What Are Your Basic Rights Under Workers’ Compensation?
Workers’ compensation insurance is a type of insurance purchased by employers for the coverage of employment-related injuries and illnesses.
Workers’ compensation insurance is a federal program administered by the states. Each state will have some variations, but the core purpose of the program remains the same – protect workers from the financial burdens connected with injuries or diseases associated with the workplace, and protect employers from being sued.
This valuable plan should not be taken for granted and you should understand your basic rights concerning the handling of the aftermath of an injury or illness from your workplace. This would include such items as receiving payment for short and long-term medical care, a right to have your own attorney, and the right to the appeal system or the civil court system if needed.
Why Know Your Basic Rights under Workers’ Compensation?
Without knowing and defending your rights, you risk the following:
- Not receiving the monetary benefits you are legally entitled to
- Foregoing medical treatments that could substantially improve your life
- Illegally losing your job because of improper action by your employer
- Having your claim denied because paperwork was not filed on time
The best way to protect yourself and gain all the benefits you deserve is to first know your rights. You will then understand what to expect after experiencing an occupational injury or illness.
You should have a working knowledge of what your approximate benefits will be and what types of allowances you will likely receive. These include, but are not limited to, temporary disability, permanent disability, medical claims, diagnostic tests, and medical treatments. More specific information is available in the article about benefits.
Is Medical Care a Basic Right?
One of your most important benefits under the workers’ compensation program is that you can receive paid medical care for work-related injuries and illnesses. Workers’ compensation insurance will cover all reasonable and necessary medical expenses under such a situation. This would include your immediate medical attention, follow-up physician visits, diagnostic tests, physical therapy, and even home care as long as these services are associated with the work-related injury, disease or disability and they are reasonable and necessary. Workers’ comp is also responsible for paying for all your medical treatments, including any necessary diagnostic tests, even after you return to work.
Your Doctor: Assigned or Chosen?
You may already have a primary care doctor. If you are injured or develop an illness from your work environment, you may want that doctor to be in charge of your treatment. If this is the case, write a letter to your employer immediately after the injury or illness indicating that you want any treatment administered by that doctor. Before you deliver the letter, make a copy for your permanent records.
If employers do not receive a request for a specific doctor, they will be free to select any doctor for diagnosis and treatment during the first thirty days after the accident. The doctor they choose may well offer a more conservative diagnosis and treatment schedule than an independent physician or your own family doctor. This could jeopardize or hinder your recovery.
After the initial thirty day time period, you can change doctors to continue your treatment if you want. If you later choose a different doctor who gives a diagnosis and treatment plan that is much more comprehensive than the original company doctor, you have a ready-made conflict.
If such a conflict develops, first speak to your physician to make certain that the necessary details are available to explain the reasons for the differences in treatment options. Then contact the workers’ compensation board and have them reevaluate the situation. If this does not resolve the issue, seek the help of an attorney who has specialized education and experience in workers’ comp cases to assist you.
The best course of action is to have your first choice of a doctor working with you from the beginning.
What if I’m Turned Down?
Do not give up if you are denied your workers’ compensation claim. A number of valid reasons could cause your claim to be turned down, including a simple mistake that may have occurred. Examples of such an error might be forgetting to sign the form, using an incorrect social security number, or giving an incomplete description of the accident.
An appeals process exists, and professional legal counsel may be advisable at this point. For further detailed information on this, see the section on Denial and Appeal.
Do I have a Right to use an Attorney?
An important provision that you have is the right to contact a private attorney to analyze your specific case. Be careful in selecting a lawyer, because you want to pick one who has specific knowledge and experience dealing with workers’ compensation laws and cases.
Workers’ compensation is not just a static set of rules and regulations that never change. In fact, the law is changing all the time as state and federal court cases examine claims and modify workers’ compensation rulings based on the decisions from those cases.
Because this field is ever changing, you may want to have a professional workers’ compensation attorney review your specific situation. This person will examine your case and determine if a civil lawsuit would be advantageous. Although your acceptance of benefits from workers’ compensation probably prohibits you from suing your employer, it would not bar a civil court suit against a third party. Also, it could turn out that giving up workers’ comp payments and filing a civil suit might be better for you in the long run, but each case would have to be analyzed.