At the turn of the 1990’s, along with the increase if industry there was also an increase of job-related work injuries. Courtrooms were swamped with work injury cases. In order to relieve the courts and ensure the welfare of America’s job force, state legislatures began passing workers compensation laws. As a result, workers compensation traditionally has been and remains a legal area relegated to state courts. Workers compensation provides disability benefits, compensation for lost wages, and medical care for workers injured on the job. Most states require employers to carry liability insurance to cover work injuries.
Workers Compensation Procedure – What to Expect
The employers insurance company will either “admit” or “deny” the workers comp case. When the insurance company denies that an injury occurred your choices are litigation or agreeing to lesser compensation than the maximum benefit entitled by law.
After a workers comp case is admitted, the worker is first eligible for temporary disability.
Temporary disability – The doctor evaluates the worker is unable to work due to injury,however there is still a likelihood of improving the condition through medical treatment. The insurance company pays 66% of the employee’s gross earnings at a current maximum rate of $490.00 per week.
Permanent disability – When the doctor has evaluated that the condition has become permanent and stationary and will stay the same in the future, then permanent disability is considered.
Medical Evaluation – If your injury has been evaluated as a permanent disability, the next step involves further medical evaluation by a medical professional specializing in the type of injury sustained. If you are unrepresented by an attorney, the insurance company will have you select a medial specialist from a list of doctors it provides. However, if you are under legal counsel, your attorney will either choose the evaluating doctor or choose an agreed medical doctor, one that he and the insurance company agree on. The insurance company may still have you evaluated by a doctor of their choice.
Settlement – When the medical reports are prepared and mailed to all parties the report is “rated” following state guidelines and the rating is converted into a monetary amount. The insurance company will at that point negotiate what is is willing to pay based on the rating. If the doctor has adjudicated that due to the nature of the injury, the worker won’t be able to return to his/her usual occupation or job held at the time of the injury, rehabilitation benefits may also be included as part of the settlement.
Benefits of Hiring a Personal Injury Lawyer
Insurance companies always strive to pay as little as possible on a claim. If your payments have been delayed, your attorney can check on the status of your compensation. If your workers comp case has been denied, receiving legal advice on the best course of action is invaluable. During settlement negotiations, a personal injury lawyer will assist you in receiving the maximum compensation to which you are entitled.
At Johnson & Monteleone LLP we look forward to being of service. Please call us at (208) 331-2100 to arrange a free consultation regarding your workers compensation concerns.