If you are an employee who sustains injuries at your workplace or suffers an illness, you can receive workers’ compensation benefits. Unfortunately, insurance companies or their employers usually deny workers’ compensation claims regardless of whether or not they are legitimate. As a result, this leaves an injured employee facing an overwhelming system of appeals. At this point, most applicants just give up and others attempt to deal with the system themselves.
Hiring an experienced workers’ compensation lawyer from Calhoon and Kaminsky P.C. can give you a good chance of getting the benefits you deserve. A lawyer can handle the workers’ compensation insurance company on your behalf, collect medical evidence to support the claim, negotiate a fair settlement, and even represent you at the workers’ compensation hearing. This article explains everything you need to know about a worker’s compensation lawyer.
Understanding workers’ compensation
It’s worth noting that almost all the states require all companies to have workers’ compensation insurance. Workers’ compensation insurance is an important and legally mandated component of your business. It can sometimes seem far harder than it is. It’s crucial that you have a good understanding of the importance of workers’ compensation insurance, how it works, how to file claims, and many more.
Workers’ compensation which is also popularly called workers’ comp refers to an insurance program that offers benefits to employees who sustain injuries or even become ill while on the job. It can assist compensate them for lost wages and medical costs when they are out of work.
Workers’ compensation insurance usually covers injuries or loss of limb, illness that are caused by the work environment, permanent impairment, repetitive motion injuries, rehabilitation, medical treatment, death, lost wages, and liability insurance. This workers’ compensation can offer coverage regardless of the party that was at fault, meaning it can cover the employer, co-workers, the employee, and even customers.
Workers’ compensation insurance may seem like just another expense for your business, but it can sometimes protect you from litigation, especially when an employee becomes sick or injured as a result of the work. Workers’ compensation insurance is there mainly to protect the employers. It’s a good idea to pay this insurance so that you can protect your business because you can sometimes get a huge claim and don’t have enough money to pay it directly.
Many states require that companies should have workers’ compensation insurance. You can get this insurance either through the state or a private insurer or your business can decide to be self-insured. Remember that each state has different rules concerning how issues are evaluated, what is covered, the benefits employees can receive, and how to deliver medical care.
For this reason, it’s always important to check the regulations in your state. Failure to take the required insurance can lead to paying these benefits out of your pocket and some penalties charged by the state.
Workers’ compensation insurance has some costs that usually vary by provider as well as industry. For example, high-risk jobs, such as construction and roofing can carry higher premiums than jobs from offices. Your company’s premiums may also either decrease or increase based on the number of claims you filed.
Accidents are generally more prone to occur in some industries than others, but workers’ compensation insurance protects all types of businesses. So don’t think that just because your employees work in an office that they can’t sustain injuries. Accidents or even work-related illness can also happen in offices.
Keep in mind that worker’s compensation protects employees and employers. It protects an employer by paying the expenses that are associated with treating your employees’ work-related injuries or illness. It also protects employees by offering them financial recourse for unexpected medical expenses after a work-related illness or injury. It can also give disability benefits, replacement of lost wages while you are on leave recovering, death benefits, and many more.
Workers’ compensation claim process
Whether you are an employee who becomes ill or is injured while you were on the job, there are some steps that you can expect to file and process a claim. There is a good chance that the HR team will make sure that your medical needs are attended to immediately. The HR team can guide you on the claim process, indicating where you can receive medical care and how your lost wages can be supplements when you are out of work.
You need to file the workers’ compensation claim with your employer’s insurance provider. This filing needs to be done within 24 to 48 hours after the illness or injury occurs. When the insurance company approves the claim or disapproves the claim, it will notify you and your employer. But you have the right to ask the insurance company to review the claim, especially when the insurer denies the claim.
That said, it’s also important to note that if you get injured while you were within the scope of your employment, even if you may have been careless, you are still covered. However, if you sustain injuries while under the influence of alcohol or drugs, then the benefits may not be covered.
Remember that the laws concerning the workers’ compensation vary by state, but if you get injured while performing your duties even if you are not at your workplace, then you are covered. This means remote workers are also covered as long as they are employed officially.
For example, if you sustain injuries while at the hotel where you are staying for work-related activities or even while out doing a task on behalf of your company, then you are covered. There are employees who are usually covered if they get injured during a company’s sponsored event like a retreat, picnic, and many more. But workers’ compensation doesn’t usually cover employees who get injured while on break regardless of whether or not they are on company property unless you are taking a client for a company sponsored lunch.
There are various injuries and illnesses that qualify for workers compensation. For instance, you can injury your back while carrying a heavy box, so you can file a workers’ compensation claim. You can also be hospitalized after contacting the coronavirus while traveling for work, meaning the workers’ compensation can still cover you.
Notably, work-related injuries may also happen off the company’s premises. If you are doing work for the company when you get injured or even become ill, you can file a workers’ compensation claim. However, illnesses or injuries that arise from your commuting to and from work don’t qualify for workers; compensation coverage.
When it comes to how long it can take for you to continue receiving compensation, it also varies by state. In most cases, you need to expect a maximum of at least three to seven years. But benefit periods of this long do not imply that you will be out of work for this whole time. You can decide to return to work either in a limited capacity or full capacity if you are well enough while still getting financial benefits from your claim.
Whenever you experience a work-related illness or injury, it’s always a good idea to speak with an attorney. They can guide you through the claim application process and even tell you how long the benefits may be expected to last.
How a workers’ compensation attorney can help you
The attorneys and claims adjusters working for the insurance companies are not there to protect your interests. Therefore, they cannot hesitate to reject your valid claim for some funny reasons. Thankfully, there are many things that an experienced and knowledgeable workers’ compensation lawyer can do on your behalf. The following are some of the things you can expect from a workers’ compensation attorney:
Developing vocational, medical, and other evidence
Lack of enough medical evidence is perhaps one of the reasons many workers’ compensation claims are denied. If the claim is approved, it means there are good chances that there are good chances of receiving all the medical treatment you deserve as well as all the other benefits. But you need to have good medical evidence to support your claim.
Your lawyer can develop the medical evidence by collecting medical records, arranging treatment with specific doctors, getting medical opinions from physicians treating you, representing you once you have been asked to appear and answer some questions at the deposition, and carrying out depositions of medical professionals.
There are various types of evidence that can improve your case. These include testimony given by a vocational expert stating your work’s physical requirements, statements from family members and friends about your daily activities, and evidence indicating the history of your employer of lack of training and poor workplace safety. An experienced workers’ compensation lawyer can know, based on your case what evidence may be required to optimize the chances of a good result.
Negotiating settlement agreements
When the time comes to negotiate with the insurance company for your employer to reach a settlement, your attorney can have an advantage. This is because they can know the worth of your case, meaning they may know the amount of benefits you deserve to receive based on several factors.
These can include the extent of the injuries and the limitations in what you may do, the past medical expenses and the cost of medical treatment required in the future, whether you have long-term impairments or not, whether the employer is owing you for the penalties for late payments and past temporary disability benefits, and your previous wages.
Further, attorneys know most of the negotiating tactics and tricks utilized by insurance companies including bogus final offers and low-ball offers. With few exceptions, attorneys can engage in more productive negotiations with insurance companies than you doing it alone.
Your lawyer can also make sure that the settlement agreement is written properly to prevent negative consequences in the future. For example, if you intend to apply for Social Security disability benefits, it can cost you a lot of money each month in benefits if the settlement agreement is designed improperly. A lawyer may also assist you to create a reasonable estimate of the future medical expenses to make sure the settlement agreement should consider it.
It’s true that workers’ compensation judges need to approve settlements, but it doesn’t make sense to depend on the judge because they may not protect your interests adequately. No doubt, you need an attorney in settlement negotiations.
Representing you when it comes to a workers’ compensation hearing or even trial
When you fail to reach a settlement agreement, then it means your case needs to go to an administrative hearing or even trial that is presided by a workers’ compensation judge. During the investigation process, your lawyer can take depositions of witnesses, do legal research, ask for medical records, write your pleadings like motions and petitions, and ensure that all the documents are submitted timely.
At the hearing, your attorney can give a theory of the case to the judge, meaning they will speak on your behalf why you need to get benefits. They will also make opening and closing statements, examine witnesses, and bring objections once the insurance company does any improper things. If you are not pleased by the outcome of the hearing, your lawyer may assist you appeal the decision.
In conclusion, perhaps, one of the important steps that you can take after getting injured or ill on the job is to get in touch with an experienced and reliable workers’ compensation attorney. The first meeting with a lawyer can give you a good idea of the strengths or weaknesses of your workers’ compensation claim and the attorneys interest and experience in the case.