At the turn of the 1900's, along with the increase of 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 employer's insurance company will either "admit" or "deny" the workers' compensation case. When the insurance company denies that an injury occurred, your choices are litigation or agreeing to lesser compensation than the maximum benefits available by law.
After a workers' compensation case is admitted, the worker is first eligible for temporary disability.
Temporary disability - When the doctor determines that the worker is unable to work due to the injury, but that 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 stationary and will not likely improve with time or future medical treatment, 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 not represented by an attorney, the insurance company will have you select a medical specialist from a list of doctors it provides. However, if you have legal counsel, your attorney will either choose the evaluating doctor or choose a medical doctor that he and the insurance company have agreed upon. 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 it 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' compensation 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 L.L.P. we look forward to being of service. Please call at (208) 331-2100 to arrange a free consultation regarding your workers' compensation concerns.
