Having an injury on the job is something many people go through in the course of their career. Not all jobs are the same and not all injuries are the same. When you’re forced to report an injury to an employer, take off work, seek treatment, and/or file a worker’s compensation claim because you have a permanent injury or you’ve been denied coverage, what rights do you have? How will get paid? Can you seek treatment with your choice of doctor? Will your job be waiting for you while off work indefinitely? What if your physical restrictions leave you unable to the job as it was performed? Can you deal directly with an insurance carrier or do you need an attorney? How will the attorney get paid? If you’re left with a permanent impairment, what is the value of your claim?
All of these are common questions that workers better know the answer to or know someone who does have the answers. Most aren’t prepared for the unforeseen accident at work and are then thrust into the hands of human resources liaisons, case nurses, adjustors and others who are most certainly going have their bottom line as the focus, not the best interests of the injured worker. That’s where knowing an experienced and competent attorney can become the difference in getting the maximum benefits available or gambling with your livelihood or health. The list below gives some insight into the processes of a worker’s compensation claim and lays out some of the best practices for people who believe they may have suffered an injury on the job.
1. In the event you’ve suffered a work injury, make certain its reported to the proper agent of your employer. If you tell a supervisor make sure that a first report of injury is filed. This goes to the issue of “notice” and worker’s compensation defense attorney make a living arguing that injured worker’s didn’t give the employer reasonable notice of the occurrence of an injury.
2. Once you’ve done that, you need to make your own record. Write down the date, time, and a full description of the occurrence and nature of your injuries.
3. Identify the witnesses and especially the people to whom you have given notice. It’s worthwhile to contact the Indiana Worker’s Compensation Board or an Attorney to ascertain whether a First report of injury was filed with them.
4. Go to a medical provider and give them a full picture of your condition. This is absolutely not the time to put on a tough guy face. Be descriptive and don’t leave any injuries out that were caused by or worsened by your work injury.
5. Temporary Total Disability payments (TTD) are your “off work checks.” They should begin no later than 14 days of being off work and relate back to the first day you were off work if you’re out at least that long. They should be 66 and 2/3% (two thirds) of your pay rate in terms of your “average weekly wage”.
6. Your treatment is very likely going to be controlled by the insurance adjuster or even your employer who can switch your medical provider to someone who costs them less and review your treating physician’s decisions in a process called “utilization review”. This doesn’t necessarily mean you won’t be permitted to use your own doctor but expect that they’ll have one lined up for you. A good attorney may be able to get an independent doctor to provide a second opinion at no expense.
7. Your employer may terminate your Temporary Total Disability payment if:
a. he offers you lighter or modified work duties within your restrictions (but it needs to be reasonable),
b. you are released to full duty, OR
c. you are declared by a treating doctor to be at maximum medical improvement.
8. The person hovering over your doctor during your treatment is your case nurse, an agent of the insurance carrier and they are trying to limit the cost of your treatment. Request to speak with your doctor outside her presence.
9. Once you’ve reached maximum medical improvement according to your treating doctor or an independent examiner for the insurance carrier, you will likely be cut off from Temporary Total Disability payments and assessed a Permanent Partial Impairment rating (PPI), which is typically the primary factor in determining a settlement value.
10. You should receive future medical treatment for your injury and it helps to have an attorney who can lay the groundwork for these future benefits early on throughout the process of your treatment.
11. You cannot be terminated in retaliation for having a worker’s compensation claim. But that does not mean your employer can not release you if you can no longer perform the work due to your permanent restrictions.
12. Your attorney in a worker’s compensation case will get a maximum of 20% of your settlement or award. Some services above and beyond the normal course of a case may warrant an additional fee for an additional recovery.
13. The value of your claim is something an attorney should be able to explain to you but can only give you their best guess as to an amount until there are some more definite determinations made by your doctor, like a PPI rating, and the value of future medical expenses. Worker’s compensation cases don’t result in the kind of larger windfalls you see in personal injury claims for similar injuries, so a good attorney will help you to manage your expectations.
Craig P. Bingham has handled Kentucky and Indiana Worker’s Compensation and Social Security claims in Kentucky and Indiana over the last 16 years as a part of his practice.
If you have questions about your work injury or a claim, contact us for a free consultation.