What happens when you get injured at work? What are the first steps you should take after an injury? These are some of the most common questions by people who are unaware of their rights to compensation.
Whether you slice off a finger while working at a deli, or perhaps fall off your chair in the office or even hit your head against a concrete block at a construction site or maybe develop an illness because of your job, compensation is meant to cover your troubles. The compensation will cover your medical costs and even pay for any days off from work.
While most if not all businesses in America have workers' compensation insurance but it does not cover everyone working for them. Some of the people excluded are independent contractors, farmers or agricultural professionals, and domestic help.
So, to be covered by workers' compensation you have to be employed by a business and then need to be injured accidentally or get sick while working. For instance, those working in the construction industry may be exposed to asbestos while taking out a ceiling for renovation. That exposure could lead to various health issues which makes them eligible for compensation.
Injured at work? The First Step Is To Contact A Medical Professional
Whether you have been injured on the job or have contracted a medical condition the first thing you should do is visit a doctor. Also, report the incident to your supervisor right away, possibly in writing. Keep in mind that handing something in writing is the best way to keep track of what was said, that way you have proof of reporting the incident to the supervisor. Some states do allow a verbal notice, but everyone agrees that writing is the best.
Once you have reported the incident and visited the doctor then make sure to file for a claim. Most states have a deadline within which you need to submit the claim, or you may lose legal rights to workers' compensation. However, it is best that you let a work injury attorney handle things like filing a claim especially if you have a serious medical condition.
Handling Things on The Medical Side
Whether it is a hand injury, leg injury, nose injury, chest injury, clavicle injury, arm injury, jaw injury, back injury at work or needlestick injury etc., it is essential to visit the right medical provider. If the injury requires emergency care, the ambulance will take you to the nearest hospital. However, if it is a non-emergency, the employer should tell you where to go. Going where your employer tells you means that the bills will be covered by the employers' workers compensation insurance.
When at the hospital make sure to tell the doctors, and other hospital employees that you were injured during work. When filling out the formal paperwork at the doctor's office or even the hospital make sure to click on the box that says you were injured at workplase. Taking these steps to ensure that your bills will be covered by the insurance company and not you.
If you for some reason choose a doctor of your own make sure that he or she is approved and certified by the insurance company. Your company's HR department should have a list so seek approval from them first. If not, then there is a good chance that the bills will need to come out of your pocket.
How to Get Paid – Your Medical Records Should be on Track
The most important part of getting paid is to ensure that your medical records are in line with your claim. Your files should include history and the circumstances surrounding your illness or injury. Keep in mind that the workers' compensation insurance will not pay to treat diseases or injuries which weren't incurred while on the job.
Under the Federal Employees Compensation Act (FECA), if a doctor submits medical records which clearly address the insurance company's concerns, then receiving compensation is not a problem. Though sometimes the insurance company may ask to get a second opinion.
In the case of a second opinion the below-mentioned guidelines apply:
- The doctor they pick may not be Board-certified in any particular field
- The insurance agency will pay expenses associated with getting a second opinion. They will then forward all the relevant medical documentation to the doctor also called statement of accepted facts.
- You have the right to bring along your doctor to a second opinion exam.
- Any rep that you may appoint should receive a formal notice for the exam.
- The doctor is obligated to submit a report in writing within 30 days of an exam.
- The doctor can only provide a medical opinion
- If the second opinion is not clear the insurance company or workers' compensation department handles following up and getting a supplemental report.
A clear and easy to understand medical history makes it easier to receive your compensation. That said an attorney should help you untangle things if it is required.
Some Employers May Say You're Not Covered!
We have certainly heard our fair share of stories where the employer outright denies that the employee is entitled to compensation. While being injured at work should assure you of compensation employers may be hesitant especially if they don't have workers' compensation insurance. They may also be hesitant if they are trying to hide the company's often unethical practices like hiring illegal aliens.
It is essential to be clear that the compensation is mandatory even if the accident was apparently your fault. So, if you were working and happen to slip on a banana peel which ends up fracturing your arm, you can't be denied compensation. Though the employer may argue that you should have been more careful and spotted the peel.
On the other hand, if a co-worker dares you to jump out the window and you do which ends up breaking your arm, you're not entitled to compensation.
Hire an Attorney
If you are asking “what are my rights?” then its best to hire an attorney. Whenever an employer outright denies that you're entitled to compensation its time to bring an attorney onboard. Most states will set workers' compensation payouts, and so you can't get more than what has been set.
In New York state a thumb is equivalent to 75 weeks of pay, so if your thumb has been disabled by 10% percent in an accident at the workplace, you get 7.5 weeks of pay. This type of value system is woven into the law. The doctor gets to decide how permanent and severe the injury is. Which is why mentioning that you've been injured at work is so important.
A compensation lawyer working for you will take around 20% percent of the settlement amount. So, it would be a good idea to avoid hiring an attorney unless you're being shortchanged, or the claim is a lot more complicated, or perhaps you're being denied coverage. Even then it would be a good idea to schedule a visit with the workers' compensation ombudsman of your state who can also help get what you deserve.
Knowing How to Get Paid – Don't Cheat the System
Knowing how to get paid for being injured at work is often taken as a short cut to getting money from the insurance company. Some people may try to cheat the system, as a matter of fact, many do, and is referred to as “malingering.” Cheaters get caught because insurance companies, as well as the employer, will do due diligence, make home visits and surveil to mainly see if any other company is contributing to the Social Security account. So, it is always a good idea to only file a claim when the injury is genuine and happened at work.