What Is the Purpose of Workers’ Compensation?
Are you unable to work because of a workplace injury or illness? If so, you are likely concerned about what to do next and how you will pay your bills. Workers’ compensation benefits can help by covering your medical expenses, replacing a portion of lost income, and more. In Indiana, most employers must provide some form of workers’ compensation lawyer insurance to protect their employees in the event of work-related injuries or illnesses.
Workers comp has been around for a long time
Workers compensation laws were passed many years ago by states as a way to act as a “compromise” of sorts to make sure injured workers have access to medical care and some pay while recovering from most workplace injuries. In exchange for these “benefits,” the employee is not able to sue their employer for any negligent conduct that may have caused the injury.
A brief history of workers compensation
The original intention of workers compensation insurance was to provide wage replacement and medical benefits to injured workers so that they could recover and return to work in a timely fashion. Workers compensation laws, which were originally passed in the early 1900’s, were developed to provide protection for both workers and employees. The worker would receive coverage of medical expenses and partial wage replacement while the employer would know that their employee would not be suing them for more than the injury warranted. While the laws are in place to conform to these intentions, there are still times when blame can be assigned and a lawsuit is warranted
As an eligible employee, you have access to workers’ comp coverage the day you start working, so you can seek workers’ compensation benefits regardless of when you get injured as long as it’s work-related.
However, the benefits available vary depending on the circumstances and could include:
- Medical benefits. Medical care is expensive, and no one should avoid seeking proper treatment for a workplace injury because of the expense. Workers’ compensation should cover all reasonable and necessary medical expenses stemming from your workplace injury. These expenses could include the costs of doctor’s visits, physical therapy, and medications.
- Wage replacement benefits. This is a vital workers’ compensation benefit because it ensures you receive at least a portion of your pre-injury income to cover your bills while you’re too hurt to work. These benefits are subject to a monetary cap based on the statewide median wage.
- Permanent disability benefits. If you suffer a permanent impairment due to a work injury, these benefits compensate you based on the impairment’s nature, location, and severity.
- Vocational rehabilitation benefits. If you cannot return to your usual job after a work-related injury, vocational rehabilitation benefits can help you get and train for another position.
- Death benefits. In Indiana, dependents of an employee who passes away due to a workplace injury can seek compensation in the form of death benefits. These benefits provide income replacement and funeral expense reimbursements to surviving dependents.
Types of Disability Benefits Available in Workers’ Compensation Cases
The four key categories of disability benefits in the workers’ compensation system include:
- Temporary partial disability benefits. When you can still work in a limited capacity after an occupational injury, you could receive temporary partial disability (TPD) benefits. TPD benefits make up for part of the difference between your pre-injury and post-injury income. Typically, you can get TPD payments until you can return to full-duty work or reach maximum medical improvement (MMI), meaning your condition is unlikely to improve with further treatment.
- Temporary total disability benefits. You might qualify for these benefits if an occupational injury prevents you from working for an extended period, but your doctor expects you to recover enough to return to work eventually. Temporary total disability (TTD) benefits provide up to two-thirds of your weekly income from before the injury. In Indiana, you can receive TTD benefits for up to 500 weeks or until you reach MMI.
- Permanent total disability benefits. You could qualify for this category of benefits if a work-related disability prevents you from returning to gainful employment in any capacity. If you have a permanent total disability, you could receive up to two-thirds of your average weekly income in benefit payments, sometimes for life.
Many factors that come into play when determining which workers’ compensation benefits you can claim. This means you might struggle to make ends meet or plan for your financial future after a workplace injury. Working with an experienced workers’ compensation lawyer is the best way to resolve this confusion and demand the benefits for which you are eligible.
When is a third-party lawsuit warranted?
Workers compensation statutes are designed to eliminate the need for litigation. However, there are times when a work accident occurs and blame can be assigned to a third party – not the employer. In these cases, you should consult with an experienced workplace attorney to help you understand your case and determine the best steps to take to pursue a personal injury claim and recover what you are entitled to.
Workers compensation is mostly compulsory in the United States
In the U.S. some form of workers compensation is required by most employers (in most states). In Indiana all employees must be covered by workers comp insurance. Businesses purchase workers compensation insurance from commercial providers, although some approved businesses may opt to self-insure.
How to File a Workers’ Compensation Claim in Indiana
In Indiana, after you notify your employer about a work-related injury, your employer should file a report of injury form with the Indiana Workers’ Compensation Board. Then, you can seek reimbursement for medical expenses and claim wage replacement benefits if necessary. Failure to notify your employer within the appropriate timeframe could result in the denial of your claim.
How to Appeal a Denial of Your Claim
One of the first steps in appealing a workers’ compensation claim denial is to understand the reason for the rejection. If the other side denies your claim, you should receive a letter explaining why they denied it.
Some common reasons for workers’ compensation claim denials include:
- Your injury is not work-related
- You did not report the injury within the required timeframe
- Your injury is not severe enough to qualify
After you review your denial letter, you should consult an attorney who can help you begin the appeals process right away.
Typically, when seeking to appeal a claim denial, you must:
- Hire a workers’ compensation lawyer. Your attorney can handle almost everything else on this list for you.
- Gather evidence. The right evidence will help you refute specific assertions in your denial letter. For instance, it’s a good idea to gather evidence such as medical records, witness statements, and anything else that shows the other side shouldn’t have denied your claim.
- Informal dispute resolution process. The Board offers a variety of ways to resolve disputes, including through an informal process that doesn’t require a hearing. If you don’t like the outcome of this informal process, you can apply for an adjustment of claim. Once the Board receives your application, they will schedule a hearing to resolve any outstanding issues.
- File a formal appeal. If you disagree with the outcome of the adjustment hearing, you can file an appeal or request a full Board review. However, remember that this process is time sensitive. After getting the results from the hearing, you have a limited time to file an appeal.
- Attend hearings. The Board should schedule your hearing for the next full Board meeting. These meetings usually occur every three months. During the hearing, your attorney will present your side and provide supporting evidence.
Appealing a denial is difficult, so get in touch with an experienced lawyer right away.
An experienced workers compensation attorney will know what benefits you are legally entitled to
If you’ve been injured at work and believe you are entitled to workers compensation benefits, you can file a claim through the Workers Compensation Board of Indiana. It does not matter if you are to blame for the accident or not, and you are not legally permitted to sue your employer. If you are filing a workers compensation claim and believe you may have grounds for a third-party (personal injury) lawsuit, contact an experienced attorney in Indianapolis for a free consultation.
We care about fighting for the rights of injured persons and workers throughout the state of Indiana. With offices in Evansville, Indianapolis, Lafayette, New Harmony, and Jeffersonville (Louisville, KY), we are well-equipped to handle your case.