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Workers Compensation How to File a Workers Compensation Claim When an employee is hurt at work It is imperative that they notify the employer as soon as they can This will help prevent delays and problems in receiving workers compensation benefits Common workers compensation benefits include disability and medical treatment and vocational rehabilitation services These benefits may differ in the amount and duration of benefits from one state to the next Medical Treatment Workers compensation claims cover medical treatment for injuries sustained on the job This type of insurance covers doctor visits hospital stays and imaging studies xrays as well as rehabilitation costs To encourage objective healing and help achieve returntowork goals the New York State Workers Comp Board sets medical treatment guidelines MTGs The guidelines are regularly revised as a result of medical advances and recommendations from doctors These guidelines are intended to ensure that injured workers receive the same treatment as other workers who suffer from occupational injuries and diseases They also help ensure that the treatment is appropriate to the specific condition or injury and that there isnt any overtreatment or unnecessary medical expense If a doctor determines that medical treatment is not necessary under the MTGs they can request an exception from the insurer in order to request an exception to these MTGs This process is complex and may take months to complete Employers and insurers should take every step to provide the treatment if it is required In the event of an argument between the employer and the employee it could be possible to not be able to provide the treatment The issue can be resolved through an evidentiary hearing before an administrator law judge Usually the treatment should be provided by a licensed health care provider in the area who is licensed to treat claimants for workers compensation However in urgent circumstances a licensed but uncertified physician can render treatments for injuries suffered by workers in the event that they have been notified of the accident and an necessary initial report of injury has been filed by the supervisor or employer Many doctors are certified in workers compensation and can charge a reduced cost for treating injured employees This may be particularly helpful to patients who have suffered an injury that is severe Alongside doctors a number of other medical professionals can offer treatment for injured employees They include physical therapists occupational therapists and chiropractors The New York State Workers Comp Board suggests that injured workers and their representatives talk to their attorneys before they receive any medical treatment In some cases this may be the only way to ensure that a worker is getting the best possible care Charges The costs of a workers compensation claim may vary depending on the particular employee and the state in which they are employed These expenses include medical costs and vocational rehabilitation costs as well as legal fees and settlement costs Most of these expenses are covered under your insurance policy Some of these expenses may be caused by the spouse of the employee the employees spouse or dependents Employers must have workers compensation insurance in most states This protects employees from lawsuits as well as other damages that result from workplace accidents like injuries or illnesses The policy covers workers who are killed on the job and offers indemnity for medical treatments or wage replacement as well as death benefits While insurance for workers compensation is essential it can also be costly In general it costs businesses about 1 per hour of work it loses due to an injury claim The losses could show up in the bottom line which can cause the loss of efficiency and profitability It can also impact the reputation of the business which can impact future business contracts and the ability of workers A company may have to pay indirect costs resulting from employee injuries in addition to workers compensation For instance expenses like the duration of time employees are off work or the cost of hiring a replacement worker can also be included in these indirect costs Another indirect cost is the cost of fixing or replacing equipment or property damaged as a result of an injuryrelated incident This is an expense that is significant to any business and is particularly common for businesses with heavyduty machinery and equipment Employers may also be subject to OSHA fines for having high incident rates These fees are often activated when an organizations death or injury rate is scrutinized A positive work environment and minimizing workers compensation claims can reduce these direct and indirect expenses for businesses It also creates an environment that is more profitable for the company and increase employee morale Time Off Work The loss of income as a result of an injury that is caused by work can be devastating However if you are receiving workers compensation benefits then you may have options to cover the gap as you recover Employees are entitled to a variety of time off such as sick and vacation time Certain of these are covered by federal or state laws while others are optional Vacation and sick leave can be a valuable tool for businesses because they allow employees to take time away from work when theyre sick or need to care for family members Some businesses offer personal time that can be used to attend doctors appointments car checksups or occasions eg parentteacher conferences Some states have laws that require employers to provide paid sick days but this isnt always the case Companies that do not have the funds to pay for this kind of leave may be able to choose not to offer this kind of leave Employers also have the option of offering flexible time Employers can offer flexible time to employees This lets them have paid time off and the employer can make up for the difference by increasing their hours or increasing their pay In addition to the above options some states have mandated that employers offer paid sick or vacation time This could be a great method for companies to encourage employees to take time to rest when theyre sick or are required to care for the family member If your employer does not provide these options its an excellent idea to talk to an attorney to learn what you can do to best utilize your rights under the law A lawyer with experience will help you understand your rights and safeguard them when you are asked to make use of your paid time off for medical treatment or other reasons Some employers also give employees the opportunity to take time off for work that theyve done above the hours theyre contracted to work which is called time off in lieu or TOIL Some employees take advantage of this time to attend medical appointments or other kinds of treatments Others be juries members or to perform other activities that they choose Appeal You have the right to appeal a denial of workers compensation benefits You may appeal to your states workers compensation board within 30 days from the date when the judge made a ruling against you Appeal is a vital element in the claim process They can help you get the benefits youre entitled to following an accident at work workers compensation case baytown can assist you navigate the appeals process to ensure you receive all the benefits you are entitled to Many injured workers are denied their workers compensation claim or have their claims significantly reduced by the insurance company This can be devastating for injured workers and is usually performed to save their employer and the insurance company money The workers compensation judge will hear the appeal This hearing is usually conducted live but it can also be conducted using videoconferencing The judge will be listening to your and your lawyers concerns regarding your workers compensation claim during this hearing The judge will take a look at medical records wages and other evidence to determine if you are entitled to workers compensation benefits and what that amount should be The judge may also look into any disagreement regarding your injury The judge can then decide what benefits you are entitled to and how long those benefits will last If you are not satisfied with the judges decision you can then appeal that decision to the higher court Typically you can appeal to the appellate division of the court of your state within 30 days of the decision of the workers compensation board Appeal can be difficult but your workers compensation attorneys will do their best to ensure you the best possible outcome A competent attorney will look over your case thoroughly and then explain to the appeals court your reasons for a better outcome If you require assistance in a workers compensation appeal get in touch with an experienced New York workers compensation law firm today The Turley Redmond Rosasco team is comprised of skilled workers compensation lawyers who can assist you in obtaining the maximum amount of workers compensation benefits to which you are entitled
