Workers Comp Questions

Questions You Need to Ask Your Workers’ Compensation Attorney

Sustaining an injury is never a part of any job description. But workplace injuries happen. Most unfortunately, those who suffer injuries or develop chronic illnesses at the workplace stand to lose a considerable portion or all of their income. Additionally, their health and well-being suffers. Furthermore, depending on the extent and gravity of the injury or illness, the road to recovery can be long, hard and arduous.

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Workplace injuries and illnesses are incredibly stressful, to say the least. Apart from the damage to your health and well-being, workplace injuries are in themselves tricky circumstances. We constantly encourage workers to consult with a dedicated workers’ compensation attorney in Buffalo in the event that they are injured or develop an illness at the workplace. This is because of the simple fact that it takes an experienced and knowledgeable expert to be able to maneuver the system effectively to receive what you deserve.

Whether you’re in Buffalo or anywhere else in the state, getting hurt at work can be extremely devastating. The loss of income, even for a short period of time, along with associated medical bills, can result in severe financial difficulties.

As your attorneys, we obtain professional opinions for the scheduled loss of use for the affected body part, which corresponds with a dollar amount which is reduced by the amount of benefits previously paid. You receive a lump sum scheduled loss award, and are still protected for treatment necessitated by your accident. This is ultimately what workers’ compensation is. It is important to note that workers’ compensation does not pay for pain and suffering, or punitive damages.

An individual with a workers’ compensation claim (also called a workman’s compensation or workers’ comp claim) should not rely on just any workers’ comp attorney. He/she should be sure to retain a workers compensation attorney in Buffalo who is familiar with both the substantive issues of workers’ compensation law and the procedural issues at the Workers’ Compensation Board.

Workers’ compensation insurance exists to prevent this from happening. Unfortunately, the workers’ compensation process does not always work as expected or isn’t enough to protect the employee fully. In these situations, an experienced legal team could give you the help you need. A general overview of workers’ compensation would be:

• it pays a percentage of wages as long the disability lasts;
• it covers all medical treatment related to the accident (including mileage to and from the doctor);
• it pays a specified amount for permanent injuries to certain body parts once you reach your best possible level of recovery. This is referred to as reaching maximum medical improvement.

Workers’ Compensation Attorney in Buffalo

Only a handful of lawyers in Western New York practice regularly at the New York State Workers’ Compensation Board. Your workers’ compensation injury demands full, fair, and just financial compensation for medical bills and lost wages.

When an employee is injured, he or she can file a workers’ compensation claim. Assuming the case meets certain basic requirements, the employee will receive weekly cash benefits and payment of medical bills, regardless of who was at fault for the injury. This means an employee who was directly responsible for his or her own injury can still receive workers’ compensation benefits. However, in most cases the employee cannot sue his or her employer even if the employer may have been directly responsible for the injuries. There are, of course, a few exceptions to this limitation.

Summary:

• Workers’ compensation refers to insurance that pays for lost wages and medical bills of employees who are hurt or become sick because of their job.
• Practically all New York State employers are required to carry workers’ compensation insurance.

1. What are the First Steps in a Worker’s Comp Claim?

There are a few things you need to do in the event that you sustain an injury or develop an illness at your place of employment. It is crucial that you follow these steps in this order.

• The first thing you must do is to get emergency medical attention, if and as necessary.
• Secondly – and only proceed to this step once you are medically fit to do so – you must report the injury or illness. This report must be in writing, and it must be submitted to the appropriate department or employer representative. Typically, these take the form of incident reports in several industries.
• Finally, you need to fill out the necessary paperwork and submit it to the Workers’ Compensation Board for review.

You may obtain your rightful benefits for all types of injuries, including, but not limited to:

• Neck and severely back injuries
• Knee, shoulder and joint injuries
• Eye and ear injuries
• Head injuries
• Burn injuries
• Amputations
• Fractures
• Repetitive injuries (carpal tunnel syndrome)
• Occupational illnesses and diseases caused by exposure to toxic chemicals and other hazardous substances

Summary:

• Always seek medical attention first.
• Only after you are medically stable should you report the injury/illness, following which you should fill out necessary paperwork and submit it to the Workers’ Compensation board.

Schedulable and Non-Schedulable Injuries

In order to understand what benefits you are eligible to receive, it is important to understand the two different kinds of injuries. Workers’ compensation contemplates two types of injuries – schedulable injuries and non-schedulable injuries.

Schedulable injuries are typically those sustained on the arms, legs, hands, feet, fingers, toes, eyes and ears. When you reach your maximum level of recovery from a schedulable injury, that is, when such an injury improves as much as can be expected (a doctor’s opinion is required at this point), they are said to have reached maximum medical improvement and we obtain opinions for the scheduled loss of use for that part of the body which corresponds to a dollar amount reduced by the weekly benefits or wages already paid and the remainder is paid to the injured employee as a scheduled loss award.

Non-scheduled injuries are most often those occurring to the neck and the back. These also include head injuries, hernias, and certain diseases for which there are no scheduled loss awards. These are typically injuries from which a person suffers a permanent disability. Non-schedule benefits are based on the employee’s permanent loss of earning capacity.

Summary:

• Schedulable injuries are typically those sustained on the arms, legs, hands, feet, fingers, toes, eyes and ears.
• Non-scheduled injuries are most often those occurring to the neck and the back.

2. What Is Covered and What Is Not Covered in a Workers’ Comp Claim?

In order to recover workers’ compensation, you must have been accidentally injured while on the job, in your position as a working employee. Additionally, your injuries must be related to the job. For instance, if you’re a professional painter and hurt your back while painting a customer’s house, that’s probably covered. But you’re likely not covered if you were injured when a drunk driver ran off the road and hit you during a painting job.

Even if you meet the requirements, you could still be ineligible to receive workers’ compensation benefits. This is likely if you were under the influence of drugs or alcohol at the time of the injury, or if you were acting inappropriately while on the job. Engaging in horseplay, or knowingly and intentionally misusing equipment are both reason to have your workers’ compensation claim denied.

Summary:

• Job-related injuries if accidentally injured while on the job are covered by workers’ comp.
• Injuries if you were under the influence of alcohol or drugs, or injuries incurred while engaging in horseplay are not covered.

3. What are the Types of Workers’ Compensation Benefits Available?

If you have been injured at your place of employment, the benefits you may expect to receive will depend upon the extent of the injury, and your ability therein to return to work. Retaining a good workers compensation attorney in Buffalo at this point will prove to be incredibly beneficial because they will ensure that you receive the workers’ compensation benefits you deserve.

Types of workers’ comp benefits to which you may be entitled include:

• Vocational rehabilitation
• Medical expenses reimbursement
• Disability pay
• Travel expenses to and from doctor appointments

The type and amount of weekly workers compensation benefits you receive depends upon your injury and the extent to which it prevents you from working. If you are completely disabled, you will receive more than if you are partially disabled. And if you are able to work light duty, you may qualify for a small amount of benefits in addition to your salary.

For certain injuries, you may be entitled to a scheduled loss award when your injury has reached maximum medical improvement. These include injuries to the toes and feet, fingers and hands, legs, eyes, ears and arms. The scheduled loss award takes into consideration that you will never regain full use or functioning of these body parts.

Depending upon your case, you may be entitled to a settlement.

Summary:

• The benefits you may expect to receive will depend upon the extent of the injury, and your ability therein to return to work.
• Types of workers’ comp benefits include vocational rehabilitation, medical reimbursement, disability pay and travel expenses to and from doctor’s appointments.

4. How Do You Calculate Workers’ Compensation Payments?

Unfortunately, you are not entitled to receiving the entire amount of your usual paycheck when you make a workers’ compensation claim. In fact, the most you can receive each week is two-thirds (up to certain limits) of your weekly wage. Sadly, it is likely to be even less than that. This is because the Workers Compensation Board calculates your weekly compensation payments based on a percentage of your weekly wage and your level of disability.

To explain this point further, let us give you an example. If your earnings were $500 per week and the Board considered you to be 100% disabled, you will receive $333.33 every week. But if you were 50% disabled, you would only get $166.67 every week. Furthermore, if you return to work, but cannot work at full capacity, you’re eligible to receive reduced earning compensation.

An injured employee is eligible to obtain all required medical care related to the work injury or illness. Medical benefits can also include out-of-pocket expenses, such as travel costs to get medical care you need. However, there are some rules on payments for the medical care.

One of the biggest restrictions is that Workers Compensation Board has to authorize any health care provider an injured party wants to use, except in cases of emergency treatment. Additionally, the employee may have to obtain prescription drugs and receive medical tests from facilities and pharmacies of the workers’ compensation insurance company’s choosing.

Summary:

• The Workers Compensation Board calculates your weekly compensation payments based on a percentage of your weekly wage and your level of disability.
• The most you can receive each week is two-thirds (up to certain limits) of your weekly wage.

 If you or a loved one has been injured at work, please contact the experienced workers’ compensation attorneys at Cole, Sorrentino, Hurley, Hewner & Gambino P.C to get on the road to recovery with the benefits you deserve.

This educational blog was brought to you by Jerry Gambino, a dedicated workers compensation attorney in Buffalo.

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