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How Workers Compensation Law May Help You If you've been injured in a work-related accident, workers' compensation law can help you recover. It's a no-fault system which protects employees from lawsuits and reduces the liability of employers. Generally, all companies with employees, with the exception of domestic servants and farm laborers are required to have workers compensation insurance. Infractions to this requirement could result in fines or even imprisonment. Medical Care A successful workers' compensation case will include medical care. It will ensure that your injured worker gets the treatment he/she needs, and help you to reduce your expenses in the long-term. New York State has reformed its workers' compensation laws to provide specific guidelines doctors and other health professionals must adhere to in treating workers who suffer from injuries. These guidelines, also known as “Medical Treatment Guidelines” or MTGs are designed to establish a standard for care and improve the medical outcomes for workers. The MTGs cover a broad range of tests and medications as well as therapy recommendations that doctors must follow. They cover the majority of injuries sustained in the workplace, including shoulder, back, neck and knee as well as carpel tunnel syndrome. In contrast to the majority of health insurance plans, workers' comp covers all medical treatments that are “reasonable and necessary” connected to an eligible claim. This includes doctor visits as well as prescription drugs and hospitalization. However, many providers are still not willing to provide treatments that are not covered by the MTGs. Most insurance companies require that doctors have pre-authorization before they offer any treatment within the MTGs. A provider can also request an exception to a specific MTG if the doctor believes that the treatment proposed is actually reasonable and necessary. The doctor must formally request this from the insurer. Utilization reviews are a crucial tool for controlling medical costs and preventing waste. It can be performed retrospectively, concurrently and prospectively. In the majority of states Utilization reviews are mandatory for all medical treatments provided under workers' compensation programs. This process can be conducted by the health system or by third parties such as health maintenance organizations. It is vital that patients with workers' compensation receive top-quality medical care. This is one of the greatest challenges in improving workers' comp medical care. This is especially crucial because the MTGs can be ambiguous and well-defined, and injured workers have only a few opportunities to “vote using their feet” on their own health care. Certain states are trying to combine the medical coverage provided by group health and workers' comp plans into the “twenty four-hour” model. Minnesota's Department of Human Services and employers have teamed up to create a program that offers “twenty-four hour” coverage. Disability Benefits Workers compensation law offers various benefits for disabled workers. These benefits include cash payments and vocational rehabilitation, medical care, and cash payments. These benefits may be in conjunction with other programs such as Social Security Disability Insurance (SSDI). If you suffer from disability and unable to work due to an illness or injury it is likely that you will receive both permanent and short-term disability benefits. Both benefits are designed to replace your income until you are able return to work or find another job. Typically, these benefits pay you an amount of your salary that is not a commission or bonus. These benefits are available for up to a year, or as small as a few days, depending on the type of coverage you have. You could also be eligible for workers' compensation and state disability benefits. However this will depend on your specific circumstances. You may also apply for Social Security disability benefits in most states. However, you must meet the strict criteria of the SSA for SSDI. workers' compensation attorney rockford will begin sending you checks for disability benefits after your doctor has determined you are completely and permanently disabled. The amount you receive will be contingent on how severe your doctor's diagnosis states that your condition prevents you from working. If your doctor concludes that you are permanently and totally disabled because of spinal cord injuries You will be awarded an overall disability rating (or percentage) of 100 percent. This means you're entitled to a weekly pay of $700. It is important to keep in mind that the workers' comp insurance company is also responsible for covering any reasonable medical expenses that you are able to incur when you claim your disability. This includes visits to doctors and other specialists. The only way to be certain that you'll be able to receive these benefits is to engage an attorney who will make the case for you. A knowledgeable attorney will fight to get your claim accepted by the insurance company and help you receive the maximum amount for your injuries. If you have any questions about disability benefits, call an experienced worker's compensation attorney at Silverman, Silverman & Seligman today. Our lawyers are proficient in dealing with all aspects of workers claims for compensation. Vocational Rehabilitation Vocational rehabilitation is a service that an injured worker receives to help them return to their job after an injury. Vocational rehabilitation is typically used to assist injured workers find a new job or become more independent. Your Workers' Compensation provider must provide vocational rehabilitation services if you have a permanent disability that prohibits you from working. This includes counseling and job search services to help you find a job. The law requires that your rehabilitation specialist develop an individual vocational rehabilitation plan for you. The plan will be developed to meet your specific needs and skills as determined in the initial assessment of your vocational needs. It could also include retraining or other support for job placement to help you find a job in an entirely new field. North Carolina General Statute SS 97-32.2 permits a vocational rehabilitation plan to be modified or revised at any time with your permission. This is an important aspect of the process of vocational rehabilitation because it guarantees you the most efficient and effective services. You must work closely with your rehabilitation specialist during this time. They can help you set your goals, be confident in your abilities , and set realistic expectations. They can also help you make positive changes in your life that will result in greater success at your new job. Your rehabilitation professional might suggest that you take up Temporary Alternative Duty (TAD) as a starting point. This is a temporary task you can perform while you heal from your injury. Although TAD can take just a few hours a day, it can last as long as you get back to your full potential. If your working capacity does not return to the pre-injury state, you could be sent to the Department Labor's Employment Services Agency for job placement assistance. If you suffer from a disability that isn't eligible for TAD and vocational rehabilitation, your counselor will devise an educational plan to prepare you for the job that pays you more than your typical weekly wage before your injury. Your vocational rehabilitation counselor will help you to create a job search strategy that will involve contacting employers and attending job fairs. They can also assist you complete application forms and build an resume. Death Benefits Death benefits are a financial resource provided by workers compensation law to the family members of deceased workers. These benefits are usually required to support the survivors of a deceased employee, who may be suffering financial and emotional losses due to the death at work of a loved one. The death benefits are intended to pay funeral costs, medical expenses and income replacement payments for those who were financially dependent on the worker at the time of the worker's death. The state determines the amount of the death benefits and it varies from one state to the next. The eligibility for death benefits is determined by the particulars of the worker's position and the circumstances of the death. If the employee's death was the result due to an injury or illness or accident, then workers' comp death benefits are usually available. While these benefits are an important source of comfort for grieving families, submitting workers' comp claims can be challenging and difficult to navigate. This is due to the fact that workers' compensation insurance companies are businesses that are dedicated to protecting their bottom line. They seek to pay as little as they can to claimants. They may also contest the claim that a death occurred caused by work-related illnesses or conditions. It is therefore essential to seek legal assistance from a lawyer for workers compensation who is well-versed in the laws and requirements for death benefits in your state. These lawyers can assist you to navigate the process of claiming your death benefits and make sure you receive the amount you are entitled to. The New York example is that the dependents of a deceased worker may receive weekly death payments equal to two-thirds of the average weekly salary in the previous year. These benefits are paid to the survivor's spouse and any dependent children until they die, attain the age of 18, or satisfy other eligibility requirements. If you lose someone you love due to an injury on the job or occupational illness you can rely on the skilled attorneys at O'Connor Law PLLC to assist you in obtaining workers' compensation death benefits. We are sensitive to the difficult feelings that follow a workplace loss and will fight for your right to be compensated for the loss you suffered.