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Some Important Things You Should Know About Workers’ Compensation


workers' compensation injury lawyersOur Experienced Personal Injury Lawyers Explain Some Important Things You Need To Know About Workers’ Compensation

If you were injured while working, you may be entitled to Workers Compensation benefits.  These benefits cover hospital/medical bills as well as lost earnings.  Here are some important things you should know about Workers Compensation benefits.

What is Workers’ Compensation?

Workers’ compensation is insurance for workers who become injured or sick while working. Employers, and their insurance carriers, are responsible for these payments to the injured worker. These benefits usually cover reimbursement of lost earnings as well as payments for hospital and medical care. The employer has the right to challenge an employee’s entitlement to Workers Compensation benefits.  If the employer does so, the employee can request a hearing before a workers’ compensation judge to settle the dispute.  The insurance company is entitled to hold back the disputed payments until the issue is resolved.

What Benefits Does Workers’ Compensation Cover?

The two main benefits covered by workers’ compensation are medical payments and reimbursement of lost earnings. Injured employees do not receive lost earnings until they have missed at least fourteen days of work. After that, they begin to receive payments for all of the days missed, beginning with the first missed day. The amount paid to the injured worker depends on the average weekly pay and worker’s degree of disability. The formula is:

2/3 x (Average Weekly Wage) x % of Disability = Weekly Benefit

There are maximum limits to these weekly benefits. The maximum for 2017-2018 is $870.61 a week.

Injured workers also receive medical benefits which are paid by the employer or the employer’s insurance carrier. Sometimes, the injured employee also receives reimbursement for travel expenses related to medical treatment.  In cases where the employee becomes seriously disabled for at least 12 months, they may also be eligible for social security benefits.

How Do I File for Workers’ Compensation Benefits?

The filing process for workers’ compensation requires multiple steps. Immediately after the work injury, the employee should seek medical attention and treatment. Within 30 days of the injury, the employee should notify their employer in writing of the accident, describing what happened. As soon as possible (and within two years after the injury), the employee must file a claim with the Workers Compensation Board, mailing the notice to the correct Board District Office. After seeing a doctor, the doctor should fill out a preliminary medical report and send it to the correct district office, the employer, and the employee.

If lost work time exceeds seven days, the insurer must begin distributing payments. If the insurer does not send out compensation benefits, due to a specific notice or dispute, the Workers’ Compensation Board must be notified. Recipients are paid every two weeks.  Doctors are required to submit progress reports to the board every 45 days. If the employee cannot return to work after 12 weeks, the insurer will recommend rehabilitation treatment.

Can I Also File a Lawsuit If I Was Injured on the Job?

In addition to filing a Workers Compensation claim, a worker is sometimes entitled to file a personal injury lawsuit to recover damages for pain and suffering.  Although there are some exceptions, like the personal injury claim available to railroad workers under the Federal Employer’s Liability Act or FELA, employees are usually not permitted to file injury claims directly against their employer.  Instead, an injured worker can file a personal injury lawsuit only if someone other than their employer is responsible for the injury.  For example:

  • a construction worker who falls from a scaffold because of an unsafe work place, does have the right to collect workers compensation benefits from his employer, but he may also have a claim against the owner and general contractor of the site for failing to keep a safe workplace;
  • a delivery worker who falls in a building because of a premises defect can file a workers compensation claim against his own employer, the delivery company, but the worker may also have the right to sue the owner and management company of the building because of the broken step that caused the fall; or
  • the home health aide who accompanies a patient to the hospital in an ambulette does have a right to file a workers compensation claim against her employer if the ambulette is involved in an accident, but the aide also has a right to file a personal injury claim against the owner and driver of the vehicles involved, provided that they were not also employed by her employer.

In short, a worker can file a personal injury lawsuit, so long as the defendant is not the worker’s employer.

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If you were injured on the job, contact our experienced personal injury attorneys for more information by email or calling (800) 762-9300.   You can also fill out a case intake form, and we will have one of our attorneys get right back to you.

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