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Workers’ Compensation FAQs

Frequently asked questions

Workers compensation questions answers.

 

Q: How much should I be receiving in workers’ compensation income benefits?

A: The amount of your weekly workers’ comp check for temporary income benefits (TIBs) is calculated by taking the average of your earnings during the 13 weeks prior to your accident and multiplying by 70%. For injuries after October 1, 2016, the new weekly Temporary Income Benefits max comp rate is $913. If you believe you may be getting underpaid, contact us.
Read more here about what you should be receiving in workers’ compensation benefits.

 

Q: Do I have the right to choose my own treating doctor for my workers’ comp injury?

A: Yes. Although there are certain insurance carriers that require that the injured worker treat within their network, you still have the option to choose who your treating doctor will be within the particular network. If the insurance carrier that is responsible for your claim does not have a network set up, you have many more choices of who your treating doctor can be. However, you will want to have a doctor that will be interested in your well-being as opposed to looking out for the interests of the employer. We can help get you to a doctor that not only will have your best interest in mind, but who is also knowledgeable in the procedures for requests for medical treatment under the workers’ comp guidelines.
Read more here about your right to choose the best doctor for your needs.

 

Q: Why isn’t my medical treatment being approved?

A: There can be various reasons why the insurance carrier is not approving your medical treatment. The Division of Worker’s Compensation recently adopted certain guidelines for medical treatment that is to be provided to the injured worker. If the treatment that your doctor is requesting falls beyond the guidelines, this may justify the reason for the denial. In other instances, the insurance carrier might only be accepting a minor injury and the treatment that your doctor requested is to remedy a much more severe injury. In this case, there may be an extent of injury issue and you will need a knowledgeable workers’ compensation lawyer to resolve this matter for you.
Read more here about workers’ medical treatment approval.

 

Q: Is there a settlement under workers’ compensation?

A: A workers’ compensation claim is different than a personal injury claim. Under personal injury, a settlement is reached that includes compensation for medical treatment, lost wages, pain & suffering, etc. Under workers’ compensation, an injured worker receives income benefits called Impairment Income Benefits (IIBs) when he or she has reached Maximum Medical Improvement. For example, if an injured worker is certified to be at Maximum Medical Improvement with a 10% whole body impairment rating and his date of accident was after 10/1/15, he or she will be entitled to 30 weeks of IIBs at a weekly maximum rate of approximately $627. Weekly IIBs amount varies depending on the date of injury. The injured worker can be working after he or she receives the impairment rating and the IIBs will still be sent to him or her on a weekly basis. The IIBs can be looked on as the settlement for the claim.

 

Q: Are there other possible claims associated with my workers’ compensation claim?

A: Yes. If another person was responsible for your injury besides your employer or a co-worker, you may have a third party claim. If a faulty machine or product caused your workers’ comp injury, you may have a product liability claim. If your employer did not pay you overtime, you may have an overtime claim. If you had been employed with your employer for several years and suddenly your employer terminates you after you got hurt, you may have a wrongful termination claim. Contact Laura Y. Rodriguez and Associates, P.C. to discuss these and other possible claims that may arise out of your workers’ compensation claim.

Q: Why do I feel like I’m being rushed through the comp system & the adjuster seems to want to close my claim?

A: You feel that way because you most certainly are being pushed out of the comp system too quickly, cheating you out of benefits you are entitled to. Keep in mind that the less medical treatment an injured worker receives, that equals more money in the pockets of the insurance companies. A company doctor will diagnose you with a minor injury (usually a pulled muscle) and then give you an examination that seems to be a follow-up consultation where the doctor produces a report saying you are as good as you will get. An impairment rating will also be given without your knowledge and if not disputed on time, this will basically mean the end of your claim.

Don’t let the insurance company push you around!