What is a Workers Compensation Case?

Workers compensation is a legal procedure which occurs when an employee is injured while on the job. It is designed to protect workers from losing their wages and also to pay for rehabilitation and medical treatment.

An injured worker can receive medical care, wage loss benefits and even a settlement when they are involved in a workers' compensation case.

1. Medical Treatment

If an employee is injured at work, workers comp insurance typically covers medical treatment. It covers the initial emergency treatment, which could include an ambulance ride, as well as ongoing care including medication and physical therapy.

Workers who have been injured are also entitled to reimbursement for their travel expenses, which will pay for transportation to and from their doctor's appointments. This is especially helpful for employees who suffer injuries that require surgery.

Employers can opt to contract with a managed-care organization or preferred provider plans in many states to treat work-related injuries. This is a way for both the employer and the insurer to reduce costs by regulating the quality of medical treatment.

It is crucial to select the best medical professional for your treatment. Your doctor can also recommend you to specialists to conduct further tests and evaluation.

Your doctor's office can often give you the list of Board-approved physicians to choose from, although there are exceptions. You should verify to make sure your doctor is on this list prior starting treatment.

After you have located a doctor, it is essential to follow their directions and guidelines. Inadequate follow-up could negatively impact your claim to workers compensation benefits.

You should also be aware that the Workers' Compensation Board regularly updates its Medical Treatment Guidelines based on new information from the medical field, as well as the advice of doctors. These changes may be detrimental to injured workers. An experienced attorney can help you understand how these changes affect your case.

To prove that you've sustained an injury related to work, workers compensation cases require proper treatment. Your doctor must be able to prove that your condition is related to the workplace and that you cannot return to work or engage in other activities unless you've been given specific restrictions to work.

In some states, your employer may be required to pay for diagnostic tests, such as xrays and ultrasounds. These tests are intended to determine if your ailments are related to your work and help you understand the medical condition you are suffering from and the steps needed to treat it. Your employer is also responsible for any reasonable and necessary surgeries, implantations or injections recommended by your physician to aid in the recovery process from your injury.

2. Wage Loss

The ability of wage loss is to replace income lost due to an injury. This is among the main benefits of workers compensation. You could be qualified for up to two thirds (depending on where you work) of the earnings you earned prior to your injury.

The severity and age of your injury can affect the amount you will receive. Many jurisdictions also have limitations on the amount of weekly wage loss you can receive when you receive workers' compensation.

You can ensure you get the most money possible by submitting your claim as soon as you are able to. Also, you must be on time to meet all deadlines and notify your employer promptly.

A skilled attorney for workers' compensation is the best way to determine whether you have a valid claim. This will ensure that you receive all the benefits that are allowed by law including lost wages as well as medical expenses. You could be entitled to a higher benefit rate if your work background indicates that you've been actively seeking work since the accident. This is especially the case if out of work for some time or are dealing with significant medical restrictions that keep you from returning to your previous work. The greatest benefit is that you don't have to pay any fees or out-of-pocket expenses!

3. Litigation

The first step on the litigation timeline is to submit the Claim Petition, which puts your case in the court system and starts the process of litigation. It will describe the incident date, time as well as other details. The insurer or employer might or may not reply to this petition however, if they do, it is then in the hands of a judge who will decide the amount of benefits you will receive and the duration of your benefits.

Some issues can be resolved by the Workers' Compensation Board informally, without a hearing. These include disputes regarding whether the injury is work-related or not, how severe your disability is, what financial awards you are entitled to and what medical care is required.

For more complex disputes, it is necessary to have a formal hearing before a Workers' Comp Law Judge. The judge will hear both sides' arguments and decide the amount of benefits you are entitled to.

During the hearing the attorneys will present written arguments to the judge. The arguments will outline the evidence they have gathered as well as their views on the issues.

If the judge is in agreement with both attorneys, the judge will issue a written decision which outlines the findings of the hearing and that your workers' compensation claim is closed. You will receive a copy this Decision by mail.

When your employer or its insurance carrier disagrees with the claim investigation, it will often require an independent medical examination (IME). This is a doctor's examination which your employer will pay to examine you and collect evidence.

The IME is a critical element of the litigation process because it gives your employer important medical evidence. The IME will examine your medical records and write a detailed report on your injuries and treatment.

Once your IME is complete, the employer will typically hire an attorney to defend its side of the dispute. This is a complicated procedure that requires numerous legal experts and a considerable amount of time on the employer's part.

Workers who have suffered injuries who are taking pain medications as part of their treatment might need to be monitored carefully in the course of litigation, panelists noted. They could develop addiction to the medication if they take too much or are using the wrong medication.

4. Settlement

A workers settlement for compensation is a contract between you and your employer's insurance company to pay you a specified amount. It could be a lump sum amount or it could be broken up into regular payments over time.

A workers' compensation settlement may be a good option to get through the long process of dealing with workplace injuries. It is not advisable to sign settlement without consulting with an experienced attorney.

Settlements for workers' compensation can be obtained to cover medical bills, lost wages and other costs related to your injuries. A settlement may also help you pay for the cost of future medical expenses and stop you from having to start a lawsuit.

Each state has its own laws on worker's compensation settlements. However you can choose whether to settle your claim by lump-sum or structured payments. The amount of your settlement will depend on your situation and the extent of your injuries.

The average workers' comp settlement is around $12,000, but it could be higher or lower depending on the nature of the injury and the state in which you live. Your workers' compensation lawyer can estimate the amount of your settlement and help you make an informed decision about the time to settle.

No matter the amount, the important thing is to settle the claim quickly. This will both you and your insurance company a lot of time and money.

Sometimes, the insurance company will offer to settle your case before you have even filed it. 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 recommend that you accept the offer or negotiate an amount that is higher. You will ultimately have to make the best choice about your future.

If your insurance company has refused your claim, then you can request a hearing before an adjudicator or a workers' compensation attorneys compensation hearings officer. The judge will examine your case and determine the fair amount to settle. It's not always easy however it is worth the effort.