The state requires employers to provide a reasonably safe and healthy work environment for every employee. Of course this is not a fail-safe system and sometimes a work injury will still happen despite employers’ best efforts. It could be a broken bone, a back injury, an occupational illness, psychological injury, or even the aggravation of a pre-existing condition. If you have been injured at work, then you may be wondering what you should do. In this blog post, we’ll provide some guidance for injured workers, including:
First off, you must report your injury to your employer. If you are able, you must get in touch with your immediate supervisor or the HR manager in the soonest possible time - this is the easiest and most important way to protect your legal rights. This is because most states require that you notify your employer regarding your injury within a given time frame which is typically the same day or within a few days of the incident.
This is because states also require employers to report any work-related injury as soon as possible (via phone or email). For instance, the state of California (per the California Code of Regulations; Title 8, Section 342) requires employers to report the incident no longer than 8 hours (or no longer than 24 hours as long as the employer can demonstrate that pressing circumstances exist).
In contrast, the state of Florida provides that you must report your work-related injury immediately or no longer than thirty (30) days. The point is, we must note that the threshold varies from state to state.
It is important to understand that workers’ compensation laws vary from state to state. Albeit in a general sense there are a few legal rights that are common across most states which includes:
Understanding your right to act is just as important as understanding your right to refuse offers or requests. This means that you have the right to refuse any form of settlement made by your employer. Or in some cases, if your employer coerces you to use your personal health insurance to fund your medical treatment, you have all the means to say no.
It is quite common for employees to worry about how making a claim affects their job. In some cases, you may be placed under pressure by your employer not to pursue a claim for personal injury compensation.
Your employer might offer you some form of incentive meant to dissuade you from filing that workers’ compensation claim, you have the right to simply say no. More so if you feel that your boss is taking extraordinary measures (e.g. coercion) to make you do otherwise.
Employers have no right whatsoever to prevent an employee from pursuing a claim stemming from work-related injuries. State laws provide that employees can pursue workers’ compensation claims without fear of reprisal or harassment from your employer. If your employer, manager, or supervisor makes it difficult for you to exercise these rights, they will face severe consequences.
The decision whether or not to pursue a claim rests on YOU. In some cases, an employee may just suffer a minor injury that does not cause long-term problems, allows one to work normally therefore does not incur lost wages - you may well decide not to pursue a claim. However, if the injuries are more serious resulting in an inability to work, a claim for compensation is clearly in order and is a right afforded to everyone.
There are cases wherein an injury is caused by a third party. For example, this third party may be an erring delivery truck driver or faulty equipment design that led to your injury. So you ask, “what are my rights against parties other than my employer?”
If the injury was caused by another party, you have a right to file a claim against that person or company - these are called “third party claims.” However, these claims are not filed in workers’ compensation courts but rather take the form of civil lawsuits filed in state or federal courts.
Work-related injury civil lawsuits differ from workers’ compensation claim because you can seek additional personal injury damages from the latter. A workers’ compensation claim is intended to reimburse you for lost wages and medical expenses - not non-economic damages which, in layman’s terms, mean seeking compensation for the “pain and suffering” the resulting injury from third party claims have caused.
We must remember that the ability to choose a workers’ compensation doctor for treating your work-related injury depends on the state where you claim is filed.
Some states require an injured employee to be seen by a doctor chosen by the employer or the work comp insurance carrier. Meanwhile, other states allow injured workers to choose any doctor within a given network whereas the admission to the network is determined by the state, the employer, or the employer’s insurance company. There are also cases whether you can choose a work comp doctor for the initial treatment visit as compared to the continuing treatment for your workers’ compensation injury. Read a full list of states and who chooses the doctor in each state.
Not all physicians treat injured workers. There are rules in place for workers’ compensation cases, which is why a doctor you prefer may not necessarily treat injured workers.
Delaware, Oregon, and New York are examples of states that allow injured workers the right to choose his/her own treating doctor, provided the employer does not have a provider plan or managed care arrangement. It is commonplace for injured workers to choose from a list of state-approved doctors or health care providers for treating work-related injuries.
The most important thing here is to exercise due diligence in order to find the best workers’ compensation doctor to treat your injury, even if you are provided a list of physicians. Here’s some criteria to help you consider whether the doctor is the one for you:
It’s also critical to understand the role your doctor plays in this entire endeavor. He/she is not only responsible for treating your work injury but he is also able to sanction paid time off or mandate any physical work restrictions you should have.
At the end of the day, choosing a doctor you feel that you can trust is key. If you need help finding one, you may confer with your workers’ comp lawyer for recommendations or you can start browsing our national directory of workers’ compensation doctors here.
Technically speaking, workers’ compensation doctors are not free. They are, in essence, paid by employers or the state. This is not done directly, however, as these are often done through the state government, an insurance company, the employer (self-insurance), or a third party administrator.
Smaller employers or those that have a low rate of work-related injuries use this program. These programs are administered by the departments of labor, industrial relations, or commerce. What happens is employers pay a premium to these state-run programs and when a claim arises, the department that oversees the program handles the payment which is taken care of by the government.
Utilizing private insurance companies is also an option employers choose. Oftentimes, larger insurance companies have a wide range of plans available for employers regardless of scale. Any workers’ compensation claim, complaints, or issues with regards to payment would be coursed through these companies.
This type of program is often adopted by larger corporations (more in a scale of Coca-Cola, Chevron, etc.) whereas they should be big enough to have assets to ensure coverage of any workers’ compensation payouts. The state then adapts an oversight function to ensure that all necessary payments are made. Employers who self-insure generally use a third-party administrator who takes care of all the administrative work.
But to put in simpler terms, you do not have to pay anything to a workers’ compensation doctor because your employer or the state ultimately takes care of it for you.
Scheduling an appointment with a workers’ compensation doctor can be done by finding a work comp doctor on our workers’ compensation doctor directory where you can then schedule a face-to-face or telemedicine appointment.
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