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Workers Compensation How to File a Workers Compensation Claim When an employee is hurt while on the job they need to immediately report the injury promptly This helps avoid problems and delays in receiving workers compensation benefits Workers compensation benefits typically include disability and medical treatment and vocational rehabilitation services These benefits can vary in amount and duration from one state to the next Medical Treatment When you are injured while working medical treatment is a vital aspect of your workers insurance claim This kind of insurance provides for medical visits hospital stays imaging studies xrays and blood tests and the cost of rehabilitation treatments The New York State Workers Compensation Board sets medical treatment guidelines MTGs to aid in the pursuit of objective healing and returntowork goals These guidelines are updated regularly according to changes in the medical field and the recommendations of doctors These guidelines are designed to ensure that an injured worker receives the same treatment as other workers who suffer similar injuries or illnesses They also help ensure that the treatment is appropriate to the specific injury or illness and ensure that there isnt any overtreatment or unnecessary medical expenses If a physician determines that medical treatment is not necessary under the MTGs or other regulations heshe can ask for an exemption from the insurance company asking for a specific exception to these MTGs This procedure is complicated and may take months to complete Employers and insurance companies must try their best to provide the necessary treatment when it is needed Failure to do so can result in a conflict between the insurer and the injured worker which is usually settled with an evidentiary hearing before an administrative law judge Typically the treatment should be administered by an accredited health care provider within the region who is authorized to treat claimants for workers compensation In emergency situations an unlicensed or not certified physician may provide treatments for injuries suffered by workers as long as they are notified of the accident and an appropriate first report of injury has been completed by the supervisor or employer Many doctors are certified in workers compensation and can offer lower costs for treating injured employees This may be particularly helpful for those who have suffered a serious injury In addition doctors and surgeons many other medical professionals can offer treatment for injured employees They include occupational therapists chiropractors and physical therapists The New York State Workers Compensation Board suggests that injured employees and their representatives talk to their attorneys before receiving any medical treatment This could be the sole way to ensure that injured workers receive the best care possible in some cases Expenses Workers compensation costs can be different depending on the state of the employee and state These costs include medical expenses and vocational rehabilitation costs legal fees and settlement costs Most of the expenses are covered by your insurance policy However some of these costs are paid by the employee or their spouse or dependents Employers are required to have workers compensation coverage in the majority of states This safeguards employees from lawsuits as well as other damages that result from workplace accidents including injuries or illnesses The policy covers medical care as well as wage replacement and death benefits for workers killed on the job While workers compensation insurance is essential it could also be expensive A workers compensation claim may cost a company about 1 per hour of work lost These losses can be seen in the bottom line of the company which could result in an increase in productivity and profitability It can also impact the reputation of the company which could negatively impact future business contracts and skilled employees A company can incur indirect costs as a result of injuries to employees as well as workers compensation The cost of a time that an employee is absent from work or the cost of hiring a replacement employee are also included in these indirect costs Indirect costs comprise the cost of replacing or repairing equipment damaged by an accident This is a significant expense for any business however it is more frequent for heavyduty machinery and equipment Additionally Occupational Safety and Health Administration OSHA fines associated with a high incident rate can be an additional expense for employers These fines are typically initiated when an organizations injuries or fatalities are assessed These indirect and direct expenses can be reduced by fostering an atmosphere of positivity and minimizing workers claims for compensation It can also create an environment that is more profitable for the business and boost the morale of employees Time Off Work The loss of income due to an injury that is caused by work can be devastating If however you are receiving workers compensation benefits then you may have some options to help cover the gap while you heal Employees can take various types of time off including sick and vacation time Certain of these are covered by the laws of the state or federal government however others are nonrequired Businesses can make use of vacation and sick time to their advantage workers compensation attorney pembroke pines can take time off work to care for family members or to help themselves Some companies also provide personal time off which can be used to handle things such as doctors appointments car checks and other occasions eg parentteacher conferences Although some states have laws that require employers to provide paid sick time for employees this isnt always the case Companies that dont have enough resources to pay for this kind of leave may be able to refuse to offer this type of leave Employers can also avail of offering flex time Employers can offer flex time to employees This lets them get paid time off and the employer can cover the gap by increasing their hours or increasing their pay In addition to the above options some states have mandated that employers provide paid sick or vacation time which can be a good way for businesses to encourage employees to take time off when theyre ill or need to carefor a family member If your employer doesnt provide one of these options its recommended to speak with a lawyer about the best way to use your rights under the law If you are being asked to use paid time off for medical treatmentor for any other reason a knowledgeable lawyer can assist you in understanding and protect your rights Some employers also offer employees time off for work theyve done over their contracted hours which is known as time off in lieu or TOIL Some employees use this time to attend medical appointments or other types of treatment Others are used to be juries members or to perform other activities that they choose Appeals If you are denied workers compensation benefits you are entitled to appeal that decision Within 30 days from the date the judge rendered a negative decision you are able to appeal to your states workers compensation board Appeals are an integral element of the claims process and can be a crucial aid in helping you receive the benefits you deserve following an accident at work A knowledgeable attorney can help you navigate the appeals process and ensure you receive the full amount of benefits to which you are entitled Many injured workers are denied a workers compensation claim or have their claims substantially reduced by the insurance company This can be a devastating situation for injured workers and is usually done with the sole purpose of saving their employer and the insurance company money The appeals process begins with an hearing before the workers compensation judge This hearing is usually conducted live but it can also be conducted through videoconferencing In this hearing the judge will be hearing from you and your attorney about your workers compensation claim The judge will examine your medical records your wages and other evidence to determine whether you are qualified to receive benefits from workers comp If yes is the case what should the amount be The judge may also look into any disagreement regarding your injury The judge will then decide what benefits youre entitled to receive and how long they will last If you dont agree with the judges decision you may then appeal that decision to an upper court Usually you can appeal to the appellate division of your states court within 30 days of the decision of the workers compensation board Appeal can be difficult but your workers compensation attorneys will work hard to get you the best result A competent attorney will look over your case in depth and explain to the appeals court your reasons for an improved outcome If you need assistance with a workers comp appeal contact a seasoned New York workers compensation law firm today The Turley Redmond Rosasco team is made up of skilled workers compensation lawyers who will help you obtain the highest amount of benefits to which you are entitled