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We apologize for any inconvenience. There is a statutory waiting period of seven calendar days for workers' compensation benefits. NYSIF must begin payments within 18 days after the onset of disability.
Subsequent benefits are paid bi-weekly. By Bill Fay March 20, A lot is determined by which state you live in and whether your claim is approved. If it is, you should start receiving compensation checks within a month of the accident. The good news is the immediate medical bills should not be a worry.
Employers in most states are required to pay medical bills before your claim is decided. You deserve to be compensated fairly. Find out your rights and discover what your claim is worth.
You must first file a claim as soon as possible after your injury. Your employer, its insurance company or a state compensation agency will determine whether to approve the claim. Laws differ from state to state, but in general, the entity hearing the claim must respond within two to four weeks. Some states allow insurance companies to ask for extensions if they need more time to investigate the accident.
Even if your claim is accepted, most states require doctors to certify you are unable to work. In general, the wait it two to four weeks after your doctor certifies you are unable to work. Rules also vary on the amount you will be paid. There is nothing more the DWC can do for you at that point, but other types of assistance may be available:. You should also be aware that the federal Americans with Disabilities Act ADA prohibits discriminating against those with physical or mental impairments that substantially limit one or more life activities, and who can perform essential job functions.
An employer is required to provide a reasonable accommodation if it would not impose an "undue hardship" on them. For more information on FEHA call The voucher does not expire if issued prior to Jan. If issued on or after Jan. The workers' comp system seems very confusing. Should I get an attorney? That's a question you have to answer for yourself. The vast majority of workers' compensation claims are resolved between injured workers and claims administrators with no problems.
You're not required to have an attorney, even if you have a disagreement with the claims administrator. However, if your case is complex you may benefit from having one. Your attorney can't directly charge you for his or her services. Your attorney's fee will be paid out of a portion of your workers' compensation benefits. Even if you decide to hire an attorney you should educate yourself about your rights and responsibilities, stay in communication with your employer and claims administrator and don't be afraid to ask them questions.
I'm having a problem getting my benefits. What resources are available to me? I'm disabled and need assistance in order to use DWC services. Is there any help available? If you have a disability and are using the services of the Division of Workers' Compensation you may be eligible for a reasonable accommodation. A reasonable accommodation is assistance given to disabled individuals to promote equal access to and participation in our programs and services. You can find out more about reasonable accommodation, including how to request one, at the disability accommodation page.
Besides workers' compensation benefits, can I get any other financial assistance? If you have an attorney, he or she should be keeping you up to date. The DWC also has a call center through which many calls to local offices are routed. The call center staff is also fully equipped to give you status updates on your case. Topics covered in this FAQ include: The basics About employer responsibilities About medical care Temporary disability benefits Permanent disability benefits Returning to work About navigating the workers' comp system About the basics: Q.
What is workers' compensation? You could get hurt by: One event at work, such as hurting your back in a fall, getting burned by a chemical that splashes on your skin or getting hurt in a car accident while making deliveries. How can I avoid getting hurt on the job? What should I do if I have a job injury? What benefits am I entitled to? Workers' comp insurance provides five basic benefits: Medical care : Paid for by your employer to help you recover from an injury or illness caused by work Temporary disability benefits : Payments if you lose wages because your injury prevents you from doing your usual job while recovering Permanent disability benefits : Payments if you don't recover completely Supplemental job displacement benefits if your date of injury is in or later : Vouchers to help pay for retraining or skill enhancement if you don't recover completely and don't return to work for your employer Death benefits : Payments to your spouse, children or other dependents if you die from a job injury or illness.
You probably are not an independent contractor when the person paying you: Controls the details or manner of your work Has the right to terminate you Pays you an hourly wage or salary Makes deductions for unemployment or social security Supplies materials or tools Requires you to work specific days or hours. Find more information about basic facts on workers' compensation in the factsheet. Back to top About employer responsibilities: Q. Before an injury or illness occurs, your employer must: Obtain workers' compensation insurance or qualify to become self-insured When hiring a new employee, provide a workers' compensation pamphlet explaining the employee's rights and responsibilities Post the workers' compensation poster in a place where all employees can see it.
Isn't there supposed to be a notice posted at my workplace? Back to top About medical care: Q. What kind of medical care will I receive for my injury? Do these guidelines apply if my case is already settled? Are there limits on certain kinds of treatment? How long can I continue to receive treatment? What is utilization review? What is a medical provider network? What is a health care organization? What is a primary treating physician PTP?
What does predesignating a personal doctor involve? Does the 24 visit cap on chiropractic visits apply to all cases? What if I disagree with the MPN doctor's treatment plan? Who decides what type of work I can do while recovering? Your treating doctor is responsible for explaining in a medical report: The kind of work you can and can't do while recovering The changes needed in your work schedule or assignments.
You may request a medical evaluation with a physician called a qualified medical evaluator or QME: If your claim is delayed or denied and you need a medical evaluation to find out if the claim is payable To find out if you are permanently disabled in some way or if you'll need future medical treatment If you disagree with what your treating physician says about your injury, work restrictions, or TD status.
However, a QME may not comment on a request for medical treatment. What qualifications do QMEs have? I don't get the QME process. Why do I need to see a QME? You might disagree over: Whether or not your injury was caused by your work Whether or not you may need future treatment for your injury Whether or not you need to stay home from work to recover A permanent disability rating.
The claims administrator may also request factual correction of the report. Back to top About temporary disability benefits: Q. What are temporary disability benefits? Are there different types of TD benefits? How much will I receive in TD payments? The minimum and maximum rates are adjusted annually. What about TTD payments for low-wage workers? When does TD start and stop?
Are TD benefits taxable? Can my first temporary disability payment be delayed? Why am I receiving so many letters? Find more information on TD in the factsheet. Back to top About permanent disability benefits: Q. What are permanent disability benefits?
How is PD identified? What happens to the doctor's report? What if I don't agree with the doctor? How much will I be paid for my permanent disability? The claims administrator will determine how much to pay you based on three factors: Your disability rating expressed as a percentage Date of injury Your wages before you were injured.
How and when are PD benefits paid? Why am I receiving so many notice letters? How is my claim finally resolved? Back to top About returning to work: Q. How is my ability to return to work determined? It can also help you avoid financial losses from being off work. These people include: Your treating doctor Managers who represent your employer The claims administrator handling your claim for your employer. You and your attorney if you have one should actively communicate with your treating doctor, your employer and the claims administrator about: The work you did before you were injured Your medical condition and the kinds of work you can do now The kinds of work your employer could make available to you.
Can I work while I am recovering? If the treating doctor says you are able to work, he or she should describe: Clear and specific limits, if any, on your job tasks while recovering. These are called work restrictions.
They are intended to protect you from further injury example: no work that requires repetitive bending or stooping Changes needed, if any, in your schedule, assignments, equipment or other working conditions while recovering example: provide headset to avoid awkward positions of the head and neck If the treating doctor reports that you cannot work at all while recovering you cannot be required to work.
I have work restrictions. Can I work? What if I have no work restrictions? What if my employer offers me work? The offer could involve: Regular work: Your old job, for a period of at least 12 months, paying the same wages and benefits as paid at the time of an injury and located within a reasonable commuting distance of where you lived at the time of your injury Modified work: Your old job, with some changes that allow you do to it.
If your doctor says you will not be able to return to the job you had at the time of injury, your employer is encouraged to offer you modified work instead of supplemental job displacement benefits SJDB. The alternative work must meet your work restrictions, last at least 12 months, pay at least 85 percent of the wages and benefits you were paid at the time you were injured and be within a reasonable commuting distance of where you lived at the time of injury Alternative work: A new job with your employer.
If your doctor says you will not be able to return to the job you had at the time of injury, your employer is encouraged to offer you alternative work instead of SJDB. The alternative work must meet your work restrictions, last at least 12 months, pay at least 85 percent of the wages and benefits you were paid at the time you were injured, and be within a reasonable commuting distance of where you lived at the time of injury.
If your employer offers you modified or alternative work: You may have only 30 days to accept the offer. If you don't respond within 30 days, your employer could withdraw the offer If you fail to respond to the offer of modified or alternative work within 30 days or reject the job offer, you will probably not be entitled to supplemental job displacement benefits.
What if my employer does not offer me work? What if the job my employer offered does not work out? The offer of modified or alternative work must meet the following conditions: You have the ability to perform the essential functions of the job The job is a regular position lasting at least 12 months The job offers wages and compensation that are at least 85 percent of those paid to you at the time of your injury The job is located within reasonable commuting distance of your residence at the time of injury.
Job offers should not be filed with DWC. To dispute the doctor's report about your ability to work: If you do not have an attorney, you must send a letter to the claims administrator stating that you disagree with the report. You must send the letter within 30 days of receiving the report If you have an attorney, contact your attorney right away. The deadline for stating your disagreement is 20 days Next, you can get a medical evaluation from another doctor.
Can the voucher be settled for a cash payment? Not for injuries on or after Jan. Does a voucher expire? Back to top About navigating the workers' comp system: Q. Other benefits may be available. You should receive a letter that gives a specific reason why your claim was denied. Depending on the reason, many denied claims can be appealed successfully. Each state has different appeal procedures and filing deadlines. Before filing an appeal, it would be in your best interest to speak with a workers' comp lawyer.
A lawyer can ensure that your appeal is properly filed in a timely manner and maximize the likelihood of winning benefits. The information provided on this site is not legal advice, does not constitute a lawyer referral service, and no attorney-client or confidential relationship is or will be formed by use of the site.
The attorney listings on this site are paid attorney advertising. In some states, the information on this website may be considered a lawyer referral service. Please reference the Terms of Use and the Supplemental Terms for specific information related to your state. Grow Your Legal Practice. Meet the Editors. Find out if a decision on your workers' compensation claim is overdue—and what happens next.
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