Workers Compensation - How to File a Workers Compensation Claim

If an employee is injured while on the job it is important to report it promptly. This can prevent issues and delays in receiving workers' comp benefits.

Workers compensation benefits typically include medical treatment along with vocational rehabilitation services and disability benefits. These benefits can vary in amount and duration from one state to the next.

Medical Treatment

Workers' compensation claims cover medical treatment for injuries that are sustained while working. This kind of insurance covers doctor visits, hospital stays imaging studies (x-rays) as well as blood tests and the cost of rehabilitation services.

The New York State Workers' Compensation Board sets medical treatment guidelines (MTGs) to help promote objective healing and return-to-work objectives. These guidelines are regularly updated as a result of medical advances and physician recommendations.

These guidelines are intended to ensure that injured workers receive the same treatment as other workers with work-related injuries and diseases. These guidelines will ensure that appropriate treatment is provided for any illness or injury and that there aren't unnecessary medical costs.

If a physician determines that medical treatment isn't necessary under the MTGs or other regulations, he/she can ask for an exemption from the insurer and request a specific exception to these MTGs. The process is lengthy and may take months to complete.

If the treatment is needed the employer or insurer should take every step to provide the treatment. Failure to do so can result in a conflict between the insurer and the injured employee, which is usually settled through an evidentiary hearing before an administrative law judge.

Typically, treatment should be administered by an accredited health care provider in the region that is licensed to treat claimants for workers' compensation. In urgent situations, however, a non-licensed, or uncertified physician may be competent to treat injuries sustained by workers when they've been informed about the incident and have completed the appropriate first injury report.

Many physicians are certified in workers' comp and will charge a lower cost for treating injured employees. This is especially helpful for patients who have suffered serious injuries.

In addition to doctors, a number of other medical professionals can provide treatment for injured employees. They include physical therapists occupational therapists and chiropractors.

The New York State Workers' Compensation Board suggests that injured employees and their representatives speak with their attorneys before they receive any medical treatment. In some cases, this may be the only way to ensure that an employee receives the best care possible.

Costs

Workers compensation costs can differ according to the state of the employee and state. These expenses include medical costs and vocational rehabilitation costs, legal fees and settlement costs.

The majority of the expenses are covered by your insurance policy. However some of these expenses are the responsibility of the employee, or their spouse or dependents.

Employers are required by law to have workers' compensation insurance in all states. This protects employees from lawsuits and other damages that may arise from workplace accidents like injuries or illnesses. The policy covers medical care or wage replacement, as well as death benefits for workers who are killed in the course of work.

Workers insurance for compensation is essential but it can be costly. It typically costs businesses around $1 per hour of work lost due to an injury claim.

These losses can be reflected in the bottom line of the company which could result in an increase in productivity and profits. It can also impact the reputation of the company, which can impact future business contracts and qualified workers.

Besides workers' compensation, a company can also incur other indirect costs arising from injuries to employees. Costs like the duration of time employees are absent from work or the cost of hiring a replacement worker could also be included in these indirect costs.

Another indirect cost is the cost of repairing or replacing equipment or property that was damaged in an accident that caused injury. This is an expense that is significant to any business, but it is particularly prevalent for businesses with heavy-duty machinery or equipment.

Additionally, Occupational Safety and Health Administration (OSHA) fines that are associated with a high incident rate could be a cost for the employer. These fines are usually initiated by inspections and other regulatory actions based on an organization's worker injury or fatality rates.

These indirect and direct expenses can be cut by creating an atmosphere of positivity and reducing the number of claims workers make for compensation. It can also create a more profitable workplace and improve employee morale.

Time Off Work

The loss of income caused by an injury that is caused by work can be devastating. You may be eligible for workers compensation benefits to cover the gap until your rehabilitation is complete.

There are many kinds of time off available by employees, including sick and vacation leave. Certain types of leave are covered by state or federal laws, while others are purely voluntary.

Businesses can use vacation and sick time to their advantage. Employees can leave work to take care of family members or look after themselves. Some employers offer personal time to use for things such as appointments with a doctor, car checksups or other occasions (e.g. parent-teacher conferences).

Certain states have laws that require employers to offer paid sick leave, however this isn't always the case. Certain companies might be able to opt-out of offering this type of leave. This can be beneficial for companies that do not have the resources to cover this type of leave.

Employers also have the option of offering flexible time. Employers may offer flex time to employees. This lets them get paid time off, and the employer can make up for the difference by increasing their working hours or increasing their pay.

In addition to the options mentioned above certain states have also made it mandatory for employers to provide paid sick or vacation time, which could be a great method for businesses to motivate employees to take time to rest when they're sick or need to take care of a family member.

If your employer isn't offering one of these options, it is recommended to speak with a lawyer about the best way to utilize your rights under the law. A knowledgeable attorney can help you understand your rights and defend them when you are asked to make use of your paid time off to receive medical treatment or other reasons.

Employers may also provide time off to employees for work that is beyond their contracted hours. This is known as time off-in-place or TOIL. Some employees make use of this time to attend medical appointments or other kinds of treatments. Others participate on juries, or in other duties they choose.

Appeal

You have the right to appeal an appeal against a denial of worker's compensation benefits. Within 30 days from the date the judge made a negative decision, you can appeal to your state's workers compensation board.

Appeals are an important part of the claims process and can be a significant tool to help you get the compensation you deserve after an injury at work. A knowledgeable attorney can help you navigate the appeals process and make sure you receive the maximum amount of benefits to which you are entitled.

Many injured workers are denied their workers' compensation claim or have their claims significantly reduced by the insurance company. This could be devastating for injured workers, and is usually performed to save their employer and the insurance company money.

The appeals process begins with hearings in front of the workers' compensation judge. The hearing is usually conducted live, however it may also be conducted through videoconferencing.

The judge will take note of your and your lawyer's concerns about your workers' comp claim at this hearing. The judge will look over your medical records, your wages, and other evidence to determine if your qualified for benefits under workers' compensation. If yes is the case, what should the amount be?

The judge can also review any dispute regarding your injury. The judge will then decide which benefits you're entitled to, and how long they should last.

If you are not satisfied with the judge's decision you can appeal the decision to an upper court. Typically, you can appeal to the appellate division of the court of your state within 30 days of the decision of the workers compensation board.

Appealing can be a challenge but your workers' compensation lawyers will do their best to ensure you the best outcome. A competent attorney will look over your case in depth and explain to the appeals court why you should get better results.

If you require assistance with a worker's compensation appeal, contact a seasoned New York workers' compensation law firm today. The Turley, Redmond & Rosasco team is comprised of skilled workers compensation lawyers who will help you obtain the highest amount of benefits to which your rights are entitled.