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What is a Workers Compensation Case A workers compensation claim is a legal procedure that occurs when an employee is injured on the job It is designed to safeguard workers from losing their earnings and also to pay for rehabilitation and medical treatment A worker who is injured can receive medical care as well as wage loss benefits and even a settlement as part of a workers comp case 1 Medical Treatment Workers compensation insurance covers the majority of medical expenses for employees that are injured at work This includes the initial emergency treatment like an ambulance ride and then ongoing care including physical therapy medication as well as other expenses The injured worker also has the right to reimbursement for travel expenses to and from doctors appointments This is particularly beneficial for those who need to undergo surgery In many states the employer has the option of contracting with a preferred provider plan or managed care company for the treatment of employees injuries This is a way for both the insurer and employer to reduce costs by regulating the quality of medical treatment It is crucial to select the right medical provider for your treatment Your doctor can also refer you to specialists to conduct further tests and evaluation Your doctors office can often provide you with a list of Boardapproved providers to choose from but there are exceptions Before you begin treatment check that your doctor is listed After you have identified a doctor it is critical to follow their directions and guidelines Failing to do so can negatively impact your claim for workers compensation benefits It is also important to know that the Workers Compensation Board periodically updates its Medical Treatment Guidelines based on new information in the medical field and the suggestions of doctors These changes can affect injured workers but an experienced attorney can assist you in understanding the impact they have on your case To prove that you have suffered an injury at work Workers compensation cases require appropriate treatment Your doctor will have to be able to prove that your condition is related to the workplace and that you are unable to return to your previous job or carry out other tasks unless you have been given specific restrictions to work It is also important to note that in certain states employers must pay for diagnostic tests like ultrasounds and xrays These tests are designed to determine if your symptoms are related to your job and help you understand the nature of your illness and what is needed to manage it Employers are also required to pay for any reasonable and necessary procedures injections or surgeries recommended by your physician to aid you in recovering from your injury 2 Wage Loss Wage loss or the capability to make up for lost income due to an injury that occurs on the job is among the most crucial workers compensation benefits Depending on the state in which you work you may receive up to twothirds of your wages prior to injury Your age and severity of your injuries will affect the amount you are awarded Additionally certain jurisdictions set limitations on the amount of wage loss each week you can receive while you receive workers compensation A good way to ensure that youre getting the most benefit from your claim is to make your claim as soon as you can Also you must adhere to all deadlines and inform your employer of the claim promptly The best way to determine whether you have a valid claims case is to speak with an experienced lawyer for workers compensation This will ensure you receive all benefits provided by law including lost wages and medical bills For example you may be eligible to receive an increased benefit rate in the event that you can prove youve been actively looking for employment since you were injured or suffered your accident This is especially the case if out of work for a significant period of time or have significant medical restrictions that prevent you from returning to your previous work The most appealing aspect is that you dont need to cover any fees or outofpocket expenses 3 Litigation The Claim Petition is the first step on the timeline for litigation The Claim Petition puts your case before the court system and thus begins the process of litigation The claim petition will outline the kind of injury you suffered when it occurred the manner in which it occurred as well as other information The insurance company or employer might or may not reply to this petition however if they do the matter is up to an individual judge who will determine the amount of benefits you can receive and how long The Workers Compensation Board can resolve some issues without having to hold an hearing workers compensation claim spokane valley includes disputes over whether the injury is related to work or not the degree of disability the amount of money you can receive to you and which medical treatment is appropriate For more complex disputes a formal hearing is required before a Workers Comp Law Judge The judge will take both sides arguments and decide the amount of benefits you are entitled to During the hearing both attorneys will submit written arguments to the judge These arguments outline the evidence they have collected as well as their opinions on the issues that are being discussed If the judge agrees with both attorneys they will issue a written Decision that states the results of the hearing and your workers compensation claim is closed The judge will then provide you with a copy of the Decision by mail If your employer or insurance carrier disagree with the investigation into your claim theyll often demand an independent medical exam IME It is a doctors appointment that your employer will pay for to examine you and gather evidence The IME is a vital part of the litigation timeline as it provides vital medical evidence to your employer The IME will review your medical records and write a detailed report on your injuries and treatment Usually once your IME is completed the employer will then hire an attorney to represent their part of the claim This is a complicated process that will require several legal experts and a lot time on the employers part Injured workers who are receiving medications for pain as part their treatment could need to be closely monitored in the course of litigation panelists noted They can be susceptible to addiction if theyre taking too much or using the wrong medication 4 Settlement A workers settlement for compensation is an agreement between you and the insurance company of your employer to pay you a specified amount This can be a lump sum settlement or it could be split into regular payments over time A workers comp settlement is a great way to end the lengthy process of dealing with an injury at work But you shouldnt sign a settlement agreement without first consulting an experienced lawyer You could receive a workers compensation settlement to pay your medical expenses lost wages and other expenses resulting from your injury Settlements can help you cover future costs and keep you from filing an action Each state has its own set of laws regarding workers compensation settlements However you can choose whether to settle your claim with a lumpsum payment or structured payment Your situation and severity of your injuries will determine the amount of your settlement The average workers compensation settlement is 12000 However it may vary depending on the type and state of your injury The lawyer representing you in workers compensation can assist you in determining the amount of your settlement and help you make an informed decision about the best time to settle No matter how large the amount the important aspect is to settle it quickly This will save your insurer time and money Sometimes an insurance company will offer to settle your claim before you have even filed it This is called an offerincommitment or preliminary offer The insurer may be motivated to put a settlement on the table because it has to start paying you benefits right away or because they are concerned that you will file a lawsuit In these instances the lawyer may suggest that you accept the offer or they can try to negotiate for a larger amount Youll ultimately have to make the best choice about your future If your insurance company declines your claim you may request a hearing before an adjudicator or a workers compensation hearings officer The judge will evaluate the case and determine the fair amount of settlement for you Its not always easy but its worth the effort