WORKERS'
COMPENSATION
What Should
I Know About Workers' Compensation?
What Are You Entitled To Receive?
Workers' compensation benefits
include medical expenses, partial pay while you are off work, and compensation
for permanent limitations or restrictions, which affect your wage earning
ability. The following paragraphs describe those benefits in some detail.
- Medical Expenses:
- Your employer is legally
obligated to pay for all medical treatment, surgical procedures,
prescriptions, medical supplies, or equipment, which is related to your
injury and prescribed by the "authorized " doctor. This may
include future medical expenses related to your injury. The employer or
their insurance company is only obligated to pay bills for
"authorized" medical treatment (unless they have refused to give
you the names of doctors to see, or the bill is for emergency room services
less than $300). State law requires your employer or their insurance company
to give you a "panel" of three doctors to use in making your
choice of doctor. Since the doctor you choose can make such a large
difference in your case, this is a decision where it is best to consult a
Lawyer who is experienced in handling workers' compensation cases.
- Partial Pay While You Are
Unable to Work:
- "Temporary total
disability" is a term, which describes the time period when an injury
prevents you from returning to work. This is generally the time needed to
recover and rehabilitate from your injury. It ends when your doctor releases
you to go back to work, or determines that you have reached your maximum
medical improvement. During your period of "temporary total
disability" you are entitled to compensation equaling 2/3rds of your
average weekly wage. The law provides a maximum figure so that, regardless
of your actual wages, your employer need not pay more than the legal weekly
maximum.
- Payment For Permanent
Limitations And Restriction:
- Most injuries do not result in
total disability, but in restrictions, which can limit a worker's strength,
endurance, or capacity for work. This is called "permanent partial
disability". As an injured worker, you are entitled to compensation for
any permanent impairment, even though you may have returned to your regular
job at the same (or even better) pay. This is in addition to the temporary
benefits you receive while recovering from your injury.
- How Much Is My "Permanent
Disability" Worth?
- The amount of compensation you
are entitled to depends on the nature of your injury, its effect on your
wage earning capacity, and the impairment rating given by your doctor. If
anyone with your employer, their insurance company or the State says,
"This is all you can get". Get a second opinion!
- What Is A Rating For
Permanent Impairment?
- When you have recovered (or reached "maximum medical
improvement") your doctor will generally determine whether or not you
have some permanent medical impairment. This will, in part, determine what
you will be paid for your permanent problems. [Doctors do not always agree
on whether someone has a permanent impairment, or how much. Doctors who
are approved by a workers' compensation company may believe that you have
no impairment, or a small impairment, when another doctor may believe your
impairment is much higher.]
- Can I Determine What My
Claim Is Worth?
- It is not easy, and if you are handling your own claim, you will
probably be dealing with an insurance adjuster who is more experienced
than yourself. The adjuster's goal is to minimize the amount paid to you,
so take anything said with a grain of salt. There are maximum payments for
work related injuries, which are permanent, but a different doctor may
evaluate your case much more favorably than the doctor paid by workers'
compensation. The question, "How much is my case worth?" is
complex enough to consider getting expert legal help.
- What Is The Benefit Review
Conference?
- When you reach maximum medical improvement your employer and/or their
insurance company may demand a " Benefit Review Conference".
During such a conference the employer and insurance company will have
representatives present to "negotiate" a settlement that is good
for them. If you've been told to come to a benefit review conference, you
should have someone with you experienced in worker's compensation. If you
go by yourself to a meeting like this, you may be told you are being
offered all your case is worth, and feel pressured to "make a
deal". Don't agree to any offers until you have had time to discuss
the possible advantages and disadvantages with a lawyer experienced in
Worker's Compensation. At Large and Associates, we do not charge a fee for
such consultation, and we see that someone goes with you to the benefit
conference who will represent your best interest.
- Do I Have To File Suit?
- If your case is not filed within one year of your injury or one year
from the time you knew your injury was permanent, you may lose any right
to make a workers' compensation claim. Many workers' compensation claims
are settled without filing suit, but filing the case may be necessary to
protect your claim. You should consult a lawyer to determine how much time
you have left before it is necessary to file suit.
Do I Need
A Lawyer To Claim Workers' Compensation?
If your injury or illness is serious or if it affects your arms, legs,
neck, or back you should talk to a lawyer about your claim. People who handle
their own claim often make innocent, but terrible mistakes.
An Attorney Experienced In
Handling Workers' Compensation Can Usually:
- Make sure that you don't lose your benefits due to a miscommunication
between the doctor and insurance company
- Confirm the insurance company is paying you the correct amount
- Evaluate the doctors on the panel offered to determine if one might be
best for your case
- Compare the impairment rating in your case to the rating given by other
doctors for the same or similar injuries
- Evaluate your case for factors which may make it worth more, or less
than other cases
- Help you evaluate the importance of keeping "future medicals"
versus a cash payment for "future medicals"
- See that you are treated fairly at any "Benefit Review
Conference"
- Advise you of the possible financial implications of a workers'
compensation settlement on social security benefits and other claims
- Advise you of the effect of your settlement on your right to ask for
additional monies if you lose your job in the future
- Structure your settlement so it will not reduce a later award for social
security disability
- Workers Compensation Act:
- Workers' Compensation is a special law passed by the Tennessee
legislature to give workers financial benefits when they are injured on
the job (provided their employer has five or more employees). This law
does not apply to farm labor, domestic help, state, or public employees.
However, state employees are entitled to similar benefits through the
State Board of Claims.
- Injuries Covered:
- Any injury, occupational disease, or death, which occurs "out of
and in the course of employment", is covered by the law. It does not
matter who was at fault in the accident. Covered injuries include broken
bones, muscle strains, back and neck problems, loss of strength and/or
flexibility, heart problems, diseases related to your employment, and
others.
- Qualifying For Benefits:
- If you are injured on the job, you must notify your employer as soon as
possible. If the employer doesn't have actual notice of your injury (as
might be the case where your supervisor approved you going to the hospital
for x-rays) then you must give the employer written notice within 30 days
of the injury. You may lose your right to claim compensation if you fail
to do this. The safest action for any injured worked is to see that
someone files a correct, written report of injury.
- The Waiting Period:
- Your benefits are limited to medical expenses for the first 7 days. If
you continue to be disabled and unable to work after 7 days, you can
receive retroactive benefits from the date of your injury or illness.
What To Do If You Have A Work
Related Injury:
- Notify your employer of when, where, and how you injured yourself
- Make sure you get a copy of the papers filled out by the employer, and
let them know if there is any mistake
- If your doctor says you are unable to work, make sure your employer
knows
- Make sure the doctor knows exactly what is happening to you, don't just
say "fine" or "a little better", give the doctor
specifics
- If you receive notice that any bill is unpaid, contact the workers'
compensation insurance company immediately and find out why the bill is
unpaid
- Everyone you talk to (your employer, the insurance company, or the
State) will be taking notes on what you say. Keep your own notes of what
happens and your conversations.
- Make sure your doctor knows that you want to get back to work as soon as
possible. If you have problems after returning to work let your doctor
know immediately.
- If your employer or co-workers ask when you will return to work, tell
them "as soon as the doctor lets me"
Can I
Afford A Lawyer?
Our policy regarding Workers' Compensation cases is to charge 20% of any
amount recovered if and only if we collect on your claim. We do not charge a
fee for attending benefit review conferences or for any partial pay you
receive while your case is pending. If we collect nothing, you owe us nothing
for our efforts.
Because there are so many possibilities in every case, the real question to
ask is "Can someone experienced in Workers' Compensation, medical
impairment, physician choice, insurance adjusters, litigation and negotiation
get 20% or more than I can get on my own?" The answer is frequently
"YES".
Large
and Associates Advances All Costs for Your Claim Until Recovery Is Made:
In Tennessee, the law requires all attorneys to hold clients responsible for
the expenses required to process their cases. However, we advance the expenses
of litigation, including court costs, expenses of investigation, expenses of
medical examination, and cost of obtaining and presenting evidence to maximize
the value of your claim and reduce financial burdens on you until your recovery
is made.
Michael Large is a member of the Workplace Injury Litigation Group and
has extensive experience sorting through the complex issues surrounding workers
compensation injury cases as well as the potential developmental disabilities
resulting from these injuries. Michael has successfully argued cases in front of
the Tennessee Supreme Court's Worker's Compensation Panel, and has helped change
Tennessee Worker's Compensation Law. If you or someone you know has suffered
from an injury on the job then it is critical that you/they seek professional
assistance from an attorney who specializes in workers compensation cases. The
right attorney will provide responsive action that will assert and protect your
rights for financial restitution and proper medical attention for your long and
short-term care.
Notice:
Each case is different and
different facts may yield a result you would never expect from reading this
brief Web page. The information on this Web site cannot replace the careful
consideration of personal factors and changes in the law, which may apply to
your legal problem. While this information may help you, do not rely on it as
the final answer to a legal question.
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