Workers Compensation – How to File a Workers Compensation Claim
Employees who suffer injuries on the worksite should report the injury as soon possible. This can prevent issues and delays in receiving workers’ comp benefits.
Typical workers compensation benefits include disability payments, medical treatment and vocational rehabilitation services. These benefits can vary in amount and duration from one state to the next.
Medical Treatment
Workers’ compensation claims are medical treatment for injuries sustained on the job. This type of insurance includes hospitalizations, doctor visits imaging studies (x-rays) and blood tests, and the cost of rehabilitation treatments.
To promote objective healing and to achieve goals for returning to work, the New York State Workers’ Compensation Board has established medical treatment guidelines (MTGs). These guidelines are reviewed regularly according to changes in the medical field and physician recommendations.
These guidelines are designed to ensure that an injured worker receives the same treatment as other employees who suffer similar injuries or diseases. They also help ensure that the treatment is appropriate for the particular condition or injury and that there isn’t any overtreatment or unnecessary medical expenses.
If a physician determines that medical treatment is not necessary under the MTGs they can request an exemption from the insurance company and request a specific exception to these MTGs. This procedure is complicated and can take months to complete.
Employers and insurers must try their best to provide the appropriate treatment if it is required. If there is disagreement between the employer and employee, it is possible that the employer fails to provide the treatment. This issue is often resolved by an evidentiary hearing before an administrator law judge.
Usually, the treatment should be administered by an authorized health care professional in the area that is authorized to treat workers’ compensation claimants. In emergencies, an unlicensed or uncertified physician may be competent to treat injuries sustained by workers when they’ve been informed of the accident and completed the required initial injury report.
Many physicians are certified in workers’ compensation and can charge a reduced amount for treating injured workers. This may be particularly helpful to patients who have suffered a serious injury.
A number of medical professionals can provide medical treatment for injured employees, in addition to doctors. They include occupational therapists, chiropractors and physical therapists.
The New York State Workers’ Compensation Board suggests that injured workers and their representatives contact their lawyers prior to receiving any medical treatment. In some instances this could be the only way to ensure that an employee receives the best possible care.
Expenses
Workers compensation costs can differ according to the state and employee. These expenses include medical costs and vocational rehabilitation expenses, legal fees and settlement costs.
Most of these expenses are covered by your insurance policy. However some of these costs are incurred by the employee, or their spouse, dependents, and/or dependents.
Employers are required to have workers’ compensation insurance in most states. This protects employees from lawsuits and other damages that may result from workplace accidents, such as injuries or illnesses. The policy covers workers who die while working and provides reimbursement for medical treatment as well as wage replacement and death benefits.
While insurance for workers’ compensation is crucial, it can also be costly. A worker’s compensation claim may cost businesses around $1 per hour of work lost.
These losses can be seen in the bottom line of the business and can result in an increase in productivity and profitability. It could also affect the reputation of the company which could impact future business contracts and qualified workers.
A company may have to pay indirect costs as a result of injuries to employees, in addition to workers compensation. These indirect costs can comprise costs like the time the employee is off work, as well as the cost of hiring an employee who is a substitute.
Another indirect cost is the cost of repairing or replacing equipment or property that was damaged in an accident that caused injury. This is a huge expense for any business but it is especially common in heavy-duty machinery and equipment.
The Occupational Safety and Health Administration (OSHA) fines associated with a high incident rate can be an additional cost for employers. These fines are often initiated by inspections and other regulatory actions based on an company’s fatality or injury rates.
These direct and indirect expenses can be reduced by fostering an environment of positive work and reducing workers’ claims for compensation. It also creates an environment that is more profitable for the company and improve the morale of employees.
Time off from Work
The loss of income resulting from an injury at work can be devastating. If, however, you are receiving workers’ compensation benefits you may have options to make up the difference while you heal.
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 not.
Businesses can make use of vacation and sick time to their advantage. Employees can take time off work to care for family members or take look after themselves. Some companies provide personal time to use to attend appointments with a doctor, car checksups, or occasions (e.g. parent-teacher conferences).
While certain states have laws that require employers to offer paid sick leave to employees, this is not always the case. Companies that don’t have enough 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 flexible time. This lets employees take an amount of paid time off, and their employer can make up the difference through other means for example, increasing their hours or their salary.
In addition to the options above, some states have required employers to offer paid sick leave or vacation time. This could be a great way for businesses to encourage employees to take time to rest when they’re sick or have to take care of a family member.
If your employer does not offer any of these options, it’s recommended to speak with a lawyer about how you can best use your rights under the law. A qualified attorney can help you understand your rights and ensure they are protected in the event that you are required to utilize your paid time off for medical treatment or other purposes.
Some employers also give employees time off for extra work they’ve completed beyond the hours they’re contracted to work, which is called time off in lieu or TOIL. Some of the time is used for a medical appointment or other forms of treatment or for other reasons, while others are used for jury service or other events that the employee decides on.
Appeal
You have the right to appeal the denial of workers’ compensation benefits. Within 30 days from the date the judge rendered a negative decision, you can appeal to your state’s worker compensation board.
Appeals are an integral part of the claims process and can be a crucial aid in helping you receive the compensation you deserve following a workplace accident. A knowledgeable attorney can assist you navigate the appeals process to ensure that you receive all the benefits to which are entitled to.
Many injured workers are denied their workers compensation claim or have their claims dramatically reduced by the insurance company. This can be devastating for injured workers and is usually used to save their employer and the insurance company money.
The appeals process begins with an appearance before the workers’ compensation judge. The hearing is usually conducted live, however it may also be conducted via videoconferencing.
The judge will listen to your lawyer’s and your attorney’s concerns about your workers’ compensation claim at this hearing. The judge will review your medical records, your wages, and other evidence to determine if your qualified to receive benefits from workers’ comp. If yes what should the amount be?
The judge can also consider any disagreement regarding your injury. The judge can then decide what benefits you are entitled to receive and how long those benefits will last.
If you aren’t satisfied with the judge’s decision you can then appeal that decision to an appeals court. Typically, you can appeal to the appellate division in your state’s court within 30 days of the decision of the workers’ compensation board.
Appeal hearings can be difficult However, you can depend on your workers’ compensation lawyers to work hard to ensure that you get the most favorable outcome. 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, call an experienced New York workers’ compensation law firm today. The Turley, Redmond & Rosasco team is comprised of skilled workers compensation lawyers who will help you receive the maximum amount of workers compensation benefits to which your rights are entitled.
