What happens after you get hurt at work? How much does workers’ comp pay? What should I expect from my claim? How long does it take to get paid? Does your employer pay you or does it go straight into the state’s coffers? These are some of the questions you might ask yourself after being injured at work.
If you get injured on the job, more than likely, you’re entitled to workers’ compensation benefits. These funds are paid directly from the insurance company to cover medical expenses, lost wages, and other costs associated with recovering from your injury.
However, there are some things you should know before filing a claim, especially things that not everyone will tell you. Here are 9 workers’ compensation facts that you need to know.
1. Your Employer is Not Required to Pay for Medical Expenses
When you file for workers’ compensation, you may think that all of your medical bills will be covered by your employer. However, this is not always true. There are cases when you will get injured on the job but your employer won’t have to pay for any medical treatment. If you were injured in an auto accident, for example, the person who caused the accident may have their own insurance policy which covers their liability. In these cases, they won’t be required to pay for your medical care. You should then be aware of which injuries can actually be covered by your employer.
2. Your Claim Can Be Denied
While most states require employers to provide workers’ compensation coverage, it does not automatically mean that every worker has access to it. Some states allow companies to deny claims if they think the employee was partially responsible for his or her injuries. This could include situations where an employee gets injured while working overtime without proper equipment or breaks. Other times, an employee could be denied because he or she had a preexisting condition. When your claim is denied, you will receive a letter explaining why it was denied. It is important to understand what grounds your claim was denied so that you can appeal the decision when necessary.
3. It Doesn’t Guarantee Income After You Recover
Most people assume that once they start receiving workers’ compensation, they will continue getting checks every month. Unfortunately, this is not always the case. Many states don’t guarantee income after recovery. Instead, they only cover costs related to your injury. This means that even though you might have been able to return to work, you won’t necessarily make the same salary you used to earn before your injury.
4. There Are Limits On How Much You Can Receive
Your state may limit how much you can receive in total. In some cases, you may be eligible for partial payment. There are limits to how much you can receive per week, per year, or per lifetime. For example, if you were hurt at work and received $1,000 per week for three weeks, you would get $3,000. Your weekly benefit would then stop until your condition improved enough to no longer warrant treatment.
5. You Will Still Have to Report Your Injury
Even though your employer may not have to pay for your medical expenses, they still need to report your injury to the state so that they can keep track of how much you’ve received over time. This is necessary because the state will use your information to calculate how much you should receive each month.
6. You Don’t Have A Right To An Attorney
In many states, you don’t have a right to legal representation when you file a worker’s compensation claim. Instead, you must go through a dispute resolution process where you talk with an independent adjuster. An independent adjuster is paid by the insurer and is not affiliated with the company that hired them. He or she is supposed to investigate your claim and make recommendations about what kind of settlement you can expect. If you disagree with the recommendations, this may be a good time for you to contact an attorney.
7. As An Employee, You Have Rights Too
So don’t let them bully you into signing anything that you don’t understand. Also, keep in mind that it’s illegal for your employer to retaliate against you for filing a worker comp claim. That means that if they fire you or otherwise punish you for reporting an injury, they could be sued. In fact, some states have laws that protect employees who report injuries in good faith.
8. There Are Additional Options Besides Workers Comp
There are other options besides workers comp. For instance, you may qualify for Social Security Disability Insurance (SSDI). If that’s the case, you won’t have to worry about finding additional income. And you may be eligible for Medicaid as well. However, these programs aren’t perfect either. They require proof of disability and can take years to become available. Plus, your benefits may be reduced if you earn more than a certain amount. The bottom line? Make sure you understand all of your options before deciding which one is best for you.
9. The Insurance Company Is Not On Your Side
It is very likely that your employer’s insurance company is going to try to pay you as little as possible for your injuries. They may try to make things confusing, or become difficult to communicate with.
As this happens, know that this may be a good time to call an attorney to discuss your options.
If you have questions about these 9 items, or anything else involving your workers’ compensation case, we are here to answer any questions you may have. It is always free to talk to us. You can call us at 336-222-2222, or email us at [email protected].