If you sustain injuries in the workplace, your primary source of recovery will be through a workers’ compensation claim. Making a successful claim through workers’ compensation is more straightforward than pursuing a personal injury action.
You only need to hire an experience workers’ compensation lawyer if you experience severe or permanent injuries. We take a deeper dive into workers’ compensation below by answering some of the most common questions.
When do weekly benefits start if you cannot work?
Starting on the day the insurance doctor says you will be out of work temporarily, the insurance company has a limited time to start benefits. There can be a penalty when they take longer.
There are board rules to follow, including filing certain forms with the State Board. These forms act as evidence that the weekly benefits may begin. You want a lawyer's help to file everything properly.
Determining the weekly disability rate
The employer files an injury form that lists the employee's 40-hour wage rate, but this rate is not always accurate. If the employee wants their correct wages on the form, they might have to pull records for the recent weeks of wages they earned before the injury. The employee must relay this information to the claims adjuster as soon as possible. When that happens, the adjuster, by law, must re-do the injury forms with the correct wage rate. That way, the employee can receive a higher benefit rate of pay.
Can I receive unemployment benefits and workers’ compensation benefits simultaneously?
Yes, but there is still a lot to consider. If the employee applies for unemployment benefits, they must certify in writing that they are ready, willing, and able to work. Additionally, if the employee cannot work, they are not eligible for workers’ compensation disability benefits. This is not entirely true.
Once the employee certifies that they are ready, willing, and able to perform only light-duty work due to their on-the-job injury, they can draw a combination of benefits.
A workers’ compensation insurance company can deduct weekly unemployment checks from the employee’s weekly workers’ compensation disability benefits. After these deductions, likely, the employee is back to square one.
The ability for one to draw unemployment benefits is quite helpful whenever workers’ compensation insurance companies deny or suspend workers’ compensation benefits. This works out better for the employee. They aren’t facing any source of income while they fight with the insurance company over entitlement to further disability benefits.
The insurance company’s goal is to settle the employee’s claim for as little as possible. If the employee is totally out of money, the insurance company is in a great position to provide pennies on the dollar to settle. At least with unemployment benefits, the employee can put food on the table for their family for a limited time.
What happens if my workers’ compensation claim receives a denial?
One of the most notorious and most significant weapons of the insurance companies is withholding medical care for the injured worker. Suppose they deny the medical claim or only accept an elbow injury, not a shoulder injury. In that case, the employee's lifeline uses group insurance to pay for other body parts that need medical treatment. If the employee wins their case, the group carrier will want its money back.
Unfortunately, many group insurance carriers argue they have no obligation to pay since the employee’s complete condition is the responsibility of the workers’ compensation insurance company. It is up to the employee to show that the workers’ compensation insurer negates the claim or parts. While also, at the same time, pay the balance due at settlement. Seek out a law firm that only has its clients pay small amounts of co-pays or deductibles to ensure continuing medical care.
What happens when doctors refuse to release medical records?
The records are yours to access, and you should not let anyone tell you otherwise. Doctor’s offices are to give the victim’s records to the workers’ compensation insurance company. They are the ones paying for the treatment. Sometimes, the doctor’s office incorrectly thinks that the victim’s medical records are the insurance company’s property.
Many doctor offices administer a form whenever a patient leaves the office. This form’s name is a work link report. The record addresses a few critical components like the patient’s work status, diagnosis, the need for physical therapy or another diagnostic testing, and the patient’s return date to the doctor’s office. Please do not leave the medical office without it.
The following crucial medical document is the actual office note or report. It addresses why the doctor may want to perform surgery or why they want to order an FCE or send the victim back to work without any restrictions. Nowadays, all doctors use the same format to create this form.
A note or report is generally available within the same day or the next few days after the victim’s appointment. It is wise to speak with an attorney and review everything the doctor wants them to do. That way, the attorney can manage the case more effectively.
When does an employer lose the right to control medical care?
The employer or insurance company does not have the right to control medical care when:
- They deny the claim as a job injury.
- The insurance company doctor states that the victim does not need medical care for job injuries.
- The insurance company believes the victim has a new injury to the same body part after the job injury.
- The employer fails to post a selection of physicians in a break room or another place for an employee to see before they suffer a job injury.
There are plenty of other ways the employer loses control. Consult with an experienced workers’ compensation and disability attorney today to explore further options.
Call a Workers’ Compensation Attorney Today
If you suffered an injury on the job, you deserve to receive full benefits. If your employer and its insurer deny your claim or refuse to pay the benefits you deserve, contact a workers’ compensation attorney about your case.