Workers Compensation — How to File a Workers Compensation Claim
If an employee is injured while on the job, they need to inform the employer as soon as they can. This helps avoid problems and delays in receiving workers compensation benefits.
Workers compensation benefits typically include disability payments, medical treatment and vocational rehabilitation services. The amount and duration of these benefits varies from state to state.
Medical Treatment
Workers’ compensation claims are medical treatment for injuries that are sustained while working. This type of insurance coverage includes medical visits, workers’ compensation law firm hospital stays, imaging studies (x-rays) as well as blood tests, and the cost of rehabilitation therapies.
The New York State Workers’ Compensation Board creates medical treatment guidelines (MTGs) to aid in the pursuit of objective healing and return to work goals. These guidelines are periodically updated based on medical developments and physician recommendations.
These guidelines are designed to ensure that injured workers receive the same treatment as other employees who suffer from work-related injuries and illnesses. They also ensure that the treatment is appropriate to the specific condition or injury and that there are no unnecessary or unnecessary medical expense.
If a doctor decides that medical treatment isn’t required under the MTGs and he/she may request an exemption from the insurer by requesting a specific exception to these MTGs. This procedure is very complex and may take months to complete.
If the treatment is required the employer or insurer should take every step to provide the treatment. Failure to do this could result in a dispute between the insurer and the injured worker, which is usually resolved with an evidentiary hearing before an administrative law judge.
The treatment should be provided by licensed local health provider who is authorized to offer workers’ compensation treatment. However, in urgent situations, a non-licensed or uncertified physician can render treatment for injuries suffered by workers in the event that they are informed of the accident and the necessary initial report of injury has been filed by the supervisor or employer.
Many doctors are certified in workers’ compensation. They can offer lower prices for treating injured employees. This is particularly beneficial for those who have suffered an injury that is severe.
There are a variety of medical professionals who are on hand to provide assistance to injured employees in addition to doctors. These include chiropractors, occupational therapists and physical therapists.
The New York State Workers’ Compensation Board suggests that injured employees and their representatives consult with their attorneys before receiving any medical treatment. In some cases this could be the only way to make sure that workers are receiving the best possible care.
Charges
Workers compensation costs can differ depending on the state and employee. These expenses include medical costs and vocational rehabilitation costs, legal fees and settlement costs.
The majority of these costs are covered by the insurance policy. Certain of these expenses might be incurred by the employee, their spouse and/or dependents.
In many states employers are required to have workers’ compensation insurance. This covers employees against lawsuits and other damages that could result from workplace accidents such as 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 crucial, it can also be expensive. Generally, it costs a company about $1 per hour of work lost because of a workers’ comp claim.
These losses can be seen in the bottom line of the company, which can cause the loss of efficiency and profitability. It could also affect the reputation of the company which could affect future business contracts as well as the qualifications of employees.
Apart from workers’ compensation a company can also incur additional indirect costs related to injuries suffered by employees. These indirect costs can comprise expenses like the duration of time employees are away from work, as well as the cost of hiring a substitute worker.
Another indirect cost is the cost of repairing or replacing equipment or property that was damaged as a result of an injury-related incident. This can be an enormous expense for any business, and is common for companies with heavy-duty machinery or equipment.
Employers can also be subject to OSHA penalties for incidents with high rates. These fees are typically triggered when an organization’s worker death or injury rate is scrutinized.
These indirect and direct expenses can be cut by creating a positive work environment and minimizing workers’ claims for compensation. It can also create a more profitable environment for the company and increase employee morale.
Time Off from Work
The loss of income due to a work-related injury can be devastating. You may be eligible for workers compensation benefits to cover the gap until your recovery is complete.
Employees can take various types of time off, which include sick and vacation days. Certain of these are covered by the laws of the state or federal government and others are not mandatory.
Sick and vacation leave are a great business tool because they allow employees to take time away from work when they’re sick or need to care for the family member. Some companies offer personal time to use for things like medical appointments, car checkups or even for events (e.g. parent-teacher conferences).
Certain states have laws that require employers to provide paid sick leave, but this is not always the case. Companies that don’t have the funds to cover this type of leave might be able to opt out of offering this type of leave.
Employers can also avail of offering flex time. This allows employees to take some paid time off, and workers’ compensation law firm the employer can compensate them with other options, such as increasing their hours or their salary.
Certain states also require employers to provide vacation or sick time. This can encourage employees to take time off when they are sick or caring for the family member they love.
If your employer does not offer these options, it’s an excellent idea to speak to a lawyer to learn how you can make the most of your rights under the law. An experienced lawyer can help you understand your rights and safeguard them when you are asked to make use of your paid time off for medical treatment or any other reason.
Some employers also offer employees time off for extra work that they’ve done above the time limits of their contract. This is called time off in lieu or TOIL. Some of the time is used for medical appointments or other forms of treatment, while some is used for jury service or other events which the employee decides.
Appeals
If you are denied workers’ compensation benefits you are entitled to appeal the decision. Within 30 days from the date the judge rendered a negative decision, you are able to appeal to your state’s workers compensation board.
The appeals process is an essential element in the claims process. They can assist you to get the benefits you’re entitled to following an accident at work. A knowledgeable attorney can assist you navigate the appeals process and ensure that you receive all benefits to which you have earned.
Many injured workers are denied their workers compensation claim or have their claims dramatically reduced by the insurance company. This can be a devastating situation for injured workers, and is usually performed with the sole aim of saving their employer and insurance company money.
The appeals procedure begins with a hearing in front of the worker’s compensation judge. This hearing is usually conducted in person, but it could also be conducted via videoconferencing.
The judge will hear your lawyer’s and your attorney’s concerns regarding your workers’ comp claim during this hearing. The judge will examine your medical records, your wages, and other evidence to determine if you’re qualified for benefits under workers’ compensation. If so how much should it be?
Additionally to this, the judge is able to review any disputed issues about your injury. The judge can then decide the benefits you’re entitled to receive and how long they will last.
If you aren’t satisfied with the judge’s decision you can appeal the decision to a higher court. Typically, appeals can be filed with the appellate division of your state’s courts within 30 days of the workers compensation board’s decision.
Appealing can be a challenge however, you can trust your workers’ compensation attorneys to do their best to ensure that you get the best result possible. A skilled attorney will go over your case and explain to the court of appeals the reasons why you should receive a better results.
If you need assistance in a workers’ compensation appeal, contact a seasoned New York workers’ compensation law firm today. The Turley, Redmond & Rosasco team of workers’ compensation lawyers has the experience and resources to help you receive the full amount of workers’ compensation benefits to which you are entitled.