If you are injured on the job, your medical bills and living expenses will be taken care of by workers compensation insurance.Workman's compensation is offered through an employer, but many individuals who have been hurt on the job face problems in receiving adequate compensation from their company.If you are hurt on the job, you should seek medical attention.By learning how to get workers' compensation benefits, you can make significant strides in guaranteeing that you are financially covered.
Step 1: Check to see if you are employed by a covered employer.
An employer is a person or organization that has employees.Employers pay into the state workers' compensation fund.Federal employees are exceptions.State workers' compensation systems do not cover federal employees.The Federal Employees' Compensation Act outlines its own method of processing and adjudicating workers' compensation claims that is unique to federal workers.The Longshore and Harbor Workers' Compensation Act can be used to protect maritime workers who are injured or killed on the job.Native American organizations are not considered to be employers.
Step 2: You should confirm that you had an injury.
If you sustain a qualified injury, you can only get workers' compensation benefits.Generally speaking, a work related injury is one sustained in the course and scope of employment.If a delivery driver strains his back picking up a heavy box, it will cause him to leave his job.If a delivery driver strains her back while moving a child into a dorm room, that injury is outside the scope of employment.By state the workers compensation rules will be different.Workers can't claim work-related stress injuries in some states.Recovery for stress injuries is allowed in some states.To find out what rules apply to your situation, you will need to talk to an attorney.
Step 3: Medical documents to be gathered.
You should keep copies of medical reports and notes related to your injury.A binder should be kept in a secure location.These documents will be needed later.
Step 4: Understand what benefits are out there.
Depending on your injury, you may be able to receive benefits.There is a partial list of benefits that can be used to replace wages while you recover permanent disability benefits.
Step 5: Get benefits.
A formula is used to determine benefit amounts.The amount of benefits you may receive is usually capped.Depending on when you were injured and if you are temporarily or permanently disabled, the amount you receive may be different.You can use an online calculator from some states to get a rough estimate of your benefits.Colorado has a calculator here.If other factors contributed to the worker's permanent disability, some states will reduce the benefit amount.
Step 6: As soon as possible, report your injury.
Let your employer know as soon as possible that you have been injured.The forms that you need to fill out should be given to you by your employer.You don't have a lot of time to tell your employer about the injury.You may lose your eligibility if you miss the deadline.The amount of time varies by state.Oklahoma workers have 30 days to report an injury.New Hampshire workers have 2 years.Unless you know for certain what your state deadline is, you should report as soon as possible.If you are a union member, you should tell your representative of the injury as soon as possible.Many states have created labor-management "carve-outs" which are alternative systems for adjudicating workers' compensation claims.
Step 7: Follow up with your employer.
You want to be sure that your employer has filed the necessary paperwork for you.You should check with your employer to make sure they have filed the claim.
Step 8: Visit the doctor.
It is likely that a medical professional will have to verify your claims of injury and fill out some paperwork.Make sure the documents specify that you were hurt on the job and that the injury occurred in the workplace.Workers' compensation medical care may be provided by your employer.You need to visit a doctor in the network.Request a list of providers from your employer.Some doctors are not allowed to treat people for workers' compensation benefits.Check with your state's Department of Labor if your employer doesn't have a list.
Step 9: You should follow the doctor's advice.
It is advisable to follow the doctor's advice so that no questions can be raised about your own conduct.Rescheduling appointments that you can't make is a must.Attend physical therapy and take prescribed medicines.
Step 10: Wait for the claims administrator to speak to you.
After your employer files the paperwork with its insurer, you must wait to find out if your claim has been accepted or denied.You will receive a denial letter if you have been denied benefits.If you are awarded benefits, the letter should tell you what to do next.
Step 11: You should read your denial letter.
3 pieces of critical information are included in the letter: why you were denied, a description of the appeals process, and deadlines for bringing an appeal.You have to identify the pieces of information.There are a variety of reasons why workers' compensation claims are denied.You did not report the injury within the required time, it is not severe enough, or it was not sustained on the job.Make sure to pay attention to deadlines.You will usually only be given a month to bring the appeal.You should begin immediately if you want to appeal.
Step 12: Hire a lawyer to represent you.
Bringing an appeal adds to the stress of being denied workers compensation benefits.It can take months to learn confusing rules of evidence in the appeals process.It is possible to streamline the process and bolster your appeal by hiring an experienced workers' compensation lawyer.The lawyer will need copies of your medical information for your appeal if you bring a copy of the denial letter.Pick up any other information your attorney needs.Delays won't affect the appeal process.Private attorneys can work on a contingency basis.If they win your case, they are paid.The attorney will usually take 20% of the benefit amount.State law often caps the amount.You will have to pay for the costs under a contingency arrangement.Filing fees, expert witness fees and money spent on mailing are some of the typical costs.You should try to get an estimate of these costs.
Step 13: To appeal, you have to find the form.
Depending on the state, this goes by various names.It's called an Application for Hearing in Michigan and a Hearing Request form in Arizona.Federal workers can request a hearing, appeal to the Appeals Board, or apply for reconsideration.Things from the employee are required for each federal appeal.You just request that the hearing representative review the claim.The representative may confirm the initial decision or give you benefits.You may not provide new evidence if you are appealing to the Employee's Compensation Appeals Board.You and your attorney can submit new evidence with a Request of Reconsideration.
Step 14: The form should be filed by the deadline.
You should always use certified mail.You will have a receipt for your records.
Step 15: The answer can be read.
Your employer and its insurance company will likely respond to your appeal.The answer gives a glimpse of what their argument will be.If you win, your employer will incur higher insurance premiums because it will retain a stake in the outcome of your case.It is likely that your employer will be involved at all stages: it will answer your complaint, attend the trial, and have a representative testify.Understand the meaning of the words.A trial and an appeal are separate events in other areas of law.There are no witnesses at the criminal appeal.An attorney writes a legal brief and no new evidence is admitted.The appeal is similar to a trial in that witnesses are questioned and evidence is presented to an appeals board.
Step 16: Go for a medical examination.
It is possible that you will be required to undergo an independent medical examination.It may be requested by your employer or insurance carrier.The purpose is to identify the cause of the injury as well as the extent of disability.The workers' compensation claims board can request an IME in some states.If you have an attorney, the IME is scheduled according to their agreement with the insurance company.Though you and your lawyer can object to the IME, an objection will often be seen as a concession that the injury isn't as severe as you claim.If you can, have a friend or family member with you.You will have a witness if the doctor testifies that you said or did something you didn't do.
Step 17: Research before making decisions.
Some states have written decisions about workers' compensation claims.Kansas has a database.If your state has a database of decisions, you should check it out.Take a look at other cases similar to yours.If you were denied workers' compensation benefits because of your pre-existing condition, you could research any prior appellate decisions that discussed it.Strong evidence in your favor can be found in a case where an appeal was granted.Your attorney will be able to research prior decisions.You can read the decisions if you ask her for copies.
Step 18: Find relevant evidence.
Evidence that supports your claim to have been injured on the job will be needed at the trial.Medical professionals who can testify to your injuries and co-workers who may have seen the injury are the most effective witnesses.It is possible that your state law does not provide for subpoena power.If it does, you can get a blank subpoena form from the workers' compensation board.A witness can be assured of their attendance by serving a subpoena.Attach the witness's name and address to the subpoena form.The date and time of the hearing, as well as where the witness is commanded to appear, should be filled in.Mail the subpoena with certified mail.Give the witness plenty of time to rearrange her schedule so she can attend.
Step 19: Prepare to tell the truth.
You will be called to testify about the injury, how it happened and the extent of your disability.Ask your attorney to do a practice run to make sure you are an effective witness.Your attorney should ask hard questions to help you understand the process.You should review your summary of the event.You should have written down what happened after you were injured.To refresh your memory, review this information.
Step 20: There is a pre- trial hearing.
The first appeal can be heard by an administrative law judge or a state appeals board.You may be called in for a pre- trial hearing.The purpose of the hearing is to prepare the parties for trial.You should ask any questions at that time.If the other side has turned over copies of their witness list or medical reports, you should ask.
Step 21: Arrive very quickly.
You don't want to be late.If you don't know where the trial is being held, give yourself an extra hour to find parking and go through any security.Courts rarely hold trials.The offices of the workers' compensation board are where they are usually held.Dress nicely.It's comfortable to look professional.If you feel awkward, you don't have to wear a suit.
Step 22: Give an opening statement.
In a trial before a jury, the opening statement will be more formal.The attorneys will clarify for the judge what issues the parties have agreed on and what are in dispute, such as whether or not you were injured on the job.
Step 23: Testify.
You will be called to testify.Your lawyer will ask you questions after you swear an oath.Speak loudly to the judge.You should have practiced your testimony.She can't ask you questions that contain the answer.She can ask more general questions such as, "Where were you on the morning of...?" and "Did you hurt yourself?"If you read the answer, you should have a good idea of what the other side will ask.If your employer or the insurance company claims you were injured while on vacation, you should anticipate questions about where you went and what you did.
Step 24: There is a closing argument.
Your lawyer should brief you on how the evidence supports your legal right.He will rebut the other side's arguments.
Step 25: Wait until the decision is made.
A written decision is typically drafted by the appeals board.You can receive it by mail.Sometimes an appeals board will either review the written order or send it back for a second look.
Step 26: Next steps to discuss with your lawyer.
An appeal of the denial is possible if your claim is denied.Discuss if another appeal is worthwhile and if your attorney will handle it.On contingency, appeals can be handled.The scope of the representation may be redefined by a new client agreement.