Job-related injuries and illnesses are concerning for all employees. Who pays for your medical care and supplements your wages? Your employer, through workers’ compensation insurance, should cover these necessities. However, employers and their insurance companies frequently try and limit how much they payout in compensation.
A personal injury attorney at Smith Hulsey knows how to negotiate with insurance companies and could advocate for a fair settlement offer on your behalf. If you need help filing for benefits or fighting a denial, an Oakwood workers’ compensation lawyer is standing by.
Employers with at least three employees must carry workers’ compensation insurance provided by private insurers. To qualify for benefits, workers must prove they experienced a work-related accident or illness. Benefits cover sudden accidents, like falls and chemical burns, and conditions that develop over time, like asbestos-related lung disease. Pre-existing conditions that are exacerbated by a work-related accident may be eligible for coverage, with potential limitations on total benefits.
Workers must report an accident to their employers within 30 days. A physician within the workers’ compensation system must diagnose the patient and prescribe treatment, which is documented for the claim’s administrator. Under state law, employers must always have a list of these treating physicians available to employees.
Although workers’ compensation claims do not require proving an employer was negligent, employees who engage in fights or horseplay or who were impaired by drugs or alcohol at the time of the accident are not eligible for benefits. Anyone who gets injured on the job should consult a local workers’ compensation attorney to help them meet requirements.
Workers’ compensation typically provides coverage for medical bills and a proportion of lost wages. However, some injuries and conditions have lasting effects on a worker’s life. In these cases, additional benefits may be available.
Some injuries and conditions may allow a worker to perform some of their former job duties. Temporary partial disability makes up a portion of the pay difference for those who can return to light duty or part-time work. The treating physician uses a formula is used to gauge the percentage of disability, which is then used to calculate benefits. An injured worker can receive temporary partial disability benefits for up to 350 weeks at two-thirds the difference between pre and post-accident wages.
Temporary total disability payments are meant for injured workers who are unable to work after the accident. Benefits are two-thirds of workers’ average wages and are paid until the worker can return to the job, or up to 400 weeks. If the injury is catastrophic, there is no limit on benefits.
If an employee does not survive the workplace accident, death benefits are paid to certain family members, including spouses and children. While no amount of money makes up for the loss of a loved one, a lawyer could help families in Oakwood achieve workers’ compensation benefits to relieve their financial concerns.
Many insurers deny claims because the less they pay out, the more their company profits. An employer might argue a claim did not happen at work, or you have a pre-existing condition. Claims administrators deny claims when documentation is incomplete or an investigation cannot confirm the injury was clearly job-related. An Oakwood attorney could appeal a denial through a court filing followed by a hearing before a workers’ compensation judge.
Employees count on an insurance system that provides coverage if they are injured at work or become ill because of workplace conditions. Successful claims can help pay for medical treatment and lost earnings, but accessing these benefits is not automatic.
Insurers and employers may dispute a claim’s validity. The application process is specific, and if you are in the early stages of recovery from your accident and feel overwhelmed by the paperwork, call Smith Hulsey. Whether you have just been injured or your claim has been denied, an Oakwood workers’ compensation lawyer is available to assist you.
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