Leanne Burr asked 5 days ago
Workers Compensation – How to File a Workers Compensation Claim
If an employee is injured at work, they need to notify the employer immediately. This will help prevent delays and problems in receiving workers’ compensation benefits.
Workers compensation benefits typically include disability payments, medical treatment and vocational rehabilitation services. These benefits may differ in the amount and duration of benefits from one state to the next.
Medical Treatment
When you are injured while working, medical treatment is a vital aspect of your workers insurance claim. This type of insurance covers hospitalizations, doctor appointments, and imaging studies (xrays), as well as rehabilitation costs.
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 periodically updated according to medical advances and physician recommendations.
These guidelines are designed to ensure that injured workers receive the same treatment as other employees with occupational injuries and illnesses. These guidelines guarantee that proper treatment is provided for each injury or illness, and that there are no unnecessary medical costs.
If a physician determines that medical treatment isn’t required under the MTGs they can request an exemption from the insurance company by requesting a specific exception to these MTGs. This procedure is very complex and may take a long time to complete.
If treatment is required, the employer or the insurer must make every effort to provide the treatment. If there is disagreement between the employer and the employee, it is possible to fail to provide the treatment. The issue can be resolved through an evidentiary hearing before an administrator law judge.
Typically, the treatment must be administered by an accredited health care provider in the area who is licensed to treat workers’ compensation claimants. In the event of an emergency it is possible that a non-licensed or uncertified doctor may be capable of treating injuries suffered by workers when they’ve been informed of the incident and completed the appropriate first injury report.
Many physicians are certified in workers’ compensation and can charge a reduced fee for treating injured employees. This is particularly beneficial for patients who have suffered a serious injury.
In addition to physicians and surgeons, many other medical professionals are able to provide treatment for injured employees. They include occupational therapists, chiropractors and physical therapists.
The New York State Workers’ Compensation Board suggests that injured employees and their representatives consult their attorneys before they receive any medical treatment. This could be the sole way to ensure that injured workers receive the highest quality treatment in certain situations.
Expenses
Workers’ compensation costs may vary according to the state and employee. These expenses include medical costs and vocational rehabilitation costs, legal fees, and settlement costs.
The majority of these expenses are covered under your insurance policy. Certain of these expenses might be paid by the employee, their spouse, and/or dependents.
Employers are required to carry workers’ compensation law firms compensation coverage in most states. This protects employees from lawsuits as well as other damages that result from workplace accidents, such as injuries or illnesses. The policy covers medical treatment as well as replacement of wages and death benefits for workers who are killed in the course of work.
While workers’ compensation insurance is important, it can also be expensive. Workers’ compensation claims can cost a business approximately $1 per hour of work lost.
These losses can be reflected in the bottom line of the company and can result in lower productivity and profitability. It could also affect the reputation of the company which could have an adverse effect on future business contracts and the ability of employees.
Apart from workers’ compensation an organization may also have additional indirect costs related to employee injuries. Costs like the time an employee is off work or the cost of hiring a replacement employee could also be included in these indirect costs.
Another indirect cost is the cost of repair or replacement of equipment or property damaged during an injury-causing incident. It is a major expense for any company however, it is more common in heavy-duty machinery and equipment.
Finally, the Occupational Safety and Health Administration (OSHA) fines that are associated with a high incidence rate can be an additional cost for the employer. These fees are often caused when an organization’s accident or fatality rates are examined.
A positive work environment and minimizing claims for workers’ compensation can help cut down on the direct and indirect costs for the business. It can also create a more profitable workplace and increase employee morale.
Time Off Work
The loss of income caused by an injury or accident at work can be devastating. You may be eligible for workers compensation benefits to help cover the gap until your rehabilitation is complete.
Employees are able to take a variety of leave, including sick and vacation leave. Certain types of leave are covered by state or federal laws however others are non-required.
Sick and vacation leave are a great business tool because they allow employees to take time away from work when they’re sick or require to take care of the family member. Some employers offer personal time to use for things such as doctor’s appointments, car checksups or other occasions (e.g. parent-teacher conferences).
Some states have laws that require employers to offer paid sick leave, however this isn’t always the situation. Some businesses may be able to opt-out from offering this kind of leave, which can be beneficial to businesses who do not have the funds to cover this type of leave.
Another alternative for employers is to offer flexible time. This allows employees to use a certain amount of paid time off, and their employer can compensate them by other means, such as increasing their hours or the amount of their pay.
Some states also require employers to offer vacation or sick time. This may encourage employees to take time off when they are sick or caring for a family member.
If your employer doesn’t provide one of these options, it is best to consult with a lawyer regarding how to best utilize your rights under the law. A qualified attorney can assist you in understanding your rights and ensure they are protected if you are being asked to take advantage of paid time off to receive medical treatment or other purposes.
Employers may also give time off to employees to work beyond their contracted hours. This is known as time off-in-place , or TOIL. Some of the time off is used to attend medical appointments or other types of treatment or for other reasons, while others are used for jury service or other activities that the employee chooses.
Appeal
If you are denied workers compensation benefits you are entitled to appeal that decision. You can file an appeal with the workers’ compensation board within 30 days of the date when the judge ruled against you.
Appeals are an important element of the claims process and can be a significant tool in helping you to receive the compensation you deserve after a workplace injury. A skilled attorney can help you navigate the appeals process and ensure you receive the full amount of benefits to which you are entitled.
Many injured workers are denied their workers compensation claim or have their claims drastically reduced by the insurance company. This can be a devastating situation for injured workers, and is often only for the purpose of saving their employer and insurance company money.
The worker’s compensation judge will decide on the appeal. This is typically an open hearing, however it may also be conducted through videoconferencing.
The judge will listen to your and your lawyer’s concerns about your workers’ comp claim at this hearing. He or she will review the medical records, wages and other evidence to determine if you are entitled to workers’ compensation benefits and what the appropriate amount should be.
Additionally to this, the judge is able to examine any issues that are disputed about your injury. The judge will then decide the benefits you’re entitled to and how long those benefits will last.
If you are not satisfied with the judge’s decision, then you can appeal the decision to an upper court. Typically you can appeal to the appellate division in the court of your state within 30 days of the decision of the workers compensation board.
Appeal can be difficult but your workers’ compensation attorneys will do their best to ensure you the best result. A skilled attorney will go over your case and explain to the court of appeals why you should receive better results.
If you require assistance in a workers’ compensation appeal, call an experienced New York workers’ compensation lawyer compensation law firm today. The Turley, Redmond & Rosasco team of workers compensation lawyers have the knowledge and experience to help you receive the full amount of workers’ compensation benefits to which you are entitled.