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Workers Compensation Legal Framework Workers compensation laws provide a framework to safeguard injured workers They guarantee monetary awards to employees in lieu of the loss of wages medical bills or permanent disability They also limit the amount an injured worker is able to claim from their employer and eliminate coworkers liability for workplace accidents This is done to minimize the time and expense of litigation What is Workers Compensation Workers compensation is a kind of insurance that offers cash benefits and medical care to employees injured while at work In exchange for employees agreeing to surrender their rights to sue their employers the insurance is designed to safeguard them from tort verdicts of a large amount and settlements Most states require workers insurance for compensation to be purchased by employers with at least two employees The coverage is not required for small companies with less than two employees and its generally not required for freelancers or freelancers who are independent contractors The system is a publicprivate partnership which was established to offer partial medical care and income protection to employees who suffer from injuries or illness Employers typically purchase workers compensation coverage through private insurance companies or state certified compensation insurance funds The industry sector the payroll and history of workplace injuries or absence of are the major factors that determine the cost of premiums and benefits for each province This is referred to as experience rating and it is more sensitive to frequency of loss than loss severity since insurance companies recognize that when accidents happen frequently there is a greater chance that the business will have massive losses over the course In addition to providing medical benefits and cash employers are also required to report and pay the cost of lost productivity when an employee is recovering from his or her injury This is the principal reason for the expense of the workers compensation system The Workers Compensation Board manages the program It is a state agency that reviews all claims and intervenes when necessary to ensure that the employers or their insurance companies pay the full amount they are responsible for including medical care It also serves as an avenue for dispute resolution which includes benefit review conferences and appeals How do I File a Claim It is vital that workers compensation claims are filed as soon as is feasible following an illness or injury on the job This is to ensure that your employer or insurance provider has the information they need to investigate your situation and determine whether you are eligible for benefits Its simple to make claims First notify your employer in writing of the accident and provide details about your rights as well the workers benefits for compensation Then you should ask a physician to complete a preliminary medical report Form C4 within 48 hours after the accident The doctor should then send the report to your employer or insurance company After you have completed the report you can make a formal application to workers compensation at the New York Workers Compensation Board You can file this online by phone or in person It is also recommended to consult an experienced lawyer about your claim They can assist you in gathering evidence to support your claim negotiate with insurance companies and represent you in court when they deny your claim If you are denied an denial you may appeal it to the Workers Compensation Board of the state or to the New York Court of Appeals An attorney can help you in these appeals as well as represent your interests in any court or board hearings They usually do not charge anything up front and will only get a percentage of your awarded benefits if the case is successful What is the next step when my employer refuses to pay my claim If your employer declines your claim for workers compensation it may be because they believe that you did not meet the states requirements to qualify for benefits or they dont believe that your accident occurred at work Regardless of the reason be aware of the situation and ensure you have all the evidence and documents you need to prove your case The most effective way to determine the reason your claim was denied is to contact the Workers Compensation insurance company used by your employer This will also help determine the chances of success in your appeal You must act immediately in the event that you receive a denial letter regarding your claim to workers insurance The state law will provide you with the procedure for appealing For more information about your options consult an attorney as soon as possible A lawyer can ensure that your claim is made right and to maximize the amount of money you receive for medical expenses wage loss benefits and other damages resulting from the denial What happens if my employers not insured If youre an injured worker and your employer isnt insured You have a variety of options available to you One option is to file a workers compensation claim through the Uninsured Employers Benefit Trust Fund UEBTF The fund operates as an insurance provider and will cover medical expenses and lost wages If you decide to sue your employer because of the injuries you suffered the UEBTF benefits must be paid out of any settlement If you decide to submit a claim to the UEBTF or sue your employer you require an experienced workers compensation lawyer to help you navigate this difficult situation Contact Jeffrey Glassman Injury Lawyers today for a free and confidential consultation about your legal rights in this type of situation Well discuss your options and help you receive the compensation you deserve Well also discuss ways to safeguard yourself from rejection or disagreement by your employer over your claims Well help you take the steps necessary to get the medical care as well as other benefits youll need What if My Claim Is Disputed It is important to contact an attorney if you believe your case is not settled This will ensure that your rights are safeguarded that you are treated fairly and that you receive the compensation that you deserve If a claim is not in dispute the Workers Compensation Board Board can issue an administrative decision This could include questions regarding whether your injury is workrelated and your level of disability how much money you are entitled to and what type medical treatment is required It is not unusual to hear of claims being denied even if they are legitimate This can be due to financial issues or personal animus against your employer Employers are legally required to purchase workers compensation insurance This means that employers could be subject to increasing monthly premiums For this reason some employers may choose to refuse your claim to save on premium costs They may also be afraid that your claim could cost them money in the end which could result in a bad relationship with you However in workers compensation attorney alexandria of instances a strong claim can be accepted and benefits will be paid by the employer or its insurer You can appeal to the Board if there is an issue In Oregon workers comp law requires that the presiding Administrative Law Judge at a Formal Hearing will issue an oral decision known as a Finding and Award or a Finding and Dismissal The decision is binding on the parties unless either party appeals to the Workers Compensation Commissions Compensation Review Board