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Workers Compensation How to File a Workers Compensation Claim When an employee is hurt on the job they need to report it as soon as they can This helps prevent problems and delays in receiving workers comp benefits Workers compensation benefits typically include medical treatment and vocational rehabilitation services and disability benefits The benefits offered can differ in duration and amount from one state to the next Medical Treatment When you are injured while working medical treatment is a crucial part of your workers insurance claim This kind of insurance covers doctor visits hospital stays and imaging studies xrays in addition to rehabilitation costs The New York State Workers Compensation Board creates medical treatment guidelines MTGs to promote objective healing and return to work goals These guidelines are periodically updated in accordance with medical advances and recommendations from doctors These guidelines are designed to ensure that injured workers receive the same treatment as other employees with occupational injuries and illnesses They also help ensure that the treatment is appropriate for the specific injury or illness and that there isnt any unnecessary treatment or unnecessary medical costs If a doctor determines that a treatment that is not in the MTGs is required the doctor can request a variance from an insurance company requesting an express exemption from the MTGs This process is complex and may take a long time to complete If the treatment is required the employer or insurer should do everything to provide this treatment In the event of disagreement between the employer and the employee it is possible for the employer or insurer to fail to provide the treatment This can often be resolved through an evidentiary hearing before an administrator law judge The treatment should usually be provided by an accredited local health care professional who is licensed to provide workers compensation treatment In emergency situations an unlicensed or not certified physician may provide treatments for injuries suffered by workers in the event that they have been notified of the accident and an appropriate first report of injury was completed by the employer or supervisor Many doctors are certified in workers compensation and will offer lower prices for treating injured employees This can be especially beneficial for those who have suffered serious injuries In addition to doctors and surgeons many other medical professionals can provide treatment for injured employees This includes physical therapists occupational therapists and chiropractors The New York State Workers Comp Board recommends that injured workers and their representatives speak with their lawyers prior to receiving any medical treatment In some cases this could be the only way to make sure that an employee receives the best possible care Expenses Workers compensation costs may vary according to the state and the worker These costs include medical expenses as well as vocational rehabilitation costs as well as legal fees and settlement costs The majority of these expenses are covered under your insurance policy Certain of these expenses could be paid by the spouse of the employee the employees spouse or dependents Employers must have workers compensation insurance in most states workers compensation lawsuit jackson covers employees against lawsuits as well as other damages that result from workplace accidents such as injuries or illnesses The policy covers workers who are killed on the job and provides compensation for medical treatment or wage replacement as well as death benefits Workers compensation insurance is crucial however it can be costly In general it costs businesses about 1 per hour of work it loses because of workers compensation claims These losses may be reflected in the bottom line of the business and can result in an increase in productivity and profits It can also impact the businesss reputation and could affect future business contracts and the ability of workers In addition to workers compensation businesses can also be liable for other indirect costs related to injuries to employees Costs like the duration of time employees are off working or the cost of hiring a replacement worker are also included in these indirect costs Another indirect cost is the cost of repairing or replacing equipment or property damaged as a result of an injuryrelated incident This can be an expense that is significant to any business and it is common for companies with heavyduty machinery or equipment In addition Occupational Safety and Health Administration OSHA fines that are associated with a high rate of incidents could be a cost for employers These fines are usually initiated when an organizations accident or fatality rates are examined Establishing a positive culture at work and reducing claims for workers compensation can reduce these direct and indirect expenses for businesses It can also create a more profitable environment for the business and boost employee morale Time off from work The loss of income caused by an injury that is caused by work can be devastating You could be eligible for workers compensation benefits to help cover the gap until your rehabilitation is complete There are many different types of time off available by employees including sick and vacation leave Certain types of leave are covered by state or federal laws while others are voluntary Businesses can use vacation and sick leave to their advantage They permit employees to take time off to care for family members or to care for themselves Some businesses offer personal time that can be used for things like appointments with a doctor car checksups or occasions eg parentteacher conferences Certain states have laws that require employers to offer paid sick time however this is not always the case Companies that dont have the funds to cover this type may be able choose not to offer this kind of leave Employers can also avail of offering flexible time Employers can offer flex time to employees This allows them to take a portion of their paid time off and the employer can compensate for the difference by increasing their working hours or raising their salary In addition to the options mentioned above some states have mandated that employers offer paid sick or vacation time which can be a helpful method for companies to encourage employees to take time off when theyre sick or are required to care for family members If your employer doesnt provide one of these options it is an excellent idea to consult with a lawyer regarding how to best utilize your rights under the law If you are being asked to take paid time off for medical treatmentor for any other reason a knowledgeable attorney can help you understand and safeguard your rights Employers may also give time off to employees to work beyond the time frame of their contract This is referred to as time offin place or TOIL Some employees take advantage of this time to attend medical appointments or other forms of treatment Others serve on juries or other activities that they choose Appeal If you are denied workers compensation benefits you have the right to appeal the decision Within 30 days from the date the judge made a negative decision you are able to appeal to your states workers compensation board Appeals are an integral element of the claims process and can be a crucial instrument to help you receive the compensation you deserve after an injury at work An experienced attorney can assist you navigate the appeals process and ensure that you get all the benefits to which you have earned Many injured workers are denied their workers compensation claim or have their claims dramatically reduced by the insurance company This is a very difficult situation for an injured worker and is often done with the sole purpose of saving their employer and the insurance company money The appeals process begins with hearings in front of the workers compensation judge The hearing is usually held in person but it could also be conducted using videoconferencing In this hearing the judge will be hearing from you and your lawyer regarding your workers compensation claim The judge will review your medical records wage records and other evidence to determine if you are eligible for workers compensation benefits If yes what should the amount be In addition the judge can also look into any disputes regarding your injury The judge will then decide on the benefits youre entitled to and the length of time they should last If you arent satisfied with the judges decision then you can appeal the decision to an upper court Typically appeals can be filed with the appellate division of the courts in your state within 30 days of the workers compensation boards decision Appeals can be challenging However you can trust your workers compensation lawyers to do their best to ensure that you receive the most favorable outcome An experienced attorney will review your case thoroughly and explain to the appeals court why you deserve the best outcome Contact an experienced New York workers comp law firm today if you need help with a workers appeal to the compensation The Turley Redmond Rosasco team of workers compensation lawyers has the knowledge and experience to help you get the full amount of workers compensation benefits to which you are entitled
