Frequently Asked Questions

Q: How do I know if I am covered by workers' compensation?

A: To be covered by workers compensation, you need to be: an employee, and have your injury as a result of your employment. However these two factors do not guarantee you will be covered because depending on the rules in your state, specific employees like agricultural workers are not covered by workers’ compensation. If you were intoxicated while on the job or purposely injured yourself, you might not be covered by workers’ compensation. If you have any doubts, contact us and we will advise you of your rights.

 

Q: If I am receiving workers' compensation benefits but return to work, do I still receive the full workers' compensation benefits?

A:  If you return to work and are able to earn equal or greater wages then before the injury, then you are likely to stop receiving the workers’ compensation benefits. However, if you return to work and are still experiencing a wage loss due to your injury, you may continue to receive wage loss benefits, but it will most likely be for a lesser amount.

 

Q: Can I recover workers' compensation benefits, no matter what I did, because it is a "no-fault" system?

A: No. Although most injuries are covered by workers' compensation, you should not act irresponsibly. You can not assume that you will collect benefits regardless of the cause of your work-related injury. For example, if you get injured as a result of intoxication or illegal drug use, the workers' compensation benefits may not be payable.

 

Q: Can I recover workers' compensation benefits, even if I was not actually at my workplace when injured?

A: It all depends on the laws in your state and the facts of your particular case. If the injury "arises out of" and occurs "within the scope of employment," it is covered. For example if you are running an errand outside of your workplace at the request of your employer, and get injured you may be able to recover such benefits. However, if you have deviated from the business errand for personal reasons, then further examination of the facts in the case would be necessary. If you are unsure if you can recover workers’ compensation benefits, contact us and we will advise you.

 

Q: Can I sue my employer over a work-related injury?

A: As a general rule, you are limited to the benefits you receive through workers' compensation, which means you can not sue your employer for damages like pain and suffering or mental anguish. Some states however, allow you to sue your employer when your employer intentionally hurt you or when your employer did not have legally required workers' compensation insurance.

 

Q: Does workers' compensation cover long-term problems and illnesses?

A: Your injury or disability need not have arose out of a specific or sudden work event. Disability can “accumulate” over time – this is what is called a Cumulative Trauma or a Continuous Trauma [CT]. Examples of this kind of injury are: repetitive-motion injuries to joints (like shoulders, elbows, wrists, hands, hips, knees, ankles), exposure to toxins, low-back and neck disability from sedentary or static posturing, heart disease, impairment of the respiratory system, diabetes, hypertension. 

 

Q: Does workers' compensation cover just my medical bills?

A: Your medical bills will be paid, assuming they the treatment has been approved by the insurance carrier. Problems frequently arise as to whether treatment is authorized. Getting treatment authorized can be a team effort between your treating doctor and your lawyer’s office. They must both follow their respective protocols to obtain authorization for treatment. Other benefits include Temporary Disability and Permanent Disability. Again, the treating doctor, evaluating doctor, and your lawyer must work together to maximize your potential recovery..

 

Q: How long will my employer be responsible for my medical treatment?  

A: Your employer or their insurance company is required to pay for all authorized medical treatment until you have been discharged from care. Treatment may continue for as long as it is medically necessary. What is “medically necessary” is frequently an issue which is litigated by your lawyer when the carrier fails to respond in a timely fashion to a treating doctor’s Request for Authorization [RFA]. If you are having trouble finding a treating physician who will treat you, contact our office for assistance.

 

Q: What benefits am I entitled to with workers’ compensation?

A: Workers' compensation insurance provides five basic benefits: Medical Care-paid for by your employer to help you recover, Temporary Disability Benefits-payments for lost wages if your injury prevents you from doing your usual job, Permanent Disability Benefits-payment if you do not fully recover, Supplemental Job Displacement Benefits-payments to help retrain or enhance a skill if you do not fully recover and do not return to work for your employer, and Death Benefits-payments to your spouse or children or other dependents if you die from a work-related injury or illness.

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