Getting Your Benefits Paid

If you have been injured at work, or suffer from an occupational disease, your entitlement to worker's compensation benefits is clear. Notice should be given to your employer as soon as possible following your injury. You have the right to obtain a copy of the Employer's Basic Report of Injury that is required to be filled in your state. Once you make a claim for benefits, the employer or its insurance company has a duty to promptly investigate your claim and make a decision within thirty days regarding your entitlement to benefits. You should submit proof of your injury including the names and addresses of your physicians as soon as possible to your employer. You should make sure that your employer reports this information to the insurance company immediately after your injury. If benefits are not paid within thirty days, certain penalties may apply depending upon the circumstances of the delay. You have every right to know the status of your claim, and you should stay in constant contact with your employer and its insurance company to make sure your claim is being properly handled.

Hiring an Attorney

The decision to hire an attorney in a worker's compensation claim is a very important one. An attorney experienced in worker's compensation law can provide valuable assistance to an injured worker by advising them of their specific rights and responsibilities under the law. An attorney that specializes in worker's compensation will be able to effectively communicate with the employer or insurance company to make sure all of your benefits are paid. In some states, the law provides that attorney fees can only be charged to an injured worker when the attorney's services result in the payment of workers' compensation benefits to an injured worker. The attorney fee charged to you is subject to maximum fees set forth in the workers' compensation law. If an attorney is successful in obtaining a voluntary payment of workers' compensation benefits on your behalf, or an award from a magistrate, the maximum fee chargeable is 30 percent of your past due benefits. The attorney will most likely forward expenses associated with handling the case, which are reimbursable out of any past due benefits or award before computing the fee. If an attorney is successful in obtaining a settlement on your behalf, different fees apply. A workers' compensation settlement is known as a redemption. Attorney fees on redemptions workers' compensation the first $25,000 obtained, and 10 percent of any amount above $25,000, after first subtracting the expenses. If a person is receiving benefits on a voluntary basis at the time of the settlement, and no dispute exists, then the maximum attorney fee is 10 percent. If a workers' compensation case proceeds to trial, and proofs presented in the case are complete, then the attorney can charge a fee of 20 percent of the amount of any settlement. All attorney fees are subject to approval by a magistrate. An experienced workers'compensation attorney should be able to provide you with advice and may not charge you a fee unless workers' compensation benefits are obtained on your behalf.

Lost Wage Benefits

If you have been injured at work or suffer from an occupational disease, and are off work for more than eight days, your employer or its insurance company is responsible for paying you for your lost wages. Your lost wage benefits are determined by averaging the highest 39 weeks of your earnings for the 52 weeks prior to the date of your injury. If you worked less than 39 weeks for the particular employer where you were injured, then your average weekly wage is based upon the total number of weeks that you've worked. Your employer is required to supply this information to their insurance company or make the necessary calculation. The benefit rate to which you are entitled is typically 80% of your after tax wages, subject to a maximum benefit rate that is tied to the state average weekly wage. Your weekly benefit rate will increase if you have dependents such as an unemployed spouse, or children under the age of 18. For injuries occurring in 1996, the current maximum benefit rate is $524. Your weekly wage loss benefits are payable for as long as you remain unable to work. There is no limitation on how many weeks of benefits you could receive if you became permanently disabled. Wage loss benefits are not subject to any local, state or federal taxes. Your weekly benefits are also exempt from attachment or garnishment, but for court ordered child support or alimony payments. You should always contact an experienced workers' compensation attorney for a detailed explanation of all of your rights under the law.

General Overview

If you have been injured at work, or suffer from an occupational disease, you are entitled to benefits. There are three basic types of benefits -- lost wages, medical and vocational rehabilitation. These benefits are aavailable to any employee regardless of who was at fault for causing the injury or making a pre-existing condition worse. The lost wage benefits are based upon your average weekly earnings for the year prior to the injury and the value of any discontinued fringe benefits. These benefits are payable weekly and represent approximately 80% of your after tax wages subject to a maximum benefit for 1996 of $524. Your are also entitled to reasonable and necessary medical treatment with a physician of your choice within ten days after an injury. Medical expenses must be paid within 30 days after proper proof of the expenses have been submitted. The company does have the right to send you for treatment to their doctor within the first ten days of an injury. If you become unable to return to your past employment because of your health conditions, you are entitled to professional assistance in finding suitable employment, retraining, or education. You should always contact an experienced workers' compensation attorney for a detailed explanation of all of your rights under the law.

Your Right to a Hearing

Most workers' compensation claims are paid voluntarily by an employer, or their insurance company. However, disputes often arise regarding a person's right to receive the benefits or to continue to receive benefits once a claim has been paid. Your employer or their insurance company can stop your benefits for a variety of reasons. They may also deny you certain benefits such as medical care or vocational rehabilitation. You have the right to request a hearing and be represented by an attorney. The hearing process is started by filing and Application for Mediation or Hearing with the Bureau of Workers' Compensation. Mediators are employed by the Bureau to try and resolve disputes informally. These informal hearings are conducted at various county offices on a daily basis. The mediator has no authority, however, to order the payment of benefits. A formal hearing is required when workers' compensation bbenefits have not been properly paid, or are improperly discontinued. Attorneys that specialize in workers' ccompensation provide valuable assistance to injured workers by presenting your case to a magistrate. Your employer, or their insurance company will be represented by their attorneys. The workers' compensation hearing is conducted by presenting the testimony of an injured worker, witnesses, and presenting medical evidence. It is not unusual for there to be long ddelays in obtaining a formal hearing date due to crowded court dockets. Only a workers' compensation magistrate can order the payment of compensation benefits to an injured worker that has the force of law. You should always contact an experienced workers' compensation attorney for a detailed explanation of all of your rights under the law.

Medical Care

If you have been injured at work or suffer from an occupational disease, your are entitled to reasonable and necessary medical treatment. Typically, within the first ten days after an injury, an employer will send you to a company clinic or preferred hospital for treatment. You should cooperate with your employer by attending any appointments, and then choose a physician of your own within ten days of your injury. You must give written notice to your employer of the name and address of the physician with whom you intend to obtain treatment. The employer or insurance company should send a letter of authorization to the physician so that you can obtain prompt medical care. The insurance company must pay your medical expenses within 30 days of receipt of the bill. Your physician must send copies of all medical records and occasionally write medical reports to support their treatment. Finally, your employer will have the right to have you examined by a physician of their choice from time to time during your disability. Many persons experience an interruption in their wage loss benefits or right to receive medical care of suffer other consequences from such an examination. You have the right to challenge the opinion of any physician who might examine you at a workers' compensation hearing. You should always contact an experienced workers' compensation attorney for a detailed explanation of all of your rights under the law.