Workers’ Compensation Benefits and Returning To Work
Workers' compensation benefits provide a safety net for employees who suffer a work-related injury. Understanding these benefits is crucial. They can help cover medical expenses, compensate for lost wages, and assist with job retraining. Workers' compensation law governs these issues.
Personal injury is a legal term that refers to injuries to the body, mind, or emotions, as opposed to property. Sometimes, a worker who suffers a work-related injury might also have a personal injury claim. This could happen if the injury were caused by someone other than the employer or coworker, such as a third-party contractor. It is essential to consult with a personal injury attorney or workers' compensation lawyer about your claim.
Under the workers' compensation system in place in most states, an injured employee is entitled to the following types of benefits.
If someone is injured in a workplace accident, the employer's insurance company should cover the costs. This is one of the reasons employers carry workers' compensation insurance. The insurance carrier pays for all necessary medical treatments and related costs. These costs include medical bills, prescriptions, and even round-trip mileage to the hospital.
The injured party has the right to all reasonable and necessary treatment. Under certain workers' compensation plans, a patient might have to use the company doctor. In most cases, this is only for a maximum of 30 days. After that time, a patient may choose a different doctor via a written request.
Some states may require an independent medical examination (IME). The insurance company might dispute the necessity of certain medical treatments. The injured person might need to involve an attorney to help resolve this dispute.
Workers who cannot perform their job duties because of their injury may qualify for temporary disability benefits. These benefits are provided as temporary disability payments. These payments provide them with partial compensation for lost wages. These payments are typically a percentage of the worker's average weekly wage. The pay rate has specific maximum and minimum limits. Typically, this equals about two-thirds of the worker's average weekly gross pay. These payments are paid out every two weeks.
The doctor needs to verify an inability to work. The first temporary disability check should arrive within a few weeks. In many states, these benefits start once the worker has been off work for several calendar days.
When workers reach their maximum medical improvement (MMI) or the point where their injury is unlikely to change regardless of additional treatments but still have work restrictions, they may qualify for permanent disability benefits. These benefits could be permanent partial disability (if the worker can still do some work) or permanent total disability (if the worker cannot work at all).
The amount and rate at which permanent disability is paid depends on how great a limitation the injury places on one's activities. Other elements considered are age, occupation, and earnings at the time of injury. Determining whether an accident caused a partial or permanent disability can be costly.
The insurance company might offer a lump sum settlement. However, talking to a workers' compensation lawyer before accepting this settlement is a good idea.
Wage Loss Benefits
Workers' compensation typically includes wage loss benefits. If workers cannot earn as much because of their injury, these benefits should make up some of the difference. However, returning to work could affect these benefits.
Most states provide different types of wage loss benefits. Two types of benefits that may be available are "temporary partial" and "temporary total" benefits. Temporary partial disability benefits are payable to an employee who has experienced a work injury and is temporarily disabled but can still earn some wages despite a temporary disability. These benefits are generally payable based on a percentage difference between the employee's pre- and post-injury earnings.
Temporary total disability benefits are generally payable to injured employees who are temporarily prohibited from working, in any capacity, due to the work injury. In some jurisdictions, these benefits are payable based on a percentage of the pre-injury wages of the injured employee.
Temporary partial and temporary total benefits are by no means an exhaustive list of the types of benefits that employees may be entitled to, and they may not be available in every jurisdiction or may not be payable for the type of disability sustained. They are described here merely as an example of the type of available wage benefits and how a return to work may affect the ability to obtain those benefits.
Remember, if there is any change in an employee's work status while receiving workers' compensation benefits, the employer or the insurer should be notified immediately and the employee's attorney. Failure to do so may adversely affect the employee's right to receive benefits.
If an injured worker cannot return to their old job because of a work-related injury, they might be entitled to vocational rehabilitation. This could include help looking for a new job or training for a different line of work. This is especially helpful when workers have light-duty restrictions. They might not be able to return to their old job because of the injury.
A partial income is distributed during vocational rehabilitation, similar to temporary disability. The vocational rehabilitation benefit usually has a maximum monetary limit. This may be replaced by an employer's offer of modified or different work.
The Effect of Returning to Work
Returning to work can significantly impact a workers' comp claim. If workers can return to work but only perform light duty, they may still qualify for workers' comp benefits. However, if they can return to their old job at their previous wage, their wage loss benefits will likely stop. If the employee is still experiencing a wage loss, they may continue to receive wage loss benefits. However, these benefits might be for a lesser amount.
The federal Family Medical Leave Act (FMLA) requires the employer to reinstate the employee to the same or similar position upon returning to work. Unlike the FMLA, workers' compensation has no such broad requirements. Workers' compensation is regulated by state laws. Most states do not require reinstatement after workers' comp leave, but some do require employees to offer rehabilitation and retraining services. See Rehabilitation Rights of Injured Workers to learn more about this topic.
Returning To Work After an Injury? Talk to a Workers' Comp Attorney
If a worker is considering returning to work after an injury, it is crucial to understand their legal rights. An experienced workers' compensation attorney can help explain the law and protect workers' rights. They can also assist with disputes with the workers' compensation insurance company. This is why it is critical to consult with a workers' compensation lawyer before making significant decisions in a workers' compensation case.
Workplace injuries happen, but your employer carries workers' compensation insurance for this reason. Unfortunately, workers' compensation claims do not always go as smoothly as planned and may require a skilled attorney's expertise. It is important to remember that each worker's compensation case is unique. As a disclaimer, the law also varies by state.
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Contact a qualified workers' compensation attorney to make sure your rights are protected.