FAQ: Worker’s Compensation

Disclaimer: It is very important to understand that the results of each case vary according to the specific facts related to that case. No two cases are the same. There are no guarantees as to specific results in any case and no potential client should have a specific expectation in terms of dollar amounts or specific results. We do promise to work diligently and to be an advocate for you in a process that sometimes can be overwhelming to injured workers dealing with their injuries in a process that is totally foreign to them and for which they may not have had any previous experience.

Q: Will I be paid for time I have lost at work?
A: If you have lost more than 7 days of work due to an on the job injury, then you are entitled to temporary compensation.
Q: Will my medical bills be paid?
A: The employer is required to pay for all related medical treatment that tends to lessen your disability. As an injured employee, you should not be required to pay any money for medical expenses related to an on the job injury.
Q: Will I be able to see the doctor of my choice or do I have to see a company doctor?
A: If the employer and their insurance carrier have agreed that you are entitled to worker’s compensation benefits then they have the right to choose the treating medical doctor. However, special circumstances may exist that may allow the injured employee to seek treatment from a doctor of their choosing. These circumstances are very fact dependent and it will be necessary for you to speak with a worker’s compensation attorney to determine if you have to see the employer’s choice of doctors.If the insurance company has denied the injured worker’s claim then the injured worker may select his own doctor for treatment and file a claim against the insurance company in an attempt to force the insurance company to pay for the medical treatment.
Q: What if I can’t return to work?
A: If your injury prevents you from returning to work for a temporary period of time then you are entitled to receive weekly compensation for the time that you are unable to work. If after receiving medical treatment, you are permanently unable to return to the work place at which you were injured then there are possibilities of receiving what is called Permanent and Total Disability or perhaps for compensation based on your lost earnings capacity. Regardless of the benefit for which you may qualify, the total that you may receive is capped at a certain number of weeks of compensation depending on the benefit awarded.Regardless of benefit for which you may qualify, it is important not to trust that the insurance company or even the employer will maximize your benefits. The motives of the insurance company and the carrier are far different from yours. The insurance carrier’s measurements of success in a claim are driven by paying a little as possible on a claim. Do not rely on the insurance company to explain to you the total benefits that you are entitled to receive. Don’t be fooled or lulled into thinking that you will be treated fairly by the insurance carrier without assistance. Seek the advice of an experienced Workers’ Compensation attorney soon as soon after the injury as possible in order to understand your rights and the benefits available to you.
Q: What if my injuries are permanent?
A: If after receiving medical treatment, you are permanently unable to return to the work place at which you were injured then there are possibilities of receiving what is called Permanent and Total Disability or perhaps for compensation based on your lost earnings capacity. Regardless of the benefit for which you may qualify, the total that you may receive is capped at a certain number of weeks of compensation depending on the benefit awarded.Regardless of benefit for which you may qualify, it is important not to trust that the insurance company or even the employer will maximize your benefits. The motives of the insurance company and the carrier are far different from yours. The insurance carrier’s measurements of success in a claim are driven by paying a little as possible on a claim. Do not rely on the insurance company to explain to you the total benefits that you are entitled to receive. Don’t be fooled or lulled into thinking that you will be treated fairly by the insurance carrier without assistance. Seek the advice of an experienced Workers’ Compensation attorney soon as soon after the injury as possible in order to understand your rights and the benefits available to you.
Q: Do I really need a lawyer to represent my case?
A: There are certainly cases where attorney representation is not required. These are normally cases where out of work is limited to a no days or only few days or very little medical treatment is required. Most attorneys including our firm, will at least one time provide a free consultation with you to understand and advise you on the best course of action for your claim. However, if you experienced any of the following then you will definitely want to consult with an attorney:

  1. Physical impairment from the injury;
  2. Insurance denial of claim;
  3. Loss of income without compensation;
  4. Third party at fault for causing the injury (ie. automobile accident, or product liability);
  5. Failure of employer to provide medical treatment.

There are different methods of resolving a Worker’s compensation claim. If you choose the wrong method without representation then you may limit the benefits that you are entitled to receive.

Q: My insurance company is non-responsive or very difficult to deal with?
A: This is one of the top reasons that clients come to us for representation. Insurance companies are often this way with people who do not have experience with the process. Sometimes this is done intentionally. Sometimes the insurance adjuster is simply overwhelmed with the volume of cases assigned to them and is non-responsive until the right buttons are pushed.
Q: What if my employer is not helping me?
A: I have had many cases where the employer has made promises to help an injured employee only to later do nothing. The longer an injured employee relies on the false promises of the employer, the worse the case will be for the injured worker. Don’t wait on the employer or the carrier to do the right thing.
Q: My employer says my accident is not a worker’s compensation accident and I must file on my health insurance?
A: This is a common problem for injured workers especially in larger companies where they have a more sophisticated human resources department. Many companies do not want to have “lost time accidents”. Management compensation and/or bonuses may be tied to lost time performance measures and lost time accidents may cost the company in terms of increased insurance premiums. So reclassifying an injury something other than a lost time accident can benefit the company financially as well as the manager that implemented the policies. If you believe that your injury was related to work then you need to our firm to discuss your possible claim. Remember, it is not necessary that the work “caused” the injury but only that the work contributed, aggravated or accelerated your physical condition so that it is worse with the work than without the work.
Q: If I open a workers’ compensation claim will I lose my job?
A: It is against the law for an employer to fire a person in response to that person filing a worker’s compensation claim.
Q: How will I feed my family in the mean time if I’m not able to work?
A: The law requires employers and their insurance carriers to provide weekly compensation checks during the time that an employee is unable to work due to an on the job injury.Worker’s Compensation is not a Government run program.Some people have the misunderstanding that when they are injured on the job that a government agency provides the benefits to the injured workers. This is totally false. Employers and/or their private insurance companies are responsible for paying benefits to the injured worker. You can be assured that private insurance companies are not going to advocate for you like your own attorney. Insurance companies are for profit organizations and paying out less in claims is a primary goal of theirs.
Q: What if I have aggravated a pre-existing condition?
A: An injured worker may be able collect compensation for aggravating pre-existing conditions.
Q: Are their time limits to filing a complaint?
A: Yes, notice of an injured must be given to the employer within 90 days of an injury and an actual claim must be filed within two years of the injury. This is the general rule, however some exceptions do exist. Please consult with our firm if you are concerned about this issue.
Q: My accident happened while driving a car on company business.
A: In this instance, you are should be covered by both a “third party” insurance company and the employer’s worker’s compensation insurance. Both will pay you benefits however there are certain procedures to follow that will allow you to recover under both insurances. A failure to follow the procedures may prevent you from collecting under one or the other insurances. You need to consult an attorney as how to handle this particular situation.
Q: I can trust my employer to do the right thing for me.
A: There are good employers no doubt. However, the problem is that employers don’t actually manage the injured worker’s claim. A private insurance company or claims management company is the group that actually manages your claim. They are highly trained and focused on how to reduce the amount of benefits that they will pay to an injured worker. They do not have the same care, compassion or relationship to the injured worker as the direct employer. The injured worker really needs an advocate, like an experienced workers compensation attorney, arguing on behalf of the injured worker against the trained insurance professionals.Also there are a few “bad apple” employers that will promise to help an injured worker but never follow up on their promises. I have received many cases after false promises made by employers to injured workers.
Q: My employer told me he did not carry insurance and could not help me.
A: A claimant should definitely not accept this as an answer. There are too many occasions when injured workers do receive compensation when the employer failed to purchase insurance. In this case, the injured worker must consult an attorney at our firm. Depending on the specific facts of your particular case, insurance or other funds may be available to pay for compensation for the claim.