Workers’ Compensation law, places many requirements on employers of 4 or more employees, such as carrying workers’ comp coverage on all their workers, reporting to their workers’ comp insurer within 7 days of learning of a worker’s on-the-job injury, and keeping an injured worker employed so long as they file their claim on time. And insurers also have the responsibility of mailing you an official brochure explaining your rights/responsibilities within 3 days of learning of the injury from your employer.
However, many falsely suppose that all, or at least nearly all, of the rules and regulations involved in the workers’ comp system apply to the employer. Nothing could be further from the truth. There are many workers’ comp compliance issues that employees need to be aware of in order to gain the full compensation they are entitled to under the law.
Workers’ Comp Compliance on the Employee Side
Not only must an injured worker be able to prove his/her injury occurred on the job site or in a work-related activity, is not simply a prior condition that resurfaced, and resulted in loss of ability to earn at previous income levels; the injured worker must also be able to verify all medical bills and other expenses arising from the injury with the proper documentation.
But these are only the basic compliance issue injured workers face. Here are some additional potential snags to watch out for:
• While you do not need to pay taxes on workers’ comp payments, you must still pay on even a very limited amount of work you may do during your recovery period, if the doctor so allows.
• You can receive both workers’ comp and social security benefits simultaneously, but you must report this and it will reduce your workers’ comp payouts. And the combined total of the two benefits cannot exceed 80% of your previous weekly earnings.
• You cannot get both workers’ comp and un- or re- employment assistance at the same time since you must, by definition, be unable to work to get the former and able to work and seeking work to get the latter.
• To receive any workers’ comp benefits, you must report the injury to your employer or the relevant insurer within 30 days of its occurrence or within 30 days of your doctor informing you of a work-related injury of which were not already aware. Fail to do this, and you lose your right to file.
• To file a claim, you must obtain the necessary forms from your employer, workers’ comp insurer, or from the workers’ comp program from your specific state. All forms must be filled out fully and accurately.
• Your claim will be closed one year from the date of your last injury-related medical treatment, ending your compensation.
The complexity of these and other requirements often make it wise to hire a good workers’ comp attorney to assist you in pursuing your claim. The last thing you want to do is find out after the fact that you did not fully comply and will lose some or all your benefits.
So, What’s the Role of an Attorney in Such Cases
Not only can an experienced workers’ comp attorney help you properly file and pursue your claim for a work-related injury, but he/she can also ensure you are getting your full benefits.
All medical expenses, including hospital bills, physician’s fees, costs of medicines and therapy, diagnosis, and even transport to/from medical facilities should be paid in full by your insurer.
You should receive 67% of your wages at the time of the injury as loss of income benefits. If you can return to work but cannot make as much money, you can also be reimbursed. Specifically, if you earn only 80% or less of what you did previously, you will be reimbursed 80% of the difference between your former and current weekly wage (but not over $886 a week.)
If you are being denied any of your temporary or permanent disability payments by your employer or insurer, you have the right to petition for your full benefits. And even if you lose initially, you have the right to appeal.
Your chances of winning an appeal are much higher when you have a lawyer, knowledgeable of the maze-like bureaucracy, fighting on your side.