Workers Compensation - How to File a Workers Compensation Claim

If an employee is injured at work it is important to report it promptly. This helps prevent problems and delays in receiving workers' compensation benefits.

The typical workers compensation benefits comprise disability and medical treatment and vocational rehabilitation services. The amount and duration of these benefits vary from state to state.

Medical Treatment

Workers' compensation claims include medical treatment for injuries sustained on the job. This type of insurance covers hospitalizations, doctor appointments, and imaging studies (xrays), as well as rehabilitation costs.

To encourage objective healing and to achieve the goal of returning to work, New York State Workers' Compensation Board has established medical treatment guidelines (MTGs). The guidelines are regularly revised in accordance with medical advances and recommendations from doctors.

These guidelines are designed to ensure that injured workers receive the same treatment as other workers with occupational injuries and illnesses. These guidelines guarantee that appropriate treatment is provided to any illness or injury and that there aren't unnecessary medical costs.

If a doctor concludes that medical treatment is not necessary under the MTGs they can request an exemption from the insurer and request a specific exception to these MTGs. This is a lengthy procedure that can take a number of months to be completed.

Employers and insurers must strive to provide the treatment if it is required. If there is disagreement between the employer and the employee it is possible that the employer fails to provide the treatment. The issue can be resolved by an evidentiary court before an administrator law judge.

Typically, the treatment should be provided by an authorized health care professional in the region that is authorized to treat workers' compensation claimants. However, in urgent situations, a non-licensed or uncertified physician can render treatment for injuries suffered by workers, as long as they have been informed of the incident and the proper initial report of injury has been completed by the employer or supervisor.

Many doctors are certified in workers' compensation and can offer lower rates for treating injured employees. This is particularly helpful to patients who have sustained serious injuries.

There are a variety of medical professionals who can provide assistance to injured employees in addition to doctors. They include physical therapists, occupational therapists and chiropractors.

The New York State Workers' Compensation Board recommends that injured workers and their representatives consult their attorneys before they receive any medical treatment. In some instances this may be the only way to ensure employees receive the best possible care.

Costs

Workers' compensation costs can be different according to the state of the employee and state. The costs include medical insurance, vocational rehabilitation costs, legal fees and settlement costs.

Most of these expenses are covered under your insurance policy. Certain of these expenses could be incurred by the employee, their spouse, and/or dependents.

In most states employers are required to have workers' compensation insurance. This covers employees from lawsuits and other damages arising from workplace accidents, including injuries or illnesses. The policy covers medical treatment, wage replacement and death benefits for workers killed in the course of work.

While workers' compensation insurance is essential, it could also be expensive. A worker's compensation claim could cost a business approximately $1 per hour of work lost.

These losses may be reflected in the bottom line, which can cause an erosion in productivity and profitability. It could also affect the reputation of the company which could affect future business contracts and qualified employees.

A company may have to pay indirect costs as a result of injuries sustained by employees as well as workers' compensation. Costs like the duration of time employees are absent from work or the cost of hiring a replacement employee can also be included in these indirect costs.

Indirect costs comprise the repair or replacement of equipment damaged by an accident. This is a significant expense for any business however, it is more frequent for heavy-duty machinery and equipment.

Employers could be subject to OSHA fines for having high incident rates. These fines are typically initiated when an organization's death or injury rate is inspected.

Instilling a positive workplace culture and minimizing workers' compensation claims can help reduce the direct and indirect costs for the business. It also creates a more profitable environment for the company and increase employee morale.

Time off from work

A work-related injury can cause income loss that can be devastating. If, however, you are receiving workers' compensation benefits, you may have some options to help cover the gap while you heal.

Employees can take many types of time off, including sick and vacation time. Some of these leaves are covered under federal or state laws and others are not mandatory.

Businesses can use vacation and sick leave to their advantage. They permit employees to take time off to care for family members or to take care of themselves. Some companies provide personal time to use for things like appointments with a doctor, car checksups or other occasions (e.g. parent-teacher conferences).

Although some states have laws that require employers provide paid sick time for employees, this isn't always the case. Certain companies might be able to opt-out of providing this type of leave, which could be beneficial for companies that don't have the funds to cover this type of leave.

Another option for employers is to offer flexible time. Employers may offer flex time to employees. This allows them to get paid time off. The employer can compensate for the difference by increasing their hours or increasing their pay.

In addition to the options above Some states have also mandated that employers provide paid sick or vacation time. This can be a useful method for businesses to motivate employees to take time off when they're ill or are required to care for a family member.

If your employer isn't offering one of these options, it is a good idea to speak with a lawyer about the best way to utilize your rights under the law. If you're being asked to take paid time off for medical treatmentor for any other reason, a knowledgeable lawyer can help you understand and protect your rights.

Some employers also give employees time off for work they've done over the time limits of their contract. This is known as time off in lieu, or TOIL. Some employees make use of this time to attend medical appointments, or other forms of treatment. Others participate in juries or other tasks they choose to take part in.

Appeal

If you are denied workers compensation benefits you are entitled to appeal that decision. You can file an appeal with the workers' compensation board within 30 days of the date that the judge ruled against you.

Appeals are an important part in the claim process. They can assist you to get the benefits you deserve following an accident at work. A well-trained attorney can help you navigate the appeals process and make sure you receive the maximum amount of benefits to which you are entitled.

Many injured workers are denied a workers compensation claim or have their claims drastically reduced by the insurance company. This is a very difficult situation for injured workers and is often performed with the sole aim of saving their employer and the insurance company money.

The workers' compensation judge will decide on the appeal. The hearing is usually held live, however it may also be conducted using videoconferencing.

In this hearing, the judge will listen to your lawyer and you about your workers' compensation claim. The judge will look at medical records, wages and other evidence to determine if you are entitled to workers' compensation benefits and what the amount should be.

Additionally to this, the judge is able to look into any disputes regarding your injury. The judge will then decide on the benefits you are entitled and how long they should last.

You may appeal the decision to a higher court in the event that you disagree with the judge's decision. Typically, appeals can be filed with the appellate division of the courts in your state within 30 days of the workers' compensation board's decision.

Appealing can be a challenge, but your Workers' Compensation lawyers will be determined to get you the best outcome. A knowledgeable attorney will examine your case thoroughly and present to the appeals court why you should get an improved outcome.

If you need assistance in a workers' compensation appeal, call an experienced New York workers' compensation law firm today. The Turley, Redmond & Rosasco team of workers compensation lawyers have the expertise and resources to help you get the full amount of workers' compensation benefits to which you are entitled.