In representing injured workers, we deal with a complex body of law that was not drafted in favor of the injured employee. Representation of someone injured on the job requires special skill, dedication, motivation, and passion to see that the workers compensation insurance companies pay every single penny they’re obligated to pay. During our free initial consultation, one phrase that stands out among others based on the frequency with which we hear it is, “I’m not looking to get rich. I just want what’s fair.” Well, that’s a very commendable perspective to hold. Our perspective is every bit as commendable; but quite different in terms of how aggressively work claims are handled. The depth of our experience in representing injured workers provides a mindset in which we hope for the best and always prepare for the worst. We’re well aware of the fact that every work comp case is likely to be an uphill battle. Getting “what’s fair” can be more difficult than most people realize. So, from the moment we undertake representation, we work to ensure you get every single benefit you’re entitled to.
To help you understand what workers compensation is and how it works, the following questions and answers will help clarify any confusion. We encourage you to contact our office for a free consultation. We can be reached at (727) 853-6275 or through our website at www.dolmanlaw.com.
1. What is workers compensation? Workers compensation is insurance coverage that certain employers are required to purchase. It provides for medical care and lost wages when an employee is injured in the course and scope of their employment.
2. What injuries qualify for workers compensation benefits? This is more easily answered by explaining that the ONLY injuries not covered under workers compensation are those that result from an entirely off-the-job accident that is not work related in any way, whatsoever. Depending on the circumstances, you can be covered if there is a connection between the activity you were engaged in at the time of the injury and the nature of your employment. Not all workers compensation claims arise from accidents that occurred on the employer’s premises. Not all individuals eligible for work comp benefits experienced a chain of events that encompasses a direct causal link involving the nature of their employment, the accident, and the resulting injuries.
3. What is the time limit for filing a claim? Generally, two years from the date of accident, or date of last injurious exposure. However, there are a few exceptions. If you are curious to know whether any exception applies to you, contact us today.
4. What benefits are available through workers compensation? Medical care for the work related injury or injuries. The medical care could be as minimal as an ointment and bandage for a minor abrasion to as invasive as numerous surgeries involving instrumentation and requiring prosthetics. In addition to the medical care referenced above, lost wages are another benefit available through workers compensation. These are paid whenever someone injured on the job is determined to be on a no-work status by their authorized treating physician, or released with physician restrictions that their employer cannot accommodate. So long as they have not reached maximum medical improvement, or already received 104 weeks, (2 years worth) of wage loss checks, they are eligible.
5. What percentage of my wages will be covered? The percentage depends on whether you’re placed on a no work status or released to work with restrictions that your employer cannot accommodate in the form of finding another type of job for you. When on a no-work status, you’re eligible 66 2/3 of your average weekly wage (AWW). Your AWW is determined by adding the gross earnings for the 13 weeks before your work accident and then averaging the total. The figure is then multiplied by .6667 to obtain your temporary total disability (TTD) rate, the weekly rate you’re to be paid when on a no-work status. The other percentage is also determined by starting with your AWW. It applies when you are released to work with restrictions but your employer has no job available that would accommodate those restrictions. It can also apply if your employer simply tells you they don’t want you back until you’re 100%. These benefits are called temporary partial disability payments (TPD). You take the total from your AWW, multiply by .80, add any earnings from concurrent employment, and then multiply by .80 again. This is your TPD rate.
6. Am I allowed to take legal action against my employer for the injury? Only if your employer deliberately intended to injure you or otherwise knew or should have known that they were placing you in circumstances that were virtually certain to result in your injury or death. Taking legal action against your employer requires overcoming a very high evidentiary threshold. Legal action is taken against your employer’s workers compensation carrier if they fail to provide workers compensation benefits at all or in a manner that is not timely.
7. What if the injury was my fault? Am I still covered? Fault does not have the same degree of significance as it might in personal injury cases when it comes to determining eligibility for work comp benefits. There is an exception – if you were engaged in activity that would represent a substantial deviation from your job duties at the time of the accident, then there is an argument that you are not entitled to work comp benefits. Also called “horseplay,” you would not eligible for benefits if the activity you were engaged in at the time of your accident represented a wholesale abandonment of your job duties and employer’s interests.
8. Is my job in jeopardy if I file a claim? Employers are prohibited from terminating or threatening any employee who makes a valid claim for workers compensation benefits. Most employers realize that firing someone who files a work comp claim puts them at risk of being sued for retaliatory discharge. The easy answer to this questions is no; your job is not at risk. However, the work environment you experienced before your accident may not be the same after your accident.
We’ve seen both ends of the spectrum; employers that continue to work with employees as they treat for their work related injuries, and employers that not so surreptitiously make the employee’s work environment mentally stressful, uncomfortable, or otherwise not where the employee wants to be. For circumstances like these, the Dolman Law Group encourages you to contact us for information about how to best handle the situation. Call us today at (727) 853-6275.
Dolman Law Group
5435 Main Street
New Port Richey, FL 34652