One of the most important pieces of advice we give to anyone involved in a workers’ compensation case is to make sure you file a report of the accident. It’s important to be as detailed as possible in order to support your workers’ compensation claim. However, what happens if you are unable to recall your injury? Is your workman’s comp case doomed for failure?
Of course, this is something that does happen, so it’s been addressed in court. If a worker falls and experiences a head injury, they might not be able to remember the exact circumstances of where, when or how they fell. This can make it difficult to prove whether or not their fall is can be compensated by workers’ compensation.
However, the courts in North Carolina have ruled that if an injured worker has an unexplained fall, then this is can be compensated by workers’ comp injury. If a worker does not remember the circumstances of their fall, they must be examined by a doctor. If the physician cannot find an explanation as to why they fell, then the employee’s injury would fall under the Unexplained Fall Law of Philbeck v. University of Michigan.
Returning to work after sustaining a work injury isn’t necessarily a cut-and-dry process. Every person heals at their own pace, and depending on the extent of your injury, you may need more time than someone else. However, in many cases, in order to continue receiving benefits you will need to return to work. This can be troublesome for some people, especially since workers’ comp law does not require that you’re pain-free or symptom-free prior to returning to work.
But keep this mind: While you might have to return to work, you may not have to return to the exact job you were working before your injury. If you’re still suffering from pain or other symptoms, there’s a good chance your physician has placed workplace restrictions on you. This means you will need to be given work that does not aggravate your injuries.
If your employer is willing to accommodate your restrictions, it’s important to discuss the details of your new job description with your physician. That way they can determine whether or not you are fit for that kind of work.
In many situations, your employer will be required to provide a formal job description for your doctor to approve before you can return to work. This will help ensure that you will continue to recover and not make your injuries worse after returning to your job. Working with your doctor and employer will help your transition back into the workplace go as smoothly as possible.
This is a totally reasonable concern. Not all employers are thrilled at the thought of having to be responsible (even in part) for your workplace injury. They might resist and even try to say that your claim is ridiculous and holds no water. They might refuse to follow the proper procedures that go along with your workers’ compensation claim.
Fortunately, your employer is required to acknowledge your claim. When they do so, if they wish to make the case that they are not liable for your claim, they must present that case to the Industrial Commission. They will do this by filing Form 61, which will detail the exact reason for their denial of liability.
If your claim is denied by the insurance company, you may request a hearing before the Industrial Commission. You can do this by submitting a Form 33. This is a request for a hearing. During your hearing, your case will be reevaluated and a final verdict will be reached.
This may seem like a long process, and often times it can be. But don’t worry; you will not be billed by medical providers during this time. Medical providers can only bill you after it has finally been determined that you are not compensable by workers’ compensation.
When you’ve been injured at work, workers’ compensation is a vital part of your recovery process. You’re reliant on that money to pay for everything from food to bills to medical expenses. It’s important that the amount in your check is correct. Your weekly checks should be for 66.66% of your pay the year before your injury.
There are several reasons the amount might be incorrect. For instance, it’s possible that the insurance carrier just didn’t calculate your income correctly. In some cases we have seen, the insurance carrier has not accounted for overtime pay, bonuses, or other pay that falls outside of your normal work hours.
It should be fairly easy to clear up any mistakes by reviewing your pay records. Here are some things you should make sure you include in the calculation of your income:
If the carrier still refuses to agree to raise your pay to meet your income after reviewing your records, an attorney can help you ask for a hearing or file a motion to clear up the underpayment. Every little bit counts when you’re out of work due to an injury. Make sure you’re receiving the compensation that’s owed to you.
When dealing with a workers’ compensation case, we often hope that everything follows procedure: that we can read attorney’s blogs and find step-by-step online “How to File for Workers’ Compensation” guides and that everything will work out fine. Unfortunately, this isn’t always possible. Sometimes things don’t always go according to plan.
What should you do if your insurance carrier fails to authorize the referral of your treating doctor? When you find yourself in this scenario, chances are you’re in need of additional medical treatment or medication, and waiting around isn’t really an option. However, there are steps you can take to get the treatment you need.
Recently we helped one of our clients deal with this situation. We advised them to take option two and encouraged them to seek their own medical care when the carrier did not authorize it in a timely manner. As it happened, instead of going to litigation, the insurance company agreed to the doctor that they selected. It can be difficult to know what to do in situations like this, so we recommend seeking advice from an experienced attorney.
