Workers Compensation Attorney

Who pays for your workers compensation claim?

Masnikoff — Tue, 30 Apr 2013 20:33:37 +0000

Who pays for your workers compensation claim?

The employers pay for these benefits depending on the law of the state. It is not necessary that the benefits received under workers compensation always come from your employer. In fact state government, an insurance company hired by your employer or a third party administrator also hired by the employer pay for the workers compensation claim depending upon the state law. Regardless of whoever pays for the claim, the benefits that you receive remain the same. Here are a few important things that one needs to know about the source;

State-run programs

In some states, it is mandatory to obtain workers compensation insurance through a state run program. Usually the employers with few workplace injuries choose to go for these programs. The employers pay the premiums to the state which in turn provides the benefits to the claimants.

Insurance companies

Most of the states allow buying workers compensation insurance from private insurance companies. These companies receive premiums from the employer and in turn provide the workers compensation benefits.

Self insurance

In case the company i self is financially strong and can demonstrate to the state that it has sufficient assets to cover the expected workers’ compensation liability, they can get the permission to handle the job themselves. Some companies that go for this option hire a third-party administrator deals with the paperwork, claims processing, and management of the claims.

Professionals at Lyle B. Masnikoff and Associates, P.A will fight to get you the medical or wage benefits you are entitled to under the law. Employers and Insurance Companies have professionals working for them and there are no fees or costs until you recover. It‘s time for you to hire us to protect your rights.

What if you lose a workers compensation case at arbitration?

Masnikoff — Tue, 30 Apr 2013 20:28:25 +0000

Many states allow an alternative case resolution through a process called arbitration. Some states make it mandatory to go for arbitration however others give an option to go for arbitration or mediation. The condition is that the parties must voluntarily agree to use an arbitrator, and must choose an independent arbitrator. The arbitrator, to whom the case is presented, acts as a judge. After listening to both the parties, he issues the decision. In most cases, the decision of the arbitrator is only considered as a recommendation not final whereas in others, the decision is considered as the final verdict.

If you are living in a state that binds arbitration, the arbitrator’s decision is considered as final and cannot be appealed further. However, i states where the arbitration is not binding for workers’ compensation cases. You can further appeal to the arbitrator’s decision or continue with the litigation. If you choose to appeal arbitration decision means that your case continues forward in litigation. You may want to consult an attorney to determining your chances of success on appeal. You should also consider the emotional and financial implications involved in continuing the litigation.

Speeding up your Social Security Disability case

Masnikoff — Tue, 30 Apr 2013 20:24:53 +0000

Hiring an attorney for your social security disability case might speed up the process. There are many advantages of having a Social Security Disability attorney represent your case during the application and appeal process. Attorneys are knowledgeable on how to get the decision on your claim faster.

Getting the decision on the original application is the fastest way to receive the social security benefits instead of appealing to the decision which can take up to one year. An attorney’s expertise can help you to get through in the first round as compared to having to wait after appealing to the decision. If you can find an attorney to represent you at the initial stage, you can get several benefits. However, an attorney will only take your case up if he sees a likely chance of winning the case. Here are several benefits of getting help from an attorney at the early stage:

He can help you fill out the form showing how you are not able to perform the work and your eligibility for the social security benefits.
In order to prove that your claim is true, he will gather relevant medical evidence.
He will request your doctor to help in the case proceedings such as making the doctor aware of relevant terminologies to be used in the case if appropriate.
Alert Social Security if yours is a terminal illness case, making it eligible for expedited treatment.

Are mental or psychiatric disorders covered under workers compensation?

Masnikoff — Mon, 29 Apr 2013 19:39:51 +0000

Sometimes mental or psychiatric disorders can be covered under workers compensation if you can prove that the condition is caused by any work related activity or stress. Generally, it must be shown that the mental condition was the result of abnormal work conditions.

Normally the claims related to workplace stress are very difficult to win. One reason is that it is very difficult to find a workers compensation lawyer to take your case. This is because the lawyer will get paid only if you win the case and the chances of winning are very thin. The lawyer will receive his share of payment through the amount you will get under permanent disability benefits. What you can hope for in most cases is for is to get compensated for your medical expenses and some temporary disability benefits to replace your wages while you take some time off work.

You would stand a better chance for getting compensated if you mental or psychiatric illness is tied to a physical accident or an illness caused at work. For example, job-related stress or tension may contribute to a heart attack. Another example might be a worker who suffers a traumatic physical injury and later develops anxiety disorder or PTSD (post-traumatic stress disorder) as a result.

In case you have a severe mental impairment that prevents you from going back to work, the best you can do is to file for Social Security disability based on your mental condition.

Workers compensation claim management

Masnikoff — Sat, 30 Mar 2013 21:45:34 +0000

Some employers believe that they would be better off without workers’ compensation mechanism in practice and that it is totally a financial mechanism but in reality it is not that simple. The workers compensation policy comprises of much more than that. If your business is experience rated, every dollar spent on the workers compensation claim will have an effect on your workers compensation insurance cost. Besides that, not every employer has an expertise in workers compensation claim management and it can prove to be costly.

Experience modification factor is a mechanism that links the claim and the cost of settling that claim. According to that factor, lesser experience the employer has in settling the claim, higher will be the cost of settling those claims. In simple terms, it compares your firm’s workers compensation experience with that of other firms in the same business. The firms which are better experience have a lower workers compensation coat as compared to those are less experienced.

In order to better manage workers compensation claim, you should:

Report the claims immediately
Put in effort to close the claims as soon as possible
Keep a track of all open claims
Work closely with the insurance claim adjuster
Put in every effort to get the injured employees back to work as soon as possible.

It is a fact that every business has to settle some workers compensation claims sometimes during the course of its operation. Providing necessary medical and rehabilitation services to get them back to work as soon as possible but when the workers compensation claim goes out of control, one should be ready to face increased cost.

Workers compensation and employees who practice telecommuting

Masnikoff — Sat, 30 Mar 2013 21:39:41 +0000

Since 1980s telecommuting has been on a rise. It started as a part of environmental movement and spread gradually. Telecommuting involves employees working away from the office of their employers for at least one o two days a week. Often the employees who telecommute do so from their home. These employees work as part time. They work at home on some days and go to office at others.

In response to the rise in telecommuting, National Council on Compensation Insurance (NCCI) has divided the telecommuting employees in two categories:

Clerical Telecommuter Employees
Telecommuting Drafting Employees

In the beginning the employers feared that employees telecommuting on their payroll will take advantage of the workers compensation insurance. However, these fears have proven to be groundless as most f the telecommuting employees do not consider filling out a worker’s compensation claim. There is a lack of case law based on claims by telecommuters for the following reasons;

The claims by both clerical and drafting employees are less costly and fewer as compared to other employees.
Telecommuting employees are long term and white collar employees who are less likely to file these claims.
All the cases that have come on the surface have been decided on the basis of the facts of the individual claims not on points of law.

Why would an employer deny the workers compensation claim?

Masnikoff — Sat, 30 Mar 2013 21:36:25 +0000

In order to get the workers compensation insurance, employer has to pay workers compensation premiums to the insurance company. The amount of this premium is directly affected by the number of benefits filed by injured workers. More the benefits filed, more will be the amount of premium that the employer has to pay. So one obvious reason for denying the claim is a simple fie lettered word ‘money’. Workers compensation premium increases when more workers file for the claim or when the company has expensive claims.

Besides money, another factor that leads to the denial of a claim by an employer is the employer bias. The employer simply believes that the injury is not serious or even valid. They believe that the worker filing for the injury is deceiving the organization for financial gains as the injury is not completely true. This happens especially in case of cumulative trauma injuries.

Common reasons given for denying a claim are:

Most commonly the claims are denied on the following grounds:

The claimant did not suffer from a serious injury.
The injury took place outside the scope of work.
The injury does not require any medical aid.
The worker does not need time off.

How to fight against a denial benefit?

In case your claim has been denied, you should write to your employer’s workers compensation insurance company. If the problem still prevails, hire a workers’ comp lawyer and request a hearing with the state workers’ comp board. The worker has given up the right to sue the employer in exchange for the workers’ comp benefits and should not feel guilty about using them.

Returning to light duty after a worker’s compensation injury

Masnikoff — Sat, 30 Mar 2013 21:29:24 +0000

In most states the law goes that if after an injury, the employer can return to a light duty job, the employer holds the responsibility to compensate him with either the same job that he left or with an alternate job that is equivalent to the one he left.

In contrast, the law in some states requires that if a worker is returning to a light duty after a worker’s compensation injury, he or she still has to get the workers compensation benefits in order to compensate him for the difference of payment of the new job and the previous one being performed by him before the injury. To avoid this double payment, employers tend to deny the light duty jobs on the ground that they d not have any such jobs available.

In order to encourage the employers to provide the light duty jobs, some states have modified the law in such a way that even if the worker accepts the alternative job being provided by the employer or not, his workers compensation benefit will be reduced by 15% but the condition is that the alternative job should be the one that can be performed by you. In contrast, if the employer does not provide the job, the workers compensation benefit will be increased by 15%.

If you do return to your previous employer, make sure your employer knows about the restrictions your doctor has put on you if the employer forces you to perform the job any way, decline it by stating that you are not allowed by the physcian.

Workplace safety for young workers

Masnikoff — Tue, 19 Mar 2013 22:49:49 +0000

It is a general observation that young workers the reason in most of the cases is unfamiliarity with the workplace and safety procedures. There are three ways in which organizations can avoid this problem:

Orientation

Providing extensive orientation to the new workers reduces the chances of workplace injuries. Orientation sessions are designed to make the new worker familiar with the workplace and environment. It tells them where things are located at the workplace, who works there and which jobs each of them perform the possible workplace hazards and how to avoid them, who to report any signs of hazards to, which steps to take in case of an injury and where to get the first aid equipment.

Training

Training should be given in order to teach the workers how to complete the work correctly and safely. The workers should be well equipped with the knowledge of safety procedures.

Supervision

The supervisors should keep a vigilant eye on the tasks performed by all the workers and give instant feedback on whether they are meeting the safety guidelines or not and should provide for on the spot corrective measures. Vigilant supervision should continue at least till the time new workers become highly familiar with are the safety standards and guidelines.

New PIP law: have insurance companies limited your coverage?

Masnikoff — Tue, 19 Mar 2013 15:15:26 +0000

Under the new PIP law, an injured person must seek medical care for injuries resulting from an auto accident within 14 days of the accident. Otherwise no PIP benefits will be paid.

In addition, if it is determined that the injury is not an emergency medical condition, your PIP benefits are reduced to $2,500.00.

Under the new PIP law, are you receiving the insurance protection you expect?

“Emergency medical condition” means a medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to result in any of the following:

(a) Serious jeopardy to patient health.

(b) Serious impairment to bodily functions.

While it is unclear what kinds of injuries would constitute an “emergency medical condition,” the insurance companies have successfully lobbied the legislature in order to severly limit consumer rights.