Workers Compensation — How to File a Workers Compensation Claim
If an employee is injured while on the job it is important to notify the employer as soon as possible. This can prevent issues and delays in receiving workers’ comp benefits.
Workers compensation benefits typically include medical treatment and vocational rehabilitation services and disability benefits. These benefits can differ in duration and amount from one state to the next.
Medical Treatment
When you are injured on the job medical treatment is an essential aspect of your workers claims for compensation. This type of insurance covers doctor visits, hospital stays and imaging studies (xrays), as well as rehabilitation costs.
To encourage objective healing and help achieve goals of returning to work, the New York State Workers’ Compensation Board establishes medical treatment guidelines (MTGs). These guidelines are frequently updated with regard to changes in medical field as well as physician recommendations.
These guidelines are intended to ensure that an injured worker receives the same treatment as other employees who suffer similar injuries or diseases. These guidelines will ensure that appropriate treatment is provided for each injury or illness, and that there aren’t unnecessary medical expenses.
In the event that a physician determines that treatment outside of the MTGs is required and appropriate, they can request a variance from the insurance carrier, requesting an express exemption from the MTGs. This is a lengthy process that can take several months to be completed.
Employers and insurers should take every step to provide the proper treatment when it is needed. Failure to do this could lead to a dispute between the insurer and the injured employee which is usually settled with an evidentiary hearing before an administrative law judge.
The treatment must be provided by an accredited local health care professional who is authorized to offer workers’ compensation treatment. In emergencies however, a non-licensed or uncertified doctor may be capable of treating injuries suffered by workers when they’ve been informed of the accident and completed the proper initial injury report.
Many physicians are certified in workers’ compensation and will charge a lower fee for treating injured employees. This is particularly helpful for patients who have sustained serious injuries.
There are a variety of medical professionals who are available to offer medical treatment for injured employees, in addition to doctors. They include physical therapists occupational therapists and chiropractors.
The New York State Workers’ Compensation Board recommends that injured employees and their representatives meet with their attorneys before receiving any medical treatment. In some instances, this may be the only way to ensure an employee receives the best care possible.
Charges
The cost of a worker’s compensation claim can vary greatly dependent on the individual worker and the state in which they are employed. These expenses include medical payments, vocational rehabilitation costs as well as legal fees and settlement costs.
Most of these expenses are covered under your insurance policy. Certain of these expenses could be paid by the employee, their spouse, or dependents.
Employers are required by law to have workers’ compensation coverage in most states. This covers employees against lawsuits and other damages that could arise from workplace accidents like injuries or illnesses. The policy covers workers who die on the job and offers indemnity for medical treatments or wage replacement as well as death benefits.
While insurance for workers’ compensation is important, it can also be costly. It typically costs a business about $1 per hour of work lost because of workers’ compensation claims.
These losses can be seen in the bottom line of the business which could result in a loss in productivity and profits. It can also impact the reputation of the business, which can negatively impact future business contracts and skilled employees.
Apart from workers’ compensation companies can also incur other indirect costs that are related to injuries to employees. Expenses such as the time an employee is off working or the cost of hiring a replacement employee can also be included in these indirect costs.
Indirect costs include the cost of replacing or repairing equipment damaged by an accident. This is a significant cost for any business but it is especially common for heavy-duty machinery and equipment.
Employers could also be subject to OSHA penalties for incidents with high rates. These fines are usually caused when an organization’s death or injury rate is scrutinized.
A positive work environment and reducing workers’ compensation claims can reduce these direct and indirect expenses for businesses. It can also create a more profitable environment for the company and improve the morale of employees.
Time Off from Work
The loss of income caused by a work-related injury can be devastating. However, if you are receiving workers’ compensation benefits, you may have a few alternatives to pay for the gap while you recover.
There are many different types of time off that can be used by employees, including vacation and sick leave. Certain types of leave are covered by federal or state laws, while others are optional.
Vacation and sick leave can be an effective option for businesses since they allow employees to take time off from work when they are sick or have to take care of the family member. Some employers offer personal time off that can be used for things such as appointments with a doctor, car checksups, or occasions (e.g. parent-teacher conferences).
While certain states have laws that require employers offer paid sick leave to employees, this is not always the situation. Companies that don’t have enough funds to pay for this kind of leave may be able to refuse to offer this type of leave.
Another alternative for employers is to offer flexible time. Employers can offer flex time to employees. This lets them take some paid time off. The employer can make up the difference by increasing the hours or increasing their pay.
Some states also require that employers offer vacation or sick time. This can help employees to take leave when they’re sick or care for the family member they love.
If your employer does not offer any of these options, it’s an excellent idea to consult with a lawyer about how to best utilize your rights under the law. If you’re being asked to use paid time off to receive medical treatment, or for any other reason, a knowledgeable lawyer can help you understand and ensure your rights.
Some employers also offer employees time off to work they’ve completed beyond the time limits of their contract. This is called time off in lieu or TOIL. Some employees take advantage of this time to attend medical appointments or other forms of treatments. Others are used to participate in juries or other roles they select.
Appeal
You have the right to appeal a denial of workers’ compensation benefits. You can file an appeal with the workers’ compensation board within 30 days of the date the judge made a ruling against you.
Appeal hearings are an essential part of the claims process and can be a crucial tool in helping you to get the compensation you deserve following a workplace accident. A skilled attorney can help you navigate the appeals process and ensure that you receive the full amount of benefits to which you are entitled.
Many injured workers are denied workers’ compensation or have their claims reduced drastically by their insurance company. This can be devastating for injured workers, and is often done to save their employers and the insurance company money.
The workers’ compensation judge will decide on the appeal. This is usually an open hearing, however it may also be conducted through videoconferencing.
The judge will take note of your and your lawyer’s concerns regarding your workers’ compensation claim at this hearing. The judge will scrutinize your medical records, your wages, and other evidence to determine if you’re eligible for workers’ compensation benefits. If so is the case, what should the amount be?
The judge is also able to review any dispute regarding your injury. The judge will then determine which benefits you’re entitled to and how long they will last.
If you aren’t satisfied with the judge’s decision, then you can appeal the decision to a higher court. Usually you can appeal to the appellate division of your state’s court within 30 days of the decision of the workers compensation board.
Appealing can be a challenge however, your workers’ compensation lawyer compensation lawyers will work hard to get you the best result. A skilled attorney will go over your case and provide the appeals court with a reason the reasons you should be able to get a better results.
If you require assistance in a workers’ compensation appeal, get in touch with an experienced New York workers’ compensation law firm today. The Turley, Redmond & Rosasco team of workers compensation lawyers has the knowledge and experience to assist you in obtaining the full amount of workers’ compensation benefits to which you are entitled.