What is a Workers Compensation Case?

Workers compensation is a legal proceeding that occurs when an employee suffers an injury during work. It is designed to protect the employee from losing income and to pay for medical treatment and rehabilitation.

An injured worker can receive medical treatment, wage loss benefits and even a settlement in the workers' compensation process.

1. Medical Treatment

Workers' compensation insurance covers a majority of medical expenses for employees that are injured while on the job. This includes the initial emergency treatment such as an ambulance ride. It also covers continuing care that includes physical therapy, medication, and other costs.

The injured worker is also entitled to reimbursement for the cost of travel to and from doctor's appointments. This is especially useful for employees who have to undergo surgery.

Employers can opt to sign a contract with a managed care organization or preferred provider plans in many states to treat injuries resulting from work. This allows both the employer and the insurer to control the quality of medical treatment and lower costs.

Choosing an appropriate medical provider for your treatment is important since you may require a physician who specializes in treating your particular injury. Your doctor might refer you to specialists for further evaluation or testing.

The list of Board-approved practitioners will be provided by the office of your doctor. However, there are some exceptions. Before you begin treatment, make sure to confirm that your doctor's name is listed.

It is important to follow the directions and guidelines of your doctor once you've discovered one. If you don't, it can negatively impact your claim for workers' compensation benefits.

It is also important to know that the Workers' Compensation Board periodically updates its Medical Treatment Guidelines based on new information from the medical field and the recommendations of doctors. These changes may be harmful to injured workers, but a knowledgeable lawyer can assist you in understanding how they affect your case.

A proper medical treatment is essential in a workers compensation case to prove that you suffer from an injury that is related to work and are eligible for the benefits of lost wages. Your doctor must prove that your symptoms are connected to your job and that you are unable to return to your previous position or perform other activities unless you've been given specific restrictions to work.

It is also important to remember that in some states, your employer is required to pay for diagnostic tests like x-rays and ultrasounds. These tests are intended to determine if your ailments are related to your job and assist you in understanding your medical condition and the steps needed to cure it. Your doctor will recommend that your employer cover any reasonable and necessary surgeries and injections to aid in the recovery process from your injury.

2. Wage Loss

Loss of wages, or the ability to replace income lost as a result of an injury sustained on the job is among the most important workers compensation benefits. Based on the state where you work, you could receive up to two-thirds of the wages you earned prior to your injury.

Your age and severity of your injuries will affect the amount you'll receive. Additionally certain jurisdictions set limits on the total amount of wage loss each week you are entitled to while you are receiving workers compensation.

One way to ensure that you receive the maximum claim possible is to submit your claim as quickly as possible. You also want to be certain that you meet all deadlines and notify your employer promptly.

An experienced attorney in worker's compensation is the best way to determine if you have a valid claim. This will ensure that you receive the most benefit under the law, including for lost wages and medical bills. For example, you may be eligible for an increased benefit rate when you prove that you have been actively searching for a job after you were injured or suffered your accident. This is especially the case if your injuries kept you out of work or you have medical restrictions that prevents you from returning to work. The best part is that you don't have to pay any costs or out-of-pocket expenses!

3. Litigation

The first step in the timeline of litigation is to make a Claim Petition that puts your case before the court system and initiates the litigation process. The claim petition will include the nature of the injury, date, time as well as other details. While the employer or insurance company might not reply to the petition, it will be given to a judge who will determine the amount and for how long.

The Workers' Compensation Board has the ability to resolve some issues without having to hold hearings. This includes disputes about whether the injury is a result of work or not, how severe your disability is, what monetary benefits you are entitled to, and the type of medical treatment you require.

For more complicated disputes an official hearing is required before a Workers' Comp Law Judge. The judge will hear both sides' arguments and decide the amount of benefits you are entitled to.

The attorneys will both present written arguments to the judge during the hearing. The arguments will outline the evidence they've collected as well as their opinions on the issues being debated.

If the judge agrees to the arguments of both lawyers, the judge will issue a written ruling that states the outcome of the hearing and concludes your workers' compensation claim. You will receive a copy of the Decision by mail.

If your employer or the insurance carrier disagree with the investigation into your claim, they will often request an independent medical examination (IME). This is a doctor's examination that your employer will pay for to examine you and collect evidence.

The IME is a crucial part of the litigation timeline because it provides crucial medical evidence to your employer. The IME will examine your medical records, and make a report on your injuries and treatment.

Once your IME is completed, your employer will typically hire an attorney to defend its side of the dispute. This can be a complex procedure that requires several legal experts as well as an extensive amount of time on the part of your employer.

Injured workers who are receiving painkillers as part of their treatment could need to be monitored closely during litigation, panelists suggested. They could be addicted when they consume too much or take the wrong medication.

4. Settlement

A workers compensation settlement is a contract between your employer and the insurance company that will pay you a particular amount. This can be a lump sum payment or it could be split into regular payments over time.

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

Workers' compensation settlements can be obtained for medical bills, lost wages or other expenses resulting from your injuries. Settlements can also help you cover future expenses and keep you from being forced to bring 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 payment. The amount you receive will depend on the circumstances and the severity of your injuries.

The average workers' compensation settlement is $12,000. However, it may vary based upon the nature and severity of your injury. The lawyer representing you in workers' compensation can assist you in determining the amount of your settlement and make informed decisions on the time to settle.

Regardless of the amount, the key is to settle quickly. This will save your insurance company time and money.

Sometimes the insurance company will offer a settlement before you have even filed your claim. 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.

In these instances you can ask your lawyer that you accept the offer or they can try to negotiate for a larger amount. Ultimately, you will have to make the best choice for your future.

If your insurance company declines your claim, you may have a hearing with the judge or the worker's compensation hearings officer. The judge will review your case and determine the amount of settlement that is fair. It can be a difficult procedure, but it's worth the effort.