Workers Compensation - How to File a Workers Compensation Claim

Workers who are injured on the worksite should report the injury immediately. This helps avoid problems and delays in receiving workers' comp benefits.

Workers' compensation benefits typically consist of medical treatment as well as vocational rehabilitation services and disability benefits. The amount and duration of these benefits varies from state to state.

Medical Treatment

When you are injured on the job, medical treatment is an important part of your workers compensation claim. This type of insurance coverage provides for medical visits, hospital stays, imaging studies (x-rays) blood tests, and the cost of rehabilitation treatment.

To encourage objective healing and achieve goals for returning to work, the New York State Workers' Compensation Board develops medical treatment guidelines (MTGs). The guidelines are regularly updated to reflect changes in the medical field and physician recommendations.

These guidelines are intended to ensure that injured workers receive the same treatment as other workers with work-related injuries and diseases. These guidelines guarantee that appropriate treatment is provided for any illness or injury and that there aren't unnecessary medical expenses.

If a physician determines that medical treatment is not required under the MTGs and he/she may request an exception from the insurer, asking for a specific exception to these MTGs. This is a lengthy procedure which can take several months to be completed.

If treatment is required, the employer or the insurer must make every effort to provide this treatment. Inability to provide this treatment could result in a dispute between the insurer and the injured employee which is often resolved through an evidentiary hearing before an administrative law judge.

The treatment should be provided by an accredited local health provider who is licensed to offer workers' compensation treatment. However, in urgent circumstances, a licensed but non-certified doctor can provide treatments for injuries suffered by workers provided they have been informed of the accident and an appropriate first report of injury has been submitted by the supervisor or employer.

Many doctors are certified in workers' compensation and charge a lower cost for treating injured employees. This is especially helpful for patients who have sustained a serious injury.

There are a variety of medical professionals who are available to offer medical treatment for injured employees, in addition to doctors. They include physical therapists, occupational therapists , chiropractors and others.

The New York State Workers' Comp Board suggests that injured employees and their representatives consult their lawyers prior to receiving any medical treatment. This could be the sole way to make sure that workers receive the best care in some instances.

Charges

Workers' compensation costs may vary depending on the state and the employee. These expenses include medical payments and vocational rehabilitation costs, legal costs, and settlement costs.

The majority of these expenses are covered under your insurance policy. Certain of these expenses could be paid by the spouse of the employee, the employee's spouse, or dependents.

In most states, employers are required to carry workers' compensation coverage. This covers employees from lawsuits and other damages arising from workplace accidents, like injuries or illnesses. The policy covers medical care, wage replacement and death benefits for those who die on the job.

Workers insurance for compensation is essential but can be costly. It typically costs a company about $1 per hour of work lost due to a workers' compensation law firm comp claim.

These losses may be reflected in the bottom line of the company which could result in a loss in profitability and productivity. It can also impact the reputation of the company which could be detrimental to future business contracts and the ability of employees.

Apart from workers' compensation, a company can also incur other indirect costs that are related to employee injuries. The cost of a time an employee is absent from working or the cost of hiring a replacement employee could also be included in these indirect costs.

Another indirect cost is the cost of repair or replacement of equipment or property that was damaged as a result of an injury-related incident. This is a huge expense for any company but it is especially frequent for heavy-duty machinery and equipment.

Employers may be subject to OSHA fines for high incident rates. These fines are usually initiated by inspections and other regulatory actions based on an organization's worker injury or fatality rates.

Direct and indirect costs can be reduced by fostering an environment of positive work and minimizing workers' claims for compensation. It also helps create a more profitable environment and increase morale of employees.

Time Off Work

The loss of income as a result of an injury at work can be devastating. If, however, you are receiving workers' compensation benefits you may have a few options to make up the difference while you heal.

There are numerous types of time off available by employees, such as sick and vacation leave. Certain of these leave types are covered by state or federal laws, while some are voluntary.

Companies can use vacation and sick leave to their advantage. Employees can use their time off to care for family members or look after themselves. Some companies also provide personal time off that can be used to handle things such as doctor's visits, vehicle inspections, and even occasions (e.g., parent-teacher conferences).

While some states have laws that require employers to offer paid sick leave to employees, this isn't always the situation. Companies that do not have the funds to pay for this type of leave could be able choose not to offer this kind of leave.

Employers can also avail of offering flexible time. Employers may offer flex time to employees. This lets them take a portion of their paid time off, and the employer can cover the difference by increasing their working hours or increasing their wages.

Some states also require employers to offer sick or vacation days. This can encourage employees to take a break when they are sick or care for a family member.

If your employer doesn't provide any of these options, it's a good idea to speak with a lawyer regarding how you can best use your rights under the law. A qualified attorney can assist you in understanding your rights and protect them when you are asked to utilize your paid time off to receive medical treatment or other reasons.

Employers can also provide time off to employees who work outside of the time frame of their contract. This is called time off-in-place , or TOIL. Some of the time is used for an appointment for medical or for other treatments, while some is used for jury service, or other tasks that the employee chooses to participate in.

Appeal

If you are denied workers' compensation benefits, you have the right to appeal that decision. Within 30 days from the date the judge issued a negative decision, you are able to appeal to your state's workers ' compensation board.

The appeals process is an essential element in the claims process. They can help you get the compensation you deserve after an accident at work. An experienced attorney can assist you through the appeals process and ensure that you receive all the benefits you are entitled.

Many injured workers are denied their workers compensation claim or have their claims significantly reduced by the insurance company. This can be a devastating situation for an injured worker and is often performed with the sole aim of saving their employer and insurance company money.

The workers' compensation judge will hear the appeal. It is typically an in-person hearing however it can also be conducted through videoconferencing.

The judge will be listening to your lawyer's and your attorney's concerns regarding your workers' compensation claim during this hearing. The judge will examine the medical records, wages and other evidence to determine whether you are entitled to workers compensation benefits and what the amount should be.

The judge may also look into any disagreement regarding your injury. The judge will then decide which benefits you're entitled to and how long they'll last.

You may appeal the decision to a higher court if you disagree with the judge's decision. Usually you can appeal to the appellate division of the court of your state within 30 days of the decision of the workers compensation board.

The appeals process can be challenging, but you can count on your workers' compensation lawyers to do their best to ensure you receive the most favorable outcome. A knowledgeable attorney will examine your case in depth and present to the appeals court your reasons for better results.

If you need assistance with a workers' compensation appeal, contact a seasoned New York workers' compensation law firm today. The Turley, Redmond & Rosasco team of workers' compensation lawyers has the experience and resources to help you get the full amount of workers' compensation benefits to which you are entitled.