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What is a Workers Compensation Case? A workers' compensation claim is a legal procedure which occurs when an employee is injured on the job. It is designed to safeguard the employee from losing income and also to help pay for medical treatment and rehabilitation. In the course of a workers compensation case it is possible for an injured worker to receive medical care or wage loss compensation and even a settlement. 1. Medical Treatment If an employee gets injured while 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 as well as other expenses. Workers who are injured also have the right to reimbursement for travel expenses to cover the cost of transportation to and from their doctor's appointments. This is particularly helpful for those who have injuries that require surgery. In many states, employers have the option of contracting with preferred provider plans or a managed care company to treat workers' injuries. This allows both the employer and insurer to cut costs by regulating the quality of medical care. It is essential to select the right medical practitioner for your treatment. Your doctor may also recommend you to specialists to conduct further tests and evaluation. Your doctor's office will often give you the list of Board-approved doctors to choose from, though there are some exceptions. You should verify to make sure your doctor is on this list prior beginning treatment. Once workers' compensation attorney passaic have found a doctor, it is critical to adhere to their guidelines and instructions. Failure to do so could affect your claim for workers compensation benefits. You should also be aware that the Workers' Compensation Board periodically updates its Medical Treatment Guidelines based on new information from the medical field and the recommendations of doctors. These changes can sometimes affect injured workers, but an experienced lawyer can assist you in understanding how they affect your case. The proper treatment is crucial in a workers ' compensation claim to demonstrate that you have an injury that is related to work and are eligible for the benefit of lost wages. Your doctor will need to confirm that your symptoms are related to your job. It is not possible to return to your previous job or engage in other activities unless limitations on work have been imposed on you. In certain states, your employer may have to pay for diagnostic tests such as x-rays or ultrasounds. These tests are designed to determine whether your symptoms are related to the workplace and help you understand the medical condition you are suffering from and the best way to take care of it. Your doctor will recommend that your employer pay for any reasonable and necessary surgeries and injections to aid you in recovering from your injury. 2. Wage Loss Loss of wages or the ability to replace income lost due to an injury that occurs on the job is among the most crucial workers compensation benefits. Based on the state in which you work, you could be entitled to up to two-thirds the amount of your pre-injury earnings. The severity and age of your injury can affect the amount you'll receive. Additionally there are many jurisdictions that place limitations on the amount of wage loss per week that you are eligible to receive when you receive workers' compensation. You can be sure to receive the maximum amount of claim you can by filing your claim as soon possible. It is also important to make certain that you meet all deadlines and notify your employer promptly. An experienced worker's compensation attorney is the best way to determine whether you have a valid claim case. This will help ensure that you receive the most benefit under the law, such as those for lost wages and medical bills. You may be qualified for a higher benefit rate if you're employment background indicates that you've been actively looking for employment following the accident. This is especially relevant if you've been off work for a period of time or are dealing with significant medical restrictions that keep you from returning to your former job. The most appealing aspect is that you do not need to cover any fees or expenses out of pocket! 3. Litigation The Claim Petition is the initial step in the timeline for litigation. It puts your case in the court system and starts the process of litigation. It will describe the incident, date, time as well as other details. The insurance company or employer may or may not respond to this petition however, if they do the matter is at the discretion of an arbitrator who will decide the amount of benefits you will receive and the duration of your benefits. Some issues can be resolved by the Workers Compensation Board on a casual basis, without a hearing. This can include disputes about whether the injury is a result of work or not, the extent of your disability, monetary awards payable to you, and which medical treatment is appropriate. More complicated disputes require a formal hearing before a Workers' Compensation Law Judge. The judge will take evidence from both sides before making a an assessment of the amount of benefits you will receive. Each attorney will present written arguments to judge during the hearing. These arguments describe the evidence they have collected and their position on the issues that are being discussed. If the judge agrees with the arguments of both lawyers, the judge will issue a written Decision that details the outcome of the hearing, and also closes your workers claim for compensation. The judge will then send you a copy of the Decision in the mail. If your employer or the insurance company do not agree with the claims investigation, they will often request an independent medical examination (IME). This is a medical examination which your employer will pay for to examine you and collect evidence. The IME is an important element of the litigation timeline as it provides vital medical evidence to your employer. The IME will review your medical records, and report on your injuries, as well as the treatment you received. Typically, after your IME has been completed, your employer will hire an attorney to represent their side of the claim. This can be a complicated process that requires multiple legal experts and an extensive amount of time on the part of your employer. Injured workers who are receiving pain medications as part of their treatment may need to be monitored closely in the course of litigation, panelists noted. They could be addicted to the medication if they take too much or use the wrong medication. 4. Settlement A workers compensation settlement is a contract between your employer and the insurance company that will pay you a specific amount. This can be a lump sum payment or it could be broken up into regular payments over time. A workers' compensation settlement is a great option to stop the long process of dealing with an injury at work. However, you should not sign a settlement agreement without first speaking with an experienced attorney. Workers' compensation settlements can be obtained for medical bills, lost wages and other costs related to your injuries. A settlement can help you pay for future costs and keep you from having to bring a lawsuit. Each state has its own laws regarding how a worker's compensation settlement is handled, but generallyspeaking, you have the option to settle your claim for a lump sum or structured payments. The amount of your settlement will depend on the circumstances and the severity of your injuries. The typical workers' compensation settlement is approximately $12,000, however, it could be higher or lower based on the kind of injury and the state where you reside. Your workers' comp lawyer can help you determine the amount of your settlement and make informed decisions about the best time to settle. Regardless of the amount, the key is to settle quickly. This will save you and your insurer much time and money. Sometimes the insurance company might offer settlement before you have even filed it. 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 scenarios, your lawyer can recommend that you accept the offer or they can try to negotiate a higher amount. In the end, you'll have to make the best decision for your future. If your insurance company has denied your claim, you can request an hearing before the judge or the workers' compensation hearings officer. The judge will look over your case and determine the amount of settlement that is fair. It's not easy, but it is well worth the effort.