Workers Compensation Attorneys
Workers compensation, also known as "workman's comp," is a form of insurance designed to help workers who have become injured or sick due to their work conditions or environment, as well as families of workers who have been killed from work-related accidents or illnesses. Rules for this important benefit system are extremely complicated, varying state by state. The resulting confusion often leads to outcomes that are unfair to sick and injured workers.
When a workers compensation claim occurs, a thorough investigation and evaluation--conducted by a personal injury attorney with direct experience handling workers compensation cases in that state--is always the best way to proceed. To find an experienced workers compensation lawyer to handle a claim in your area, contact the law offices of Schwartz Roller LLP. Our personal injury lawyers and workman's comp attorneys handle hundreds of workers compensation cases every year and have a track record of obtaining full justice and fair compensation for injured workers and their families.
What You Need to Know About Workers Compensation Claims and Settlements
Workers compensation insurance provides compensation (which normally includes medical care, payment of a specified percentage of a worker's wages, and, in many cases, the continuation of certain benefits) to employees who become hurt or contract an illness as the result of their jobs. In exchange, the hurt or sick employee relinquishes his or her rights to sue the employer for negligence. This tradeoff, known as "the compensation bargain," assures a fixed amount of coverage and eliminates the need for litigation, the uncertainty of reaching a settlement, and limited recourse for a worker outside the workers compensation system. The system does, however, leave room for negotiation and, in some instances involving extreme negligence, an employer still can be sued.
While workers compensation is a no-fault system that exists in all states, plans and types of settlement agreements differ widely between jurisdictions, and there are separate provisions for non-military federal employees and other special classifications of workers. In general, however, provisions include regularly scheduled payments in place of wages, compensation for economic loss (past, present, and future), reimbursement for or payment of medical and injury-related expenses, plus benefits payable to the dependents of workers killed because of work-related accidents or illnesses. General damages for pain and suffering, and punitive damages for employer negligence, are generally not available in worker compensation plans. Some laws also protect employers and fellow workers by limiting the amount an injured employee can recover from an employer and by eliminating the liability of co-workers in most accidents.
Injured or sick workers who have a compensable workers compensation claim typically receive a gross dollar amount that is equal to 66 percent, or two thirds of their regular wages or salary. There are, however, other issues that affect workman's comp benefits, including whether or not a worker's injuries or impairments are temporary or permanent, and total or partial.
Why You Need an Experienced Workers Compensation Attorney
The process of filing workers compensation plans and negotiating favorable settlements can be difficult, time-consuming, and confusing. In general, there are two types of settlements in a workman's comp case: Stipulated Finding and Award and Compromise and Release.
A Stipulated Finding and Award is an agreement with the same effect as a decision handed down by a judge. The difference is that it is voluntary. Typically, the benefits are paid out over time, not in one lump sum. In workers compensation cases, the main elements of a Stipulated Finding and Award are the percentage of disability and the possibility that further medical care will be necessary. The percentage of disability is determined using a formula based on the language in the medical report and the doctor's opinion of the disability, as well as the age of the hurt or sick employee and his or her occupation. Typically, when disputes arise they revolve around the level of disability, since this is what determines the monetary award.
Another key sticking point in Stipulated Finding and Award agreements is the decision whether or not the employee is entitled to medical care in the future. The answer may be "yes," "no," or "may be entitled." A finding of "may be entitled" allows the insurance company to make the final decision as to whether the care is necessary. In most cases, the doctor will look need to clear it with the insurer before starting treatment in these situations.
The second type of settlement, a Compromise and Release, closes the case completely and eliminates the need for payments over time. In this type of agreement, the employer and the employer's insurance carrier agree to pay wage loss benefits to the employee in the form of a one-time, lump sum of money. The amount of the monetary award depends on average weekly wage and the projected length of the disability, as well as other factors, like the risk of pending litigation or the earning of other wages.
In addition, there are two ways of resolving the medical benefits portion of the claim in a Compromise and Release Agreement. The first and least common method is accepting a lump sum payment of wage loss benefits only and leaving the medical claim open. In this case, the employer and its insurance company would continue to be responsible for payment of reasonable and necessary medical expenses. There are pros and cons to both methods, depending on the specifics of the workers compensation claim. However, most employers are unwilling to settle cases this way. They prefer to offer a separate sum of money for payment of future medical bills so that they can close their file, completely settle the case, and eliminate any provision for future medical care. Before settling a case, an injured worker should sit down with an experienced workers compensation attorney or personal injury lawyer and actually add up the total possible medical costs that might be incurred over the years following a settlement.
The settlement value of each workers compensation case is different and dependent upon the facts and circumstances involved. Factors that affect the value include how much exposure the employer and its worker's compensation insurance company have to medical expenses, income benefits, and permanent partial disability benefits. Not only is the settlement value of every case very fact-specific but timing also is important. There are deadlines for filing a WC-14 Notice of Claim with the State Board of Workers' Compensation, as well as deadlines for getting mileage reimbursed and medical bills paid.
Given the complexity of the legal and liability issues involved in workers compensation lawsuits and settlements, hiring a skilled personal injury lawyer or workers compensation attorney to investigate, litigate, negotiate, and resolve claims is especially critical. If you have suffered a work-related injury or illness, been involved in an on-the-job accident, or are a dependent of a worker who died as the result of working conditions or employer negligence, use the convenient form on this Web site to contact the personal injury attorneys at Schwartz Roller LLP and receive a free, confidential evaluation of your
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