What is a Workers Compensation Case? Workers compensation is a legal procedure that is initiated when an employee is injured in the course of work. It is designed to shield workers from losing their wages and to cover rehabilitation and medical treatment. An injured worker can receive medical treatment as well as wage loss benefits, and even a settlement in a workers' compensation case. 1. Medical Treatment Workers comp insurance covers most medical expenses for employees that are injured while on the job. It covers the initial emergency treatment, which could include an ambulance ride, and ongoing care including medication and physical therapy. Workers who are injured also have the right to reimbursement for travel to pay for transportation to and from doctor's appointments. This is particularly beneficial for employees who suffer injuries that require surgery. Employers have the option of contract with a managed care organization or preferred provider plan in most states to treat injuries resulting from work. This allows both the insurer and employer to reduce costs by regulating the quality of medical treatment. It is essential to select the right medical provider for your treatment. Your doctor may also refer you to specialists for further testing and evaluation. Your doctor's office can often provide you with a list of Board-approved providers to choose from, though there are some exceptions. You should verify to confirm that your doctor is on the list prior to starting treatment. After you have found a doctor, it is critical to follow their directions and guidelines. Inadequate follow-up could negatively impact your claim of workers compensation benefits. Additionally, the Workers' Compensation Board regularly changes its Medical Treatment Guidelines. This is dependent on the latest information and recommendations from doctors. These changes can affect injured workers, but a skilled attorney can assist you in understanding how they affect your case. To prove that you've suffered an injury from work, workers compensation cases require appropriate treatment. Your doctor will need to confirm that your symptoms are related to your job. You cannot return to your previous job, or engage in other activities, unless special limitations on work have been imposed on you. It is also important to remember that in certain states, your employer is required to pay for diagnostic tests like ultrasounds and x-rays. These tests can help determine whether your symptoms are connected or not to your job. Your doctor will recommend that your employer cover any necessary and reasonable procedures, implantations, or injections to aid in the recovery process from your injury. 2. Wage Loss The loss of wages, or the ability to replace income lost due to an injury on the job is among the most important workers ' compensation benefits. Based on the state where you work, you could be entitled to to two-thirds of the wages you earned prior to your injury. The amount you receive is based upon a variety of factors, including your age and the severity of your injury. Some jurisdictions also have limitations on the amount of weekly wage loss you are entitled to while you are receiving workers’ compensation. You can ensure that you receive the most amount of compensation you can by filing your claim as soon possible. Also, you must be sure that you are meeting all of your deadlines and inform your employer promptly. The best method to determine whether you have a valid claims case is to talk to an experienced attorney for workers' compensation. This will help ensure that you get the maximum benefits available under the law, which includes those for lost wages and medical bills. For example, you may be eligible to receive a higher benefit rate when you prove that you've been actively looking for employment since you were injured or were involved in an accident. This is especially true if your injuries have caused you to be unable to work or you have medical restrictions that prevents you from returning to work. The best thing is that you don't have to pay any costs. 3. Litigation The first step in the litigation timeline is to submit the Claim Petition which places your case before the court system, and starts the litigation process. It will describe the incident, date, time and other information. Although the insurance company or employer company may not respond to the petition, it will be sent to a judge who will decide how much and for how long. The Workers' Compensation Board is able to solve certain issues without needing to conduct hearings. These include disputes about whether the injury is related to work the severity of your disability is, the amount of monetary compensation you are entitled to and the type of medical treatment you require. For more complicated disputes the need for a formal hearing before a Workers' Compensation Law Judge. The judge will consider evidence from both sides before making a an assessment of the amount of benefits you could receive. Both attorneys will submit written arguments to the judge during the hearing. These arguments outline the evidence they've collected and their position on the issues raised. If the judge accepts the arguments of both lawyers, they will issue a written decision that outlines the results of the hearing and closes your workers' compensation claim. The judge will then provide you with a copy of the Decision by mail. If your employer or the insurance carrier disagree with the claims investigation they may require an independent medical examination (IME). This is a medical exam that your employer will pay to examine you and collect evidence. The IME is a critical element of the litigation timeline because it gives your employer important medical evidence. The IME will look over your medical records, and then write a report on your injuries and treatment. Usually, once your IME has been completed, your employer will employ an attorney to represent its side of the claim. This is a lengthy process that requires several legal experts as well as lots of time on the part of your employer. Workers who have been injured and are taking medications for pain as part their treatment may have to be closely monitored in the course of litigation, panelists noted. They could develop addiction when they consume too much or use the wrong drug. 4. Settlement A workers compensation settlement is an agreement between your employer and the insurance company, which will pay you a particular amount. This may be a lump-sum payment, or it can be organized into regular payments over time. A workers' compensation settlement could be a good option to get through the long process of dealing with workplace injuries. You should not agree to settlement without consulting with an experienced attorney. Settlements for workers' compensation can be obtained for medical expenses, lost wages, or other expenses related to your injuries. A settlement can help you pay for the cost of future medical expenses and stop you from being forced to start a lawsuit. Each state has its own laws governing worker's compensation settlements. However you have the option of deciding whether to settle your case for a lump-sum or structured payments. The amount of your settlement will depend on your situation and the extent of your injuries. The average workers' compensation settlement is $12,000. However, it may vary depending on the type and state of your injury. Your lawyer for workers' compensation can estimate the amount of your settlement and assist you to make an informed decision about the time to settle. Regardless of the amount, the key is to settle the claim quickly. This will save your insurance company time and money. Sometimes the insurance company might offer to settle your case before you even file it. This is called an "offer-in-commitment" or "preliminary offer." The insurer may be motivated to put a settlement on the table because it has to start paying you benefits right away or because they are concerned that you will file a lawsuit. Your lawyer could recommend that you accept the offer or negotiate for more. In the end, you'll need to make the best choice for your future. If your insurance company rejects your claim, you can request a hearing before the judge or the worker's compensation hearings officer. The judge will review your case and determine the amount of settlement that is fair. It's a long process, but it is worth the effort.