Below, we’ve put together a list of some of our clients’ most frequently asked questions about their workers’ compensation cases. The goal of our work comp attorneys is to provide you with the information you need to stay informed throughout the process. If you have questions about your workers’ compensation claim, we are here for you.
Eligibility for Benefits
- Do I qualify for workers’ compensation benefits? If you suffered an injury at work while performing some duty connected to your employment, you most likely qualify for work comp benefits.
- How long do I have to give my employer notice of my injury?
You have 45 days from the date of the injury to give notice to one of your supervisors, but do so as soon as possible.
- How long do I have to file a claim? Generally, you must file a claim with the IWCC (not just the work comp carrier) within three years of the date of your accident.
- What if my injury occurred gradually over time? If your injury occurred as a result of repetitive job duties, your claim would be compensable.
- If I’ve had a prior injury to the same body part, can I still file a claim? Yes. The work comp carrier would still be responsible for paying any benefits resulting from a new or more extensive injury to that body part.
- Do I have to show that my employer was negligent? No. Work comp is no-fault, so you don’t need to show that your employer was negligent, and your employer can’t allege negligence on your part as a defense to payment of benefits.
- Who pays my medical bills?The work comp carrier should authorize and pay for the medical treatment recommended by your treating physicians.
- Do I have to treat with my employer’s doctor?No. You are free to treat with any two doctors of your choosing, and anyone they refer you to.
- Workers’ compensation denied my claim; can I still seek treatment?Unfortunately, it is not uncommon for workers’ compensation to deny a claim, at least during the initial stages. This denial of benefits means the necessary medical treatment for your injuries will not be approved. However, this does not mean you cannot, or should not, seek immediate treatment. Always seek medical treatment right away for your injuries. If you have group insurance, whether it be through your employer or not, you can have your medical providers authorize the necessary treatment through your group insurance until your workers’ compensation claim has been approved.
- What is a nurse case manager?A nurse case manager is a nurse hired by the workers’ compensation insurance carrier to be involved with the employee’s care and treatment related to the work injury. Typically, nurse case managers will discuss the employee’s care and treatment with the employee and his or her treating physician, coordinate the scheduling of appointments, and draft reports summarizing the medical care and treatment, which are then sent to the workers’ compensation carrier.
- Who pays my wages while I’m off work?The work comp carrier should pay ⅔ of your average weekly wage for each week you are off work per your treating physician.
- What if I’m on light duty but my employer can’t accommodate my restrictions?You should be paid ⅔ of your average weekly wage per week by the work comp carrier, the same as if you were off work.
- Do I have to use my sick days or FMLA while I’m off work?You don’t have to use your sick days while off work for a work injury. However, your employer may require you to run your FMLA time concurrently.
- I suffered an injury at work and workers’ compensation isn’t paying me weekly wages. Can I apply for unemployment?Yes, provided your treating physician has you on light duty restrictions, and your employer either cannot accommodate your restrictions, or you’ve been terminated. In order to be eligible to apply for unemployment, you must be able to perform some form of employment. Therefore, if your doctor has you off work entirely, you aren’t able to perform any work, and you would not be eligible for unemployment.
Independent Medical Examinations
- What is an independent medical examination?An IME is an examination you attend at the request of your employer with their doctor to evaluate various aspects of your injury and recovery. Prior to the appointment, the doctor will review the medical records provided by your employer, including any available diagnostic imaging. At the IME, the doctor will perform a physical exam and ask you questions regarding your injury and treatment. After the exam, the doctor will draft a report answering any questions your employer has asked the doctor to address.
- Do I have to go to the IME? What happens if I don’t attend?Pursuant to Section 12 of the Workers’ Compensation Act, your employer has the right to require you to be evaluated by a physician of your employer’s choosing, and you must attend. Because the Act mandates your attendance, your employer is permitted to stop issuing benefits if you fail to attend the IME without justification.
- The IME report is in and the doctor disagrees with my treating physician. Is my case over?No. It is not uncommon that an IME doctor disagrees with your treating physician on whatever issue or issues were in question. Where there are differing opinions between your treating physician and the IME doctor, then your case boils down to determining which doctor’s opinions are most credible.
- Am I entitled to any compensation at the end of my case?Most likely, yes. In addition to payment of your medical bills and weekly wages while you are off work, you may be entitled to an award for permanent partial disability. Permanent partial disability awards compensate employees who are able to return to work, but continue to experience symptoms or difficulties as a result of the injury. In most circumstances, if you’ve suffered a compensable work injury, you are entitled to an award for permanent partial disability.
- Someone I know had the same injury…why did they get more money?No two cases are exactly alike. There are multiple variables that come into play when determining the value of a case, other than just the type of injury, so permanent partial disability awards for the same injury can vary widely. It is also important to note that permanent partial disability calculations are based on your average weekly wage, so employees with higher average wages will receive more than employees with lower average wages, even if all other factors are the same.
- Why can’t you tell me what my settlement will be at the beginning of my case?It’s impossible to know from the outset what kind of treatment you will undergo and how well you will recover from your injury. Because the value of permanent partial disability is heavily dependent on these factors, permanent partial disability values can’t accurately be estimated until near or at the end of your course of treatment.
- If I file a claim, will I be fired? No. Retaliation for exercising your work comp rights is prohibited by the statute.
Fees & Expenses
- How are attorney fees paid in work comp cases? We are paid 20% of any disputed benefits we recover for you. You pay nothing up front and in the unlikely event we don’t recover anything for you, you don’t owe any fees.
A workers’ compensation claim is often a complex process, and the most seemingly straightforward cases often become complicated and frustrating for the employee. If you’ve been injured in a workplace accident, you no doubt have questions.
Contact Woodruff Johnson and Evans at (630) 585-2320 to discuss any questions you have and see how we can assist you with your workers’ compensation claim.