A workers compensation settlement is an agreement between your employer and the insurance company. They will pay you a specific amount. It could be a one-time lump sum settlement or it could be broken down into regular payments over time.
A workers' compensation settlement could be a good option to speed through the long process of dealing with workplace injuries. However, you should not make a decision to settle a claim without consulting an experienced attorney.
You can receive a workers compensation settlement for your medical costs, lost wages as well as other expenses that are related to your injury. Settlements can also help you pay for future costs and keep you from having to start a lawsuit.
Each state has its own laws on worker's compensation settlements. However you have the option of deciding whether to settle your case by lump-sum or structured payment. The severity of your situation and the extent of your injuries will determine the amount of your settlement.
The average workers' compensation settlement is $12,000. However, it may vary based on the nature and state of your injury. Your lawyer for workers' compensation can help you determine the amount of your settlement and make informed choices about the time to settle.
Whatever the amount, the most important thing is to settle quickly. This will save your insurance company time and money.
Sometimes the insurance company will offer a settlement prior to the time you even file your claim. This is called an "offer-in-commitment" or "preliminary offer." The insurer may be motivated to put a settlement on the table because it has to start paying you benefits right away or because they are concerned that you will file a lawsuit.
Your lawyer may suggest that you accept the offer or negotiate more. It is up to you to make the right decision about your future.
If your insurance company has denied your claim, you can request an hearing before an official judge or a workers' compensation hearings officer. The judge will look over the case and determine the fair amount of settlement for you. It's not easy, but it is well worth the effort.