Frequently Asked Questions About Workers’ Compensation

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What Should I Know About Workers’ Compensation?

What Are You Entitled To Receive?

Workers’ compensation benefits include medical expenses, partial pay while you are off of work, and compensation for permanent limitations or restrictions, that affect your wage earning ability. The following paragraphs describe these benefits in some detail.

Medical Expenses

Your employer is legally obligated to pay for all medical treatment, surgical procedures, prescriptions, medical supplies, or equipment, related to your injury and prescribed by your doctor. This may also include future medical expenses related to your injury. The employer or its insurance company is obligated only to pay bills for “authorized” medical treatment. State law requires your employer or their insurance company to give you three doctors from which to choose for your treatment. The doctor you choose can have a big impact on your case. Consult a lawyer who is experienced in handling workers’ compensation cases before you make a decision.

Partial Pay While You are Unable to Work:

“Temporary total disability” is a term, which describes the time period when an accident injury prevents you from returning to work. This is generally the time needed to recover and rehabilitate from your injury. It ends when your doctor releases you to go back to work, or determines that you have reached your maximum medical improvement. During your period of “temporary total disability” you are entitled to compensation equaling 2/3 of your average weekly wage. The law provides a maximum figure so that, regardless of your actual wages, your employer need not pay more than the legal weekly maximum.

Payment for Permanent Limitations and Restriction:

Most injuries from work accidents do not result in total disability, but in restrictions, which can limit a worker’s strength, endurance, or capacity for work. This is called “permanent partial disability”. As an injured worker, you are entitled to compensation for any permanent impairment, even though you may have returned to your regular job at the same (or even better) pay. This is in addition to the temporary benefits you receive while recovering from your after the accident.

How Much Is My “Permanent Disability” Worth?

The amount of compensation you are entitled to depends on the nature of your injury, its effect on your wage-earning capacity, and the impairment rating given by your doctor. If your employer, its insurance company or a state worker says, “this is all you can recieve,” get a lawyer and a second opinion!

What Is A Rating For Permanent Impairment?

When you have recovered (or reached “maximum medical improvement”) following your accident, your doctor will determine whether you have some permanent medical impairment. This will, in part, determine what you will be paid for your permanent problems. [Doctors do not always agree on whether someone has a permanent impairment, or to what extent. Doctors who are approved by the company for workers’ compensation may decide that you have no impairment, or a small impairment, while another approved doctor may believe your level of impairment is much higher.]

Can I Determine What My Claim Is Worth?

Determining a claim’s worth is not easy. If you are handling your own claim, you will probably deal with an insurance adjuster who is more experienced than yourself. The adjuster’s goal is to minimize the amount paid to you, so remain skeptical about anything said. There are maximum payments for work-related injuries that are permanent. Another doctor may evaluate your case much more favorably than the doctor paid by workers’ compensation. Consequently, the question, “how much is my case worth?” is complex enough to consider getting expert legal help.

What Is A Benefit Review Conference?

When you reach maximum medical improvement, your employer and/or its insurance company may demand a “Benefit Review Conference”. During such a conference, the employer and insurance company will have representatives present to “negotiate” a settlement that is good for them. If you’ve been told to come to a benefit review conference, you should have someone with you experienced in workers’ compensation. If you go by yourself, you may be told that you’re being offered all your case is worth, and you may be pressured to accept the deal. Don’t agree to any offers until you have discussed the advantages and disadvantages with an experienced lawyer. At Mitch Grissim & Associates, we do not charge a fee for such a consultation, and we ensure that someone goes with you to the benefit conference who represents your best interests.

Do I Have To File Suit?

If your case is not filed within one year of the injury-causing accident, or one year from the time you learned your injury was permanent, you may lose any right to make a workers’ compensation claim. Many workers’ compensation claims are settled without filing suit, but such action be necessary to protect your claim. You should consult a lawyer to determine how much time remains before it is necessary to file suit.

Do I Need A Lawyer To Claim Workers’ Compensation?

If your injury or illness is serious or if it affects your arms, legs, neck, or back, you should consult a lawyer about your claim. People who handle their own claim often make innocent, but terrible mistakes.

An Attorney Experienced In Handling Workers’ Compensation Can:

  • Make sure that you don’t lose your benefits due to a miscommunication between the doctor and insurance company.
  • Confirm the insurance company is paying you the correct amount.
  • Evaluate the doctors on the panel offered by the employer to determine if one might be best for your case.
  • Compare the impairment rating in your case to the rating given by other doctors for the same or similar accidents that led to injuries.
  • Evaluate your case for factors that may make it worth more, than other cases.
  • Help you evaluate the importance of keeping “future medicals” versus a cash payment for “future medicals”.
  • See that you are treated fairly at any “Benefit Review Conference”.
  • Advise you of the possible financial implications that a workers’ compensation settlement may have on social security benefits and other claims.
  • Advise you of your settlement’s effect on your right to ask for additional monies should you lose your job in the future.
  • Structure your settlement so it will not reduce a later award for social security disability.

Workers’ Compensation Act:

Workers’ Compensation is a special law passed by the Tennessee legislature to give workers financial benefits when they are injured in a job-related accident (provided their employer has five or more employees). This law does not apply to farm labor, domestic help, state, or public employees. However, state employees are entitled to similar benefits through the State Board of Claims.

Injuries Covered:

Any injury, occupational disease, or death, which occurs “out of and in the course of employment,” is covered by the law. It does not matter who was at fault in the accident. Covered injuries include broken bones, muscle strains, back and neck problems, loss of strength and/or flexibility, heart problems, diseases related to your employment, and others.

Qualifying For Benefits:

If you are injured on the job, you must notify your employer as soon as possible. If the employer doesn’t have actual notice of your injury (as might be the case where your supervisor approved you going to the hospital for x-rays) then you must give the employer written notice within 30 days of the injury-causing accident. You may lose your right to claim compensation if you fail to do this. The safest action for any injured worker is to see that someone files a correct, written report of injury.

The Waiting Period:

Your benefits are limited to medical expenses for the first 7 days following the accident. If you continue to be disabled and unable to work after 7 days, you can receive retroactive benefits from the date of your injury or illness.

What Do You Do If You Have A Work-Related Injury:

  • Notify your employer of when, where, and how you injured yourself
  • Make sure you carefully reviewthe paperwork filled out by the employer, and notify them of any mistakes.
  • If your doctor says you are unable to work, make sure your employer knows
  • Be specific when telling the doctor about your condition and symptoms. Make sure the doctor knows exactly what is happening to you.
  • If receive notice that any bill is unpaid, contact the workers’ compensation insurance company immediately and find out why.
  • Everyone you talk to – your employer, the insurance company, or a state worker – will be taking notes on what your say. Keep your own notes of what happened at the accident and your conversations.
  • Tell your doctor that you want to get back to work as soon as possible. If you have problems after returning to work, let your doctor know immediately.
  • If your employer or co-workers ask when you will return to work, tell them, “as soon as the doctor lets me”

Can I Afford A Lawyer?

Our policy regarding Workers’ Compensation cases is to charge 20% of any amount we collect on your claim. We do not charge a fee while your case is pending. If we collect nothing, you owe us nothing.

Because there are so many variables in every case, the real question is “Can someone who’s experienced in Workers’ Compensation, medical impairment, physician selection, insurance adjusters, litigation, and negotiation get 20% or more for my case than I can get on my own?” The answer is frequently, “yes”.

Mitch Grissim and Associates Advances All Costs for Your Claim Until Recovery Is Made:

In Tennessee, the law requires all attorneys to hold clients responsible for the expenses required to process their cases. However, we advance the expenses of litigation, including court costs, expenses of investigation, expenses of medical examination, and cost of obtaining and presenting evidence to maximize the value of your claim and reduce financial burdens on you until your recovery is made.

Each case is different and different facts may yield a result you would never expect. The information in this summary cannot replace the careful consideration of personal factors and changes in the law, which may apply to your legal problem. While this information may help you, it should not be considered the final answer to a legal question.

Our staff has years of experience in Tennessee’s complex Workers’ Compensation Law.
We look forward to helping you. o schedule a free consultation, call today at 615-255-9999; or contact us online.

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