Workers compensation is designed to help people who’re injured on the job. It compensates them for money that they’ve lost when their injury stops them from working. It can also compensate them if they’re injured because of something negligent that their employer did, or something that employer was supposed to correct or warn about but did not. How it works and what it can do for you are both very important issues that all employees should understand.

Who Qualifies For Workers Compensation?

In order to qualify for workers compensation, you need to be working for someone else. A self-employed writer who gets carpal tunnel, for example, wouldn’t be eligible for workers compensation. It’s a type of insurance, and it has to be paid by the employer. The regulations on who has to provide workers compensation insurance to employees can vary based on the size of the business and what type of company it is. Not every company is obligated to provide it, and some are only obligated to provide it to certain employees – such as full-time and not part-time workers. If you aren’t sure about qualifying, talk to your employer to get answers.

Do You Need A Lawyer?

Even though most on-the-job injuries are covered by workers compensation provided the employer is required to have coverage, that doesn’t mean that the employer wants to pay the employee for injuries. This can get very expensive, so it’s understandable that an employer would try to avoid paying. However, it’s also unfair to the injured employee. If you’ve been injured on the job and your employer won’t pay, you may need to get a lawyer to help you. You won’t necessarily have to sue your employer, though, because getting a lawyer involved may be enough to have the employer do what’s right. The fear of being sued might be sufficient to get things moving. If it’s not, you can always decide whether you want to proceed with a lawsuit.

What To Expect From A Compensation Claim

When filing a compensation claim, you shouldn’t expect to get rich. What you should expect is fairness, financially speaking, for the loss that you’ve suffered. If you can’t work, you should receive an amount comparable to the amount you were making. You also shouldn’t be fired or mistreated for filing a compensation claim, so don’t assume that filing a claim will cause problems. If it does, you may have to get a lawyer involved to protect your rights.

Workers compensation insurance is designed to protect your rights if you’re injured on the job, so don’t live in fear of filing a claim if it’s really necessary. Be respectful and only bring the court system into it if necessary, but don’t give up on your rights if things get difficult. You’re entitled to that compensation.

By: Tom Sangers

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A C4 Form is a workers’ compensation board form titled “Attending Doctor’s Report,” that requests information about claimaint/claim identification, claim parties of interest, injury history, diagnosis, treatment, disability, causal relation of accident to disability, and degree of impairment. The form is to be filed by the doctor within 15 days of the initial treatment, with additional reports during treatment, and a final report at the completion of treatment. Once the initial form is filed, subsequent visits should be billed out within 45 days of the visit.

C4 forms are required when billing for services related to workers’ compensation, or when a patient was injured on the job. Many practice management systems come with these forms as a standard insurance form listed in the insurance form menu of the program. That is the easiest way to submit them. You actually print the claim on white paper, and the program not only prints up the charges and other information, but actually creates the form too.
If your practice management system does not have the form available, you can usually get a blank form online through your state’s website.

Once you have a blank form, you can either type the information in, or if your software has the capabilities, you can program your software to fill in the boxes on the form. In any case, you will need to submit a copy directly to the workers’ compensation carrier, and the state workers’ compensation board as well.

It is extremely important that all boxes on the C4 form are completed accurately. A copy of the form is submitted to the state workers’ compensation board and those forms are usually scanned into a computer system. When or if a case goes to a hearing, the information on these forms is used. If the information is not completed, or is not accurate, it can adversely affect the outcome of the hearing. For example, if the doctor does not complete the box indicating the patient is disabled, and the patient is truly disabled, the employers lawyers can argue that the disability has not been established. So even leaving a field blank can be detrimental.

The forms are fairly easy to fill out and are pretty self explanatory.

By: Michele Redmond

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If you fail to tell the medical providers where you hurt and how you were hurt you could not only be harming yourself physically but also legally as well. We all know that it is very important to advise the medical providers of all our complaints so that the physician can give us the proper treatment but it is equally important to your claim for benefits as well.

When the insurance company is investigating a claim they not only take statements from the injured party and witnesses they also inspect the medical records. They are looking to see what was said in the medical records as to how the injured employee reported they were hurt and to what body parts they identified as being injured.

For this reason, when you report to any medical provider be clear and detailed when discussing the nature of your injuries and how they occurred. Always, identify where you were hurt and if there was anything unusual that caused your injuries.

When an injured employee comes to my office and the insurance company has either denied their claim completely or they do not wish to provide medical treatment to a specific body part, one of the biggest hurdles I find is that the accident or injury was not reported in the medical records until several weeks or months after the initial date of injury. Insurance companies scrutinize these records and if it is not in the medical records they have a difficult time compensating the injured employee.

Moreover, and most importantly, if it is necessary for your case to go to trial the medical records are one of the most compelling pieces of testimony that will be entered in at trial. When being evaluated by the Deputy Commissioner they are given greater weight as they are written by a third-party that has no stake in the claim.

More importantly it is a long established principle that people are most honest when they are reporting their physical complaints to physicians as they want to get better and the physician needs all the information that he can get to make a proper diagnosis. Remember, this practice is recommended not only for your first visit or with just the emergency room – continue to repeat this information for every appointment.

This article has been prepared for informational purposes only and not as legal advice. The reading of this article does not constitute an attorney-client relationship. An attorney-client relationship does not begin until the attorney is hired to represent your claim in writing. Please do not act upon any information read within this article without first seeking legal counsel within your state.

By: Benjamin T. Cochran

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Workman’s Comp is a benefit system that was established decades ago to safeguard workers in the event they became hurt on the job. Fundamentally, the system works like this: when a worker becomes injured, rather than sue their employer (which around the turn of the century was the only option available to an injured worker), an employee can file a claim that provides for the following:

1. Protection of the worker’s job (an employer cannot fire an employee simply because they are injured)

2. Continuation of the worker’s pay while the worker is injured.

3. Payment of medical expenses (usually including the cost of emergency care, necessary surgery, and rehabilitative services).

Workman’s comp essentially relies on the concept of employer liability for job injuries and work related illness but with no fault. In other words, the way the workman’s comp system is setup (regardless of the state in which a worker lives), the benefits flow in two ways.

On the one hand, an employer will provide an injured or sick worker certain benefits that are normally covered under workers comp (which normally includes medical care, payment of a certain
percentage of a worker’s wages, and, in many cases, the continuation of certain benefits); on the other hand, the employer will not normally face litigation for work related injuries or illness.

In many unfortunate situations where a workplace accident or injury has occurred, workman’s comp can ideally provide an injured worker with necessary medical care and replacement income during the time for which the worker is unable to work. However, not all situations are ideal. In such instances, a worker may have difficulty with an employer or the employer’s insurance carrier (for all intents and purposes, the two entities are, in a workman’s comp claim, one and the same). And the rational for this is, sadly enough, fairly clear. Each time an employer’s insurance carrier is forced to “payout” on a claim, the cost of the employer’s insurance premium rises. In other words, the interests of the employer and the injured worker are sometimes, if not often, at odds.

What should you do when you’ve been injured on the job and learned that your workman’s comp insurance is reluctant to pay? Get a consultation with an attorney who specializes in this type
of labor law. Because when an insurance company’s financial interests are in opposition to your own, it makes perfect sense to be fully armed, in a legal sense.

By: Timothy Moore

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For many employers, worker’s compensation insurance isn’t as much of an issue because so many of their employees work at a desk. Sure, there might be some risk of carpal tunnel syndrome, but for the most part desk workers won’t get seriously injured from their jobs. But what about employees who work in construction and mining, industries that are quite prevalent in Florida and West Virginia, (respectively)? For them worker’s compensation insurance is a necessity.

And, when it comes to West Virginia, the mining industry has been very receptive to the issue. This is largely because in the past West Virginia offered worker’s compensation through state-run programs. This made things much easier for employers.

Florida does not have the same track record. According to research done by FIU, approximately 42 percent of all construction workers do not have workman’s comp. This is despite the fact that the state has legally mandated the insurance.

Why would so many construction companies skirt the law? Well, in their defense, it’s not always a malicious situation. Some businessmen believe that if you hire a subcontractor you don’t have to worry about workman’s compensation insurance; they believe that’s only a requirement for ‘real’ employees. However, when it comes to Florida law, subcontractors must be offered the insurance, even if a company is only working with one at a time.

So, as you can see, quite a few employers in Florida will need to get worker’s compensation insurance for their employees or subcontractors. Yet, don’t think that West Virginia is out of the picture. In recent times the state has decided to transition to privatized workman’s comp programs. This means employers will lose some of the convenience they may have had before with the state-run policies.

But if you happen to be running a company in these states, don’t fret because there are plenty of workman’s comp plans that are affordable. You just have to find them, a process that isn’t too hard thanks to the Internet. All you really need to do is fill out a 2-minute form. After that you will be sent a free quote within minutes.

In fact, you may want to consider doing this even if you’re a sole proprietorship. Granted, sole proprietors aren’t legally required to have workman’s comp on themselves, but if something happens they are given some compensation. West Virginia provides $33, 100, while Florida gives $48,900.

By: Alan Rahab

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When a lot of people think of Iowa, they think that it is a state covered in corn fields and that is it. There are a lot of great things to do and see in the Des Moines area according to a Des Moines workers comp lawyer that practices there. This article will discuss some of the great attractions and sights to see in this great Midwestern city and why you consider planning a trip to see it. A Des Moines workers comp attorney recommends going in the summer when the weather is beautiful or maybe even during the exciting Iowa caucus time if you are a political junkie.

If you are interested in the arts, there are a few places you can see some wonderful performances in Des Moines. The Civic Center of Great Des Moines regularly has Broadway shows and other levels of great live theatre there. They also have several options to see the opera, ballet and symphony at different locations in the city. If you love art, the Art Center is a great place to see beautiful art exhibits as well as areas where you can do some hands on learning too. The latest addition to the arts scene there is the Papa John Sculpture Park which is an outdoor art museum that was completed in September of 2009.

If you are interested in sports, Des Moines has some fun events to see there including a minor league baseball team, the Iowa Chops which is an AHL hockey team, the Iowa Energy which is a NBA development team and the Iowa Barnstormers which is an arena football team. Although, the sports are not as high a level as in some cities, the action, venues and the fans are all quite big in Des Moines. One of the best known sports events that happens every year the Drake relays held at Drake University which attracts the top collegiate track and field athletes from all over the nation.

If you are a history fan, take a tour at the capitol building that houses a WWII memorial, a smaller scale of the USS Iowa and an 1894 Soldiers and Sailors Monument. If you want to learn more about the state of Iowa, you can visit the State of Iowa Historical Museum. The Jordan House is another stop to see for some more interesting history of the area. It is a Victorian home that was built in 1850 and was once part of the Underground Railroad.

Some fun attractions are the Blank Park Zoo, East Village and Adventure land Park. The zoo is a beautiful park featuring a tropical rain forest and it sits on 22 acres of land. The East Village is a fun area located along the river is a great place to window shop at unique boutiques, fun restaurants and cafe’s and beautiful homes. Adventure land Park is an amusement park located just outside the city that has all of the fun rides and roller coasters you want.

By: Connor R Sullivan

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A victim of an accident or other mishap while working on the job must get the legal representation of a worker’s compensation lawyer in order to help them file the appropriate claims against their employer or the state worker’s compensation system. Although the employee may have some concern that he or she is jeopardizing their job, this is sometimes your only recourse. Therefore, finding a suitable worker’s compensation attorney should be your fist course of action after receiving intial treatment for your injuries.

Your lawyer will know exactly what you should be entitled to as they will have spent many long years learning the complexities of your states worker’s compensation system, including what type of compensation is available, and who bears responsibility for the costs of these injuries. The first thing you will need to do is locate an attorney who is competent in the field of employment law and worker’s compensation in your state. Personal qualifications are as important as your attorney’s knowledge of this specific area of the law, so you will need someone who you feel confident will handle this matter appropriately and with complete competence.

Any on the job accident that may happen to someone can vary from an automobile mishap, a slip or fall, or a construction site or manufacturing plant injury. A qualified attorney will provide many services to the injured worker including gathering all of the necessary information, and preparing all the necessary paperwork in order to get the claims process started. Your attorney will then follow up by appearing at all hearings and meetings required to further your worker’s compensation rights.

Your attorney will also understand all of the complexities involved including any medical issues relating to your case. There will always be several factors in determining what type of compensation you may be entitled too, and how your attorney will have to proceed to maximize your recovery. The chance of you winning a compensation case without the enormous experience that you will get from a worker’s compensation lawyer is small and even if you do, will you get as much as you deserve?

You may also be concerned about the legal fees in this matter. Many injured employees will fail to pursue a legitimate claim because of these fee concerns. This should generally not be a concern with a worker’s compensation cases, as most worker’s compensation attorneys will usually pursue you claim on a contingency fee basis. This means that they will not charge any fees up front, but will collect a percentage of any money which you are awarded. In some states this percentage fee may even be capped, allowing you to maximize your recovery.

First and foremost, when choosing a worker’s compensation attorney, do you homework. Make sure that you do as much research on the internet as you can, and always meet with and interview an attorney before signing any binding agreement.

By: Harry Bernstein

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Worker’s Compensation Insurance for construction-related framing contractors has always been expensive. Danny Harter, owner of DH Framing already knew that much because he faithfully carried this insurance in order to work in legal compliance with State insurance requirements. But what Danny wasn’t expecting – to be suddenly cancelled by his Worker’s Compensation Insurance carrier – happened in November, 2004 – all because “out of the blue,” his insurance carrier simply decided that his company was “too small” for their interest. Danny had two employees, including himself, and a weekly payroll between $1,500 and $2,000.00.

Danny was notified of his cancelled workers comp policy when the client he was busily working for one morning, came up to him and said, “You can’t work on this job – I’ve got a notice here that you don’t have valid Worker’s Comp Certificates with your insurance carrier anymore.” How embarrassing!

Danny obviously lost time on the job, and income. But he did what he needed to do, and immediately started contacting insurance carriers, trying to find someone who would not consider him “too small,” or otherwise, undesirable. After all, he was and still is a successful, hard-working small businessman. Shouldn’t someone be interested in writing his business?

To no avail, Danny could not find an insurance carrier that would underwrite his business. Fortunately, he contacted an insurance agent who just happened to know about the Worker’s Comp Co-Op. “Call these guys,” the insurance agent said. And Danny did. I picked up the phone and talked to Danny about his business, and what happened to him.

Within one week, Danny and his employee were not only back on the job with the client who had to stop his work – he also had payroll services and worker’s comp insurance coverage without those big deposits you have to put down with traditional insurance agents. So Danny saved not only saved his business. He saved additional, unnecessary hours – weeks – of downtime on the job, and those huge upfront fees.

By: Gary Rifkin

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New workers comp laws in Texas have some healthcare professionals changing the way they practice medicine and the injured workers are caught in the middle.

Early in 2006, the Texas Workers Comp legislation made extreme changes from their past operational methods. Certified networks have been established, affording better discounts for employers and insurance carriers.

Healthcare professionals in Texas have major decisions to make as far as how they are going to run their practices. Many have opted out of workers comp altogether, while others are attempting to be a part of these networks, only to be turned away with the statement “our panel is full”.

In researching these provider databases posted by the Networks/Carriers, we have found many descrepancies in providers that are listed, but are not taking work comp cases, or in some cases, it appears that company doctors or company owned medical centers, make up the majority of the healthcare panel, offered to patients and employers. It hardly seems fair, that consumers and injured workers are forced to go to providers that are not of their choosing.

New workers comp laws in Texas have some healthcare professionals changing the way they practice medicine and the injured workers are caught in the middle.

In many states there is an “any willing provider” law that allow any healthcare professional that is willing to take the insurance carrier discounts, may participate in any insurance plan without fail. Unfortunately, Texas is not one of those states.

Providers in most cases are at the mercy of these networks. Many times, former patients try to come in for care only to find that their carrier/network has not allowed their provider to be included for whatever reason. this has been very disturbing to many patients that we have spoken to. In some cases, patients may speak to their HR department or write letters to their insurance carriers, asking for their chosen provider to be allowed in their network. In some cases with some carriers, this may work.

Some healthcare specialties, chiropractors in particular, are forced to apply for network participation through outside entities to even be included in the panels with major carriers. Once again, these providers fight and struggle to be a part of these networks and are not allowed to participate due to the old statement “our panel is full”.

In this day and age of consumer rights, it seems to the author, that all providers should be allowed to participate in which ever network they choose to participate in if they meet the state criteria for participation and are willing to accept the discounts offered by these carrier/networks. Providers are loosing patients on a daily basis and loosing money that is necessary to continue to offer affordable healthcare to their patients. We have even found in our research where some medical doctors are even going back to “cash” practices because they are so disillusioned with the healthcare systems we are force to accept.

As a consumer or injured worker, the only answer to make sure you get to see the provider you wish to have treat you is to stand up and speak out to your legislators, employers and your congressmen.

By: Michele Graham

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What is your hand worth? According to the Illinois Workers’ Compensation Commission, the maximum value of a hand lost at work (for a worker who makes the average Illinois annual salary of $42,754.40) is $168,551, whereas that same hand would be worth $156,218 in Iowa and $143,885 in Nebraska.

In Illinois workers’ compensation law, the value of human body parts is determined by an actuarial analysis of probabilities and future values of injuries. The values are continually adjusted to keep up with inflation and changes in the economy. The Illinois Workers’ Compensation Commission uses the fixed values of body parts in order to strike a fair balance between compensating workers without driving insurance companies into financial ruin.

Workers’ Compensation Overview

Workers’ compensation is one of the first examples of tort reform enacted in the United States. Before workers’ compensation law, people hurt at work were faced with two unpleasant alternatives: (1) they could either file lawsuits against their employers or (2) they could suck it up and pay for their own injuries.

Now, employers in every state but Texas are required to hold workers’ compensation insurance. When people are injured at work, it is almost as easy to file claims within their states’ workers’ compensation systems, as it is to file insurance claims after car accidents.

In order to ensure that injured workers, employers and insurance companies are all treated fairly, the Illinois Workers’ Compensation Commission continually makes changes to the Illinois Workers’ Compensation Act.

Below is an overview of the most recent set of changes to the Illinois Workers’ Compensation Act, which took place in July of 2005.

Fraud Statute Established

Any party involved in committing fraud relating to a workers’ compensation dispute is guilty of a Class 4 felony and must pay complete restitution in addition to a fine. In addition, those who knowingly receive benefits by making false workers’ compensation claims can be liable for either three times the value of benefits wrongfully obtained or twice the value of coverage attempted, plus attorney fees required to bring the claim.

Penalties Increased for Uninsured Employers

Employers who fail to purchase workers’ compensation insurance are guilty of creating an immediate and serious danger to public health. As a consequence, a work stop order can be imposed, requiring the cessation of all business operations until the employer obtains proof of workers’ compensation insurance.

Furthermore, a knowing failure of an employer to provide workers’ compensation insurance coverage is considered a Class 4 felony, and each day’s violation constitutes a separate offense.

Medical Fee Schedule Established

The Commission has established a medical fee schedule, setting maximum medical fees that employers are liable for. The maximum fees are 90% of the 80th percentile of charges in a certain geographic area. If a worker’s medical bills are less than what is established by the fee schedule, then the employee will receive full workers’ compensation coverage for those bills.

Benefits Increased and Changed

The Illinois Workers’ Compensation Commission sets maximum compensation for specific work injuries. As of February of 2006, the maximum compensation that a worker can receive as the result of a death injury is the greater of $500,000 or 25 years worth of salary. This is higher than the previous maximum (the greater of $250,000 or 20 years).

Expedited Hearings

When an injured worker is not receiving any compensation for an injury from his or her employer, that worker can request an expedited hearing. An employer can also request an expedited hearing if a worker continues receiving compensation until a judgment is rendered and the employee has been released back to work.

Utilization Review Established

If an employer has reason to believe that an inured workers’ medical treatment was unnecessary or unreasonable, the employer can have the case evaluated at a utilization review. In order to qualify for a utilization review, employers must register with the Department of Financial and Professional Regulation once every two years.

Happy Employees, Employers and Insurance Companies

The Illinois Workers’ Compensation Commission strives to reach fair results for all parties involved in work injuries. Illinois workers compensation laws benefit employees by providing fast compensation for injuries without the stress of filing lawsuits. Employers benefit from workers’ compensation insurance coverage, because it eliminates the risk of lawsuits brought by injured employees. Even insurance companies benefit from workers’ compensation law, because it sets maximum rates, which reduces the chances of unreasonable payouts. Furthermore, when insurance premiums paid by employers are invested at favorable rates, insurance companies can actually stand to gain the most from the Illinois Workers’ Compensation system.

By continually adjusting the Illinois Workers’ Compensation Act, the Illinois Workers’ Compensation Commission is reaching fair results for all those involved in work injuries.

Fixed maximum benefits for specific injuries can be found at: http://findgreatlawyers.com/HotTopics/WorkersComp/15ChangestoAct.htm.

By: Emily Gleason

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