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What is a Workers Compensation Case? A workers compensation claim is a legal process that occurs when an employee is injured while on the job. It is designed to safeguard the worker from losing income and to help pay for medical treatment and rehabilitation. An injured worker could receive medical care or wage loss compensation, and even a settlement as part of a workers' comp case. 1. Medical Treatment If an employee gets injured on the job, workers comp insurance typically covers medical treatment. This includes the initial emergency treatment like an ambulance ride and continuing care that includes physical therapy, medication and other expenses. Workers who have been injured are also entitled to reimbursement for their travel expenses, which will pay for transportation to and from their doctor's appointments. This is particularly beneficial for those who need to undergo surgery. Employers have the option to join a managed care organization or preferred provider plans in the majority of states to treat work-related injuries. This permits both the employer as well as the insurer to monitor the quality of medical treatment and reduce costs. It is important to choose the right medical provider for your treatment. Your doctor may refer you to specialists to conduct further tests or evaluations. The office of your doctor will usually give you the list of Board-approved physicians to select from, however there are exceptions. It is important to confirm that your doctor's name is on the list prior to beginning treatment. Once you have located a doctor, it is critical to follow their instructions and guidelines. Failure to follow these guidelines could adversely affect your claim for workers compensation benefits. You should also be aware that the Workers' Compensation Board is constantly updating its Medical Treatment Guidelines based on new information in the medical field as well as the recommendations of doctors. These changes can be harmful to injured workers, but an experienced attorney can assist you in understanding the impact they have on your case. A proper medical treatment is essential in a workers ' compensation case to show that you suffered an injury that is related to work and therefore are eligible for the benefits of lost wages. Your doctor must document that your symptoms are associated with your work environment and that you cannot go back to your previous occupation or do other work unless you have been given specific work restrictions. It is also important to remember that in certain states, your employer is required to pay for diagnostic tests such as ultrasounds and x-rays. These tests can help you determine whether your symptoms are connected or not related to work. Your doctor will recommend that your employer pay for any necessary and reasonable procedures such as implantations, injections, or implantations to aid you in recovering from your injury. 2. Wage Loss Wage loss is the ability to replace lost income due to an injury. This is among the biggest benefits of workers compensation. Depending on workers' compensation law firm lynn in which your job is located, you may be entitled to up to two-thirds the amount of your pre-injury earnings. The severity and age of your injury will impact the amount you receive. A lot of jurisdictions also set an upper limit on the weekly wage loss you can receive when you are receiving workers' compensation. You can ensure that you receive the highest amount of compensation possible by filing your claim as quickly as possible. You also want to be sure that you meet all deadlines and inform your employer as soon as you can. An experienced lawyer for workers' compensation is the best way to determine if you have a valid claim case. This will guarantee you receive all the benefits that are allowed by law that include lost wages and medical expenses. For example, you may be eligible for more benefits when you can prove that you've been actively searching for work since you injured or had an accident. This is especially true if you have been out of work for some time or are dealing with significant medical restrictions that keep you from returning to your previous job. The most appealing aspect is that you do not have to pay any charges or out of pocket expenses! 3. Litigation The Claim Petition is the initial step in the litigation timeline. This brings your case before the court system and starts the process of litigation. It will state what injury you suffered, the date it occurred, the manner in which it happened, and any other information. The Employer or Insurance Company could or might not respond to this petition however, if they do it will be up to a judge who will decide the amount of benefits you will receive and the duration of your benefits. Certain issues can be addressed by the Workers Compensation Board without formality without hearing. These include disputes regarding whether the injury is work-related and the severity of your disability, the amount of monetary awards that are payable to you, and what medical treatment is suitable. More complex disputes require an official hearing before a Workers' Compensation Law Judge. The judge will listen to the evidence of both sides and decide the amount of benefits you are entitled to. Both attorneys will present written arguments to the judge during the hearing. The arguments will outline the evidence they've gathered as well as their opinions on the issues raised. If the judge is in agreement with the arguments of both attorneys, they will issue a written decision that details the outcome of the hearing and your workers' compensation claim will be closed. You will receive a copy the Decision via mail. When your employer or its insurance carrier is not happy with the investigation into claims and request an independent medical evaluation (IME). This is a doctor's exam which your employer will pay for in order to examine you and gather evidence. The IME is a vital element of the litigation timeline because it provides crucial medical evidence to your employer. The IME will review your medical records, and prepare a report about your injuries and treatment. Usually, after your IME has been completed, your employer will engage an attorney to represent their part of the claim. This is a lengthy procedure that requires numerous legal experts and plenty of time on the part of your employer. Injured workers who are receiving painkillers as part of their treatment may have to be closely monitored in the course of litigation, panelists noted. They can be susceptible to addictions if they're using too often or taking the wrong medications. 4. Settlement A workers settlement for compensation is an agreement between you and your employer's insurance company to pay you a specified amount of money. This may be a lump sum payment or it could be structured into regular payments over time. A workers' compensation settlement can be a successful solution to speed up the process of dealing with an injury at work. You should not agree to a settlement without consulting an experienced attorney. You may be eligible for a workers' comp settlement for your medical costs, lost wages and other expenses resulting from your injury. Settlements can help pay for future expenses and keep you from having to file an action. The state you live in will have its own laws that govern how a workers' compensation settlement is dealt with, but generally you can choose whether to settle your case in a lump sum or structured payments. Your situation and severity of your injuries will determine the amount of your settlement. The typical workers' compensation settlement is approximately $12,000 but it could be higher or lower depending on the nature of the injury and the state you reside in. The lawyer representing you in workers' compensation can assist you in determining the amount of your settlement, and make informed decisions on the best time to settle. Whatever the amount, the main thing is to settle quickly. This will both you and your insurance company many hours and money. Sometimes, insurance companies will offer a settlement prior to the time you have even filed your case. 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. In these instances you can ask your lawyer that you accept the offer or bargain for a greater amount. Ultimately, you will have to make the right decision for your future. If your insurance company has refused your claim, then you can request an appearance before a judge or workers' compensation hearings officer. The judge will evaluate your case and decide on a fair settlement amount. It's a bit complicated, but it is well worth the effort.