Workers Compensation Lawsuit

Practice Area: workplace

Workers compensation is an insurance cover for employees who suffer injuries on the job. Under the worker's compensation plan, companies make payments into the worker's compensation fund. Workers comp is a program offered in most states. If injured on the job, employees are compensated, and in return, the employer is protected from a lawsuit. Workers compensation is issued on a state basis.There are different federal programs for specific groups such as coal miners, federal employees, and longshore workers.

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Workers Compensation Benefits

The worker's compensation policy provides benefits to employees injured based on the applicable state laws. While these benefits may differ from one state to another, most states will offer the following benefits:

  • Medical coverage
  • Rehabilitation
  • Disability benefits
  • Death benefits

Medical Coverage

Employees who file a workers compensation claim receive medical coverage. This cover includes payments for doctor visits, medications, hospital treatment, medical diagnostic tests, durable medical equipment (wheelchairs and crutches) and physical therapy. The medical coverage offered is not subject to copays, deductibles or dollar limits. These benefits are offered until one makes a full recovery. State laws may also allow for chiropractic care but limit the number of visits. Generally, worker's comp does not pay for investigative or experimental treatments.

Rehabilitation Benefits

Rehabilitation benefits cover both medical and therapeutic care and includes physical therapy needed to cope with the injuries and recover. Rehabilitation benefits can also cover for any training necessary for the employee to regain their abilities and skills to help them return to work. If you suffer an injury and you are not able to return to work, then the program can offer vocational rehabilitation which includes retraining, tuition and other expenses incurred to help you gain skills to work in a different job.

Disability Benefits

Worker's comp disability provides coverage to workers for lost wages as they recover from injury or illness. Disability benefits are classified into four types.

  • Temporary partial disability: This covers you when you are not able to perform specific duties for a certain period
  • Temporary total disability: This includes workers who have suffered injury or illness and are not able to perform all of their responsibilities for a specific period.
  • Permanent partial disability: this refers to a permanent impairment that hinders the worker partially from performing their previous duties.
  • Permanent total disability: this provides coverage to workers who have suffered permanent and total disability meaning that they cannot return to work or even work in a similar job.

The worker's compensation received under disability depends on how much the workers were earning before the injury. Workers receive one-third of their wages. Workers have to wait for a certain period before receiving the compensation, and they are not expected to pay income tax on disability payouts.

Death Benefits

Workers compensation death benefits provide financial relief to close family members if a worker dies due to work-related accidents or injuries. The benefits are paid to the relatives who were financially dependent on the employee. This benefit also pays a sum to cover for funeral expenses. Death benefits are calculated based on the worker's earnings. Some states impose maximum and minimum amounts that can be paid in the form of death benefits. Others will offer a lump sum. There are instances when legal issues arise about the dependents. States have different guidelines when dealing with spouses, unmarried partners, stepchildren, siblings, in-laws and other relatives who were dependent on the deceased. It is essential to consult with a workers compensation lawyer to guide you on the best approach when it comes to such legal complexities.

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How to File for a Workers' Compensation Claim

The first step in the process of filing for a workman's comp claim is to report the injury. You should notify your employer immediately. Most states require employees to report a claim within 30 days. However, it can be longer in some cases or in instances where there are extenuating circumstances.

Once you report the injury, you should receive a form to fill out. Give detailed information about your injuries and include your doctor's recommendations and evaluation. The employer will submit the form to the insurance company and the compensation agency as well. Once you have filed the workman's comp claim, the insurance company will conduct its investigation into your claim. The insurance is supposed to issue feedback in two to four weeks.

If the insurance company approves your workers' compensation claim, you will receive benefits. There are instances when the insurance company may reject your claim. If this happens, you have a right to appeal. It is wise to bring in a lawyer at this point. It is typical for insurance companies to deny claims or to give insufficient payouts. A workers compensation lawyer will look at the merits of your claim and advise you on your options. Strict deadlines bind the appeal process. A good reason why you need to consult with a lawyer immediately.

When to Consider Filing a Workers' Compensation Lawsuit

There are several instances when employees should consider filing a lawsuit as discussed below. There are also particular circumstances when employees can file outside of workers compensation.

When the Insurance Company Delays or Denies the Claim

It is not unusual for insurance companies to deny or delay claims. If this has happened to you, you can benefit from the services of a compensation attorney. The lawyer will fight to ensure that you are adequately compensated for the injuries suffered in the line of duty. The lawyer can also negotiate for a fair settlement with the insurance company.

If the Employer Threatens to Terminate You

There are instances when an employer may threaten the employee with termination if they file a worker's compensation claim. In most cases, the employer is afraid that their premium rates will increase. If this happens to you, then you have reasonable grounds to file a workers' compensation lawsuit, and you should do so without fear. Wrongful termination is illegal, and your lawyer will defend your rights.

If You Suffer Injuries from a Toxic Substance

This type of claim can be handled under worker's compensation or as a personal injury claim. If you suffer an injury as a result of a toxic substance, then you can file a lawsuit against the manufacturer of the product.

If the Injury Is a Result of Intentional Conduct

If you face an injury that was intentionally caused by your employer, you can also file a personal injury lawsuit against them. In most cases, workers compensation does not include punitive damages. For instance, if an employer fails to implement safety standards in unsafe working conditions. A lawsuit will not only pay for the injuries incurred when working under dangerous situations, but the employer will be forced to comply and offer safe working conditions for the other workers.

If Your Employer Does not Offer Worker's Compensation Insurance

In most states, employers are expected and required by law to carry worker's compensation insurance. If they fail to do so, you can file a lawsuit and receive compensation from the state fund.

If the Injury was Caused by a Third Party

You can file outside of workers compensation for injuries caused by third parties, or if a third party is partially to blame for the injury.

Attorneys Experienced with Workers Compensation Lawsuit

A workers' compensation lawsuit has time limitations. These cases are also legally complex. It is in your best interest to seek the advice of a workers compensation lawyer. These lawyers have dealt with similar cases before, and they have a wealth of knowledge to help you navigate a complicated legal process.

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