This is a common question from people who want to settle their workers’ compensation claim but would like to keep their lifetime casually related medical coverage in case they need care later. This is a valid concern, and your medical situation is a big factor in deciding whether or not to settle. In theory, it is possible to settle only the wage replacement benefits, with leaving the medical benefits open, and this does (rarely) occur. Unfortunately, in most cases, the insurance carrier will not settle a case with an agreement to keep medical benefits open. This is because part of the value to the insurance carrier in settling is to be able to completely close your case and not have any further monetary exposure after the settlement monies are paid. The value of the future medical benefits is considered within the settlement amount, and the timing of a settlement is important (if you are having surgery soon, holding off on settlement may make sense; if you are only occasionally treating settlement may be a good option). For more information or to discuss your particular case, please call The Moses Law Firm at 540-552-2052.
Yes. Workers’ compensation pays wage replacement benefits but doesn’t protect your job. FMLA doesn’t pay wage replacement benefits, but can protect your job for up to 12 weeks, and also requires that group health insurance benefits be maintained for those 12 weeks. FMLA (Family and Medical Leave Act) applies to all public agencies, all public and private elementary and secondary schools, and to companies with more than 50 employees. To qualify for FMLA (which is a federal law), you must have worked for your employer at least 12 months, at least 1,250 hours over the past 12 months, and work at a location where the company employees 50 or more employees within 75 miles. If you are out of work, ask your human resources office for FMLA paperwork, which your physician will need to also complete. Contact us at The Moses Law Firm for further information.
When you are hurt at work in an accepted case, you are entitled to receive payment of benefits for an “injury by accident” or an “occupational disease.” To be covered, an “accident” must (1) occur at work or during a work-related function; (2) be caused by a specific work activity; and (3) happen suddenly at a specific time (most injuries incurred gradually or from repetitive trauma are not covered, although diseases caused by repetitive trauma may be covered). For an occupational disease to be covered, it must (1) be caused by the work; (2) not be a disease of the back, neck, or spinal column; and (3) be supported by medical evidence. For additional information, please contact us.
When you get hurt at work and can’t immediately return due to your injuries, how much will you be paid a week? If you are temporarily unable to perform any work, you are entitled to 2/3 of your gross pre-injury average weekly wage (in an accepted case). There must be seven days of disability before benefits are payable. However, if you are disabled more than three weeks, you do receive payment for the first seven days. If you cannot return to your regular work and are given a light duty job earning a wage lower than your gross pre-injury wage, you can get 2/3 of the difference between your pre-injury wage and the wage currently being earned (subject to marketing/job search requirements if you are not under an award order). The weekly amount paid to you is limited by minimum and maximum rates; currently, the maximum rate $1,043.00, and the minimum rate is $260.75. Wage replacement benefits are payable for a maximum of 500 weeks (unless you are permanently totally disabled). For additional information, please contact us.
You may have heard your physician mention maximum medical improvement (MMI). In workers’ compensation, MMI means that your physician believes you have recovered as much as you are going to. This doesn’t mean you shouldn’t keep treating, rather it means that your physician no longer expects improvement. However, if you are in pain we recommend that you keep treating. Continuing to treat also keeps the carrier aware that you do need additional medical care related to your injury. Ongoing treatment at least a few times a year helps keep your case active with the carrier and with your physician. Once you reach MMI, your physicians may discharge you to return “PRN”, which is treatment as needed. You can (and should) still make an appointment to return to your physician periodically. Once you reach MMI, if you have an injury to an extremity (leg, arm, hand, fingers, etc.) the question of whether there is permanent impairment should arise. If you have reduced range of motion or reduced strength due to your workers’ compensation injury, there may well be permanent impairment. A permanent impairment award is a way to get more money to you, without settling or closing your case. If you are at MMI and believe you have a permanent impairment, please contact us for additional assistance.