Workers’ Comp FAQ
These are a few of the more commonly asked questions around Workers’ Compensation that we see at Edwards & Kautz:
What Is The Workers’ Compensation Claims Process From Start To Finish?
When you have been injured on the job, the first thing you must do is report the injury to a supervisor. The supervisor is then required to report this injury to the employer’s workers’ compensation insurance company. Once the insurance company receives word of the injury, they will establish a claim for the injured worker.
Once the insurance company investigates the incident, it should pay for medical services for the worker which are reasonable and necessary. Additionally, they should pay the worker if he has been taken off of work by his treating physician.
After a worker has healed from his injuries, he may be entitled to benefits if he has suffered from a permanent injury. This could include weekly monetary benefits and/or future medical expenses.
If the workers’ compensation insurance company is unwilling to provide these benefits, the injured worker’s remedy is to file a workers’ compensation claim with the Department of Workers’ Claims, an administrative agency here in Kentucky.
Once a claim is filed, a workers’ compensation judge will be appointed to preside over the injured worker’s claim. After a final hearing is held, this judge will ultimately make two decisions: (A) Was the worker injured on the job? And if so, (B) What is the appropriate compensation?
How Can I Expect My Workers’ Compensation Claim To Go?
The most important key to success for any workers’ compensation claim is dependent on the worker reporting the injury to their supervisor as soon as possible. Many times, a worker will not tell their supervisor of an injury because they believe the symptoms will go away or they fear losing their job. The longer the injured worker waits to report the incident, the more difficult it is to connect the injury with the work incident.
If an injured worker reports his or her injury as soon as possible to their supervisor, it will greatly improve their chances of a successful claim.
Is There Such A Thing As Pain And Suffering In A Workers’ Compensation Claim?
There is no pain and suffering compensation in a workers’ compensation claim. Normally, when you initiate litigation against a person or a company, or in other words, “sue them,” you have to prove they did something wrong or that the incident which injured you was their fault.
When you are injured on the job, however, you don’t have to prove it was anyone’s fault. All you have to prove is that you were injured “within the course and scope of your employment.”
So, even if you made a mistake that led to injury, you can still recover. That’s the advantage to workers’ comp.
The disadvantage is that workers’ comp is the only remedy you have. You can’t sue your employer in regular civil court if you get hurt on the job. Additionally, you don’t have the right to a jury trial where you could argue for damages such as pain and suffering.
The employer has immunity from this type of lawsuit since they are required to pay for and provide workers compensation insurance coverage to their employees.
Will I Be Repaid For All My Lost Wages?
That depends. If you have been unable to work due to a work-related injury AND a doctor has taken you off of work during this same time period, you could be entitled to receive what’s called Temporary Total Disability (TTD) checks. These checks will be two-thirds of your average gross pay from your employer. Not two-thirds of your net or “take-home” pay, but two-thirds of your gross pay (before taxes are taken out). These checks are designed to replace your normal income while you are recovering from your injuries.
Again, it’s not enough that you were unable to work. You also need a qualified expert such as a doctor to advise against working during this same time period. In other words, you need your doctor to back you up on your inability to work.