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What is a Workers Compensation Case? A workers' compensation claim is a legal procedure which occurs when an employee is injured while on the job. It is designed to shield employees from losing their income as well as to pay for rehabilitation and medical treatment. In the course of a workers' compensation case it is possible for an injured worker to receive medical attention and wage loss benefits and even an settlement. 1. Medical Treatment If an employee is injured on the job, their comp insurance usually will cover medical treatment. It covers the initial emergency treatment, such as an ambulance ride, and regular care, including medication and physical therapy. Workers who are injured also have the right to reimbursement for travel expenses to pay for transportation to and from their doctor's appointments. This is particularly helpful for employees who have to undergo surgery. Employers have the option of sign a contract with a managed care organization or preferred provider plans in many states to treat work-related injuries. This permits both the employer and the insurer to regulate the quality of medical treatment and to reduce the cost. It is essential to select the best medical professional for your treatment. Your doctor can also refer you to specialists for further evaluation and testing. The list of Board-approved doctors will be provided by the office of your doctor. However, there are exceptions. It is important to confirm that your doctor is on this list before starting treatment. It is important to follow the instructions and guidelines of your physician when you've found one. Failure to follow these guidelines could negatively affect your claim for workers compensation benefits. Additionally, the Workers' Compensation Board periodically changes its Medical Treatment Guidelines. This is based on new information and advice from doctors. These changes can be detrimental to injured workers. An experienced attorney can help you understand how these changes affect your case. A proper medical treatment is essential in a workers ' compensation case to demonstrate that you have an injury from work and are eligible to receive the benefit of lost wages. Your doctor must confirm that your symptoms are related to the workplace. You cannot return to your previous occupation, or engage in other activities unless work restrictions have been imposed on you. It is also important to keep in mind that in certain states, your employer is required to pay for diagnostic tests like ultrasounds and xrays. These tests can help you determine whether your symptoms are related or not to the workplace. workers' compensation lawyer fresno is also required to pay for all reasonable and necessary surgeries, implantations or injections suggested by your doctor to help you recover from your injury. 2. Wage Loss The ability of wage loss is to replace lost income because of an injury. This is one of the most important benefits of workers compensation. Based on the state where you work, you could be entitled to up to two-thirds of the wages you earned prior to your injury. The amount you are awarded is determined by a variety of factors, including your age and the severity of your injury. In addition there are many jurisdictions that place an upper limit on the total amount of wage loss per week you could receive while you receive workers compensation. You can make sure you receive the most money possible by filing your claim as soon possible. Additionally, you must meet all deadlines and inform your employer of the claim promptly. An experienced worker's compensation attorney is the best way to determine whether you have a valid claim case. This will ensure that you are entitled to all benefits provided by law including lost wages as well as medical bills. For example, you may be eligible for more benefits when you can prove that you've been actively looking for employment since you were injured or sustained injuries in your accident. This is particularly relevant if you've been out of work for a significant time or have serious medical issues that hinder you from returning to your previous work. The best part is that you don't have to pay any fees. 3. Litigation The first step on the timeline of litigation is to submit the Claim Petition, which puts your case before the court system and initiates the process of litigation. The claim petition will outline the kind of injury you suffered, when it happened, how it happened, and other information. Although the Employer or Insurance company might not reply, the petition is then sent to a judge, who will decide what the amount and for how long. Certain issues can be resolved by the Workers' Compensation Board informally without hearing. This includes disputes over whether the injury is related to work, your degree of disability, the amount of monetary awards that are payable to you, and which medical treatment is appropriate. More complex disputes require an official hearing before a Workers Compensation Law Judge. The judge will listen to both sides' arguments and make a determination about the amount of benefits you are entitled to. During the hearing attorneys present written arguments to the judge. These arguments will explain the evidence they have gathered and their opinions on the issue. If the judge accepts the arguments of both lawyers, he or she will issue a written ruling which outlines the outcome of the hearing and concludes your workers' compensation claim. You will receive a copy the Decision by mail. If your employer or insurance carrier is not happy with the claims investigation, it will often demand an independent medical exam (IME). This is a medical exam which your employer will pay to examine you and gather evidence. The IME is an essential element of the litigation process because it provides your employer with crucial medical evidence. The IME will review your medical records, and report on your injuries, as well as the treatment you received. Typically, once your IME is completed, the employer will then hire an attorney to represent their part of the claim. This can be a complicated process that requires several legal experts as well as a lot of time on the part of your employer. Injured workers who are receiving pain medication as part of their treatment could need to be monitored closely in the course of litigation, panelists noted. They could become addicted in the event that they take too much or take the wrong drug. 4. Settlement A workers settlement for compensation is an agreement between you and the insurance company that covers your employer to pay you a certain amount of money. It could be a one-time payment or it could be made into regular installments over time. A workers' compensation settlement can be a good option to speed through the long process of dealing with workplace injuries. Do not sign any settlement without consulting an experienced attorney. Workers' compensation settlements are available for medical expenses, lost wages, and other costs related to your injuries. Settlements can also help you cover future costs and keep you from being forced to bring a lawsuit. Each state has its own laws governing worker's compensation settlements. However you have the option of choosing whether to settle your claim for a lump-sum or structured payments. Your situation and the severity of your injuries will determine the amount of your settlement. The average workers' compensation settlement is approximately $12,000, but it could be greater or less depending on the nature of the injury and the state where you reside. Your lawyer for workers' comp can estimate the amount of your settlement and assist you to make an informed choice about how much to settle. No matter how big the amount, the main factor is to settle it quickly. This will save you and your insurer a lot of time and money. Sometimes an insurance company will offer to settle your case prior to you even file it. This is called an “offer-in-commitment” or “preliminary offer.” The insurer may be motivated to put a settlement on the table because it has to start paying you benefits right away or because they are concerned that you will file a lawsuit. In these cases you can ask your lawyer that you accept the offer, or negotiate for a larger sum. In the end, you will have to make the best decision about your future. If your insurance provider denies your claim, you can have a hearing with a judge or a worker's compensation hearings officer. The judge will evaluate the case and determine an appropriate settlement amount for you. It's not easy, but it is well worth the effort.