Workers Compensation - How to File a Workers Compensation Claim

If an employee is injured while on the job it is important to inform the employer promptly. This helps prevent problems and delays in receiving workers comp benefits.

Workers' compensation benefits typically consist of medical treatment and vocational rehabilitation services and disability payments. These benefits can vary in duration and amount from one state to the next.

Medical Treatment

If you're injured on the job medical treatment is a vital element of your workers compensation claim. This type of insurance covers medical visits, hospital stays, imaging studies (x-rays) and blood tests and the cost of rehabilitation treatment.

To encourage objective healing and achieve the goal of returning to work, New York State Workers' Comp Board develops medical treatment guidelines (MTGs). These guidelines are reviewed regularly according to changes in the medical field and the recommendations of doctors.

These guidelines are intended to ensure that injured workers receive the same treatment as other workers with work-related injuries and diseases. They also help ensure that the treatment is appropriate for the specific injury or illness , and that there isn't any overtreatment or unnecessary medical costs.

If an individual physician decides that a treatment that is not in the MTGs is necessary then he or she can request a variance with the insurance company, requesting an express exemption from the MTGs. This is a lengthy procedure that could take a few months to complete.

Employers and insurers must take every step to provide the proper treatment in the event that it is required. If there is a dispute between the employer and the employee it is possible that the employer fails to provide the treatment. This is usually resolved by an evidentiary hearing before an administrator law judge.

Usually, the treatment should be administered by an authorized health care professional within the region who is licensed to treat workers' compensation claimants. In the event of an emergency however, a non-licensed or uncertified physician might be competent to treat injuries sustained by workers if they have been notified of the incident and completed the appropriate first injury report.

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

Alongside doctors in addition, other medical professionals are able to provide treatment for injured employees. They include occupational therapists, chiropractors and physical therapists.

The New York State Workers' Compensation Board suggests that injured workers and their representatives speak with their lawyers prior to receiving any medical treatment. In certain cases this could be the only way to ensure an employee receives the best possible treatment.

Costs

Workers' compensation costs may vary depending on the state and employee. The costs include medical insurance and vocational rehabilitation costs, legal fees and settlement costs.

The majority of these expenses are covered by the insurance policy. However, some of these expenses are paid by the employee himself, or their spouse and/or dependents.

In many states, employers are required to carry workers' compensation coverage. This shields employees from lawsuits and other damages that result from workplace accidents, including injuries or illnesses. The policy protects workers who are killed on the job and offers reimbursement for medical treatment or wage replacement as well as death benefits.

Workers' compensation insurance is important however it can be costly. Workers' compensation claims can cost a business approximately $1 per hour of lost work.

These losses may be reflected in the bottom line of the business and can result in an increase 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.

A business may incur indirect costs resulting from injuries sustained by employees as well as workers compensation. Costs like the period during which an employee is off work or the cost of hiring a replacement employee could also be included in these indirect costs.

Another indirect cost is the cost of the repair or replacement of equipment or property damaged in an accident that caused injury. This is an expense that is significant to any company, and it is common for companies that have heavy-duty machinery or equipment.

Employers may also be subject to OSHA fines for incidents that have high rates. These fees are often initiated by inspections and other regulatory actions based on an employer's fatality or injury rates.

Establishing a positive culture at work and reducing claims for workers' compensation can help to reduce the cost of these indirect and direct expenses for businesses. It can also create a more lucrative environment and improve employee morale.

Time off from Work

The loss of income due to an injury at work can be devastating. You may be eligible for workers compensation benefits to help cover the gap while your recovery is complete.

There are a variety of types of time off that can be used by employees, including sick and vacation leave. Certain types of leave are covered by state or federal laws while others are not.

Vacation and sick leave can be a valuable option for businesses since they allow employees to take time off from work when they are ill or need to take care of the family member. Some companies offer personal time that can be used for things like doctor's appointments, car checksups, or events (e.g. parent-teacher conferences).

Although some states have laws that require employers provide paid sick leave for employees, this is not always the case. Certain businesses might be able to opt-out from offering this kind of leave, which could be beneficial for companies that do not have the resources to pay for this kind of leave.

Employers can also avail of offering flexible time. This permits employees to take some paid time off, and their employer can compensate them by other means, such as increasing their hours or salary.

Some states also require employers to offer vacation or sick time. This can encourage employees to take time off when they are sick or need to care for the family member they love.

If your employer isn't offering one of these options, it's recommended to speak with a lawyer regarding the best way to use your rights under the law. If you're being asked to use paid time off for medical treatment, or for any other reason, an experienced attorney can help you understand and defend your rights.

Some employers also offer employees time off for work they've done over the hours they're contracted to work, workers' compensation attorneys which is called time off in lieu, or TOIL. Some employees use this time to attend medical appointments or other forms of treatments. Some also participate on juries, or in other tasks they choose to take part in.

Appeals

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

Appeals are an important part of the claims process and can be a significant aid in helping you get the compensation you deserve after an injury at work. An experienced attorney can assist you navigate the appeals process and ensure you get the full amount of benefits to which you are entitled.

Many injured workers are denied a workers' compensation claim or have their claims significantly reduced by the insurance company. This can be devastating for injured workers, and is usually done to save their employers and the insurance company money.

The appeals process begins with a hearing in front of the workers' compensation judge. This hearing is usually conducted live, however it may also be conducted using videoconferencing.

The judge will hear your and your lawyer's concerns regarding your workers' compensation claim during this hearing. The judge will review your medical records, wages and other evidence to determine whether you are eligible for benefits under workers' compensation. If so how much should it be?

The judge can also review any disputes regarding your injury. The judge will then decide which benefits you are entitled to and workers' compensation attorneys how long they'll last.

If you don't agree with the judge's decision, you may then appeal that decision to an appeals court. Typically, an appeal should be filed with the appellate division of the courts in your state within 30 days of the workers compensation board's decision.

Appeal can be difficult, but your workers' compensation attorneys will work hard to get you the best result. A competent attorney will look over your case in depth and then explain to the appeals court your reasons for a better outcome.

Contact an experienced New York workers' compensation lawsuits comp law firm today if need assistance with a workers'' compensation appeal. The Turley, Redmond & Rosasco team of workers' compensation lawyers has the expertise and resources to assist you in obtaining the full amount of workers' compensation benefits to which you are entitled.