About half of our clients are people injured in work accidents. Some of our clients have minor injuries and just need a little help navigating the system. But many of our clients have had devastating injuries which will affect their ability to work in the future. In either case, the process of handling a workers’ compensation is based on a few simple rules.
1. We look at whether the injury is work-related. This differs from a personal injury claim because in a workers’ compensation claim, we need not blame someone for the injury. We only need to show that the injury happened at work, due to a work-related cause.
2. We look for who is financially responsible for taking care of the injury. Every employer with three or more regular employees must have Workers’ Compensation Insurance coverage. So usually an insurance company provides medical care and payment for any lost wages.
3. We look to the employer and their insurer to provide medical care. Every employer must have a Panel of Physicians posted somewhere obvious at the job. Usually, it is in the break room or some other room accessible by all employees. The general rule is this: If the employer has a valid Panel of physicians, then the injured worker must use one of the doctors listed on the panel. The employer and insurer must pay for the medical treatment directly to the provider. On the other hand, if the employer DOES NOT have a Panel of physicians, the employee may choose their own doctor and the employer and their insurer must pay for the treatment.
4. We analyze the work situation. Once medical care has been established, the authorized doctor provides the injured worker with a work status. If the work status is “No Work” – then the insurer must pay for the lost wages (after a 7-day waiting period). Most injured workers will not be taken completely out of work. Instead the doctor will usually place the injured worker on work restrictions. The general rule is this: If the doctor places the injured worker on restrictions, the employer has the choice to either provide suitable work within those restrictions or pay the injured worker as if they were totally disabled.
Most work injury cases follow a simple pattern. A worker is injured. They see a workers’ compensation doctor who puts them on work restrictions and prescribes therapy. While the employee is going through the treatment, the work restrictions allow their bodies to heal and they get better. Once their injuries have healed, the doctor releases them to return to their regular jobs and releases them from care. Then the employee goes back to work and the claim gets closed. The workers’ compensation system provides everything it is supposed to provide. There is no lump sum settlement. There is no lawsuit. There is little disruption in the relationship between employee and employer.
There are two general problems we see regularly.
First, sometimes ,the employee’s injuries are permanent. They can not get back to their job. The employee should definitely hire an attorney. This is because a settlement will need to be eventually worked out between the employee and the employer’s insurance company. We will charge 25% of the settlement in return for working on the case.
Second, sometimes ,the insurance company is refusing to provide a benefit (like medical care or lost wages). The employee must file a request for hearing in front of a judge with the Workers’ Compensation Board. This should only be handled by an attorney experienced in handling workers’ compensation litigation. We will charge 25% of the lost wages or disability payments we can obtain on your behalf.
If you do not have one of the two problems listed above, I would still encourage you to call us. If you do not need an attorney, I will tell you what to do on your own to fix your problem. If you are in over your head and need an attorney to handle your issues, I will tell you.