By John Maxwell
Often times employees who suffer injuries in the workplace see no need to consult with an attorney about the rights and benefits they may be entitled to. Typically, after notifying their employer of the injury, an adjuster will reach out to the injured employee and arrange for those benefits an employee is initially entitled to such as medical care and the payment of temporary total incapacity benefits if the employee’s physician believes that the employee is incapable of working in any capacity as a result of the work-related injury.
The injured employee will say to himself or herself, “Why should I consult a lawyer? The adjuster is pretty nice and I am getting everything I am entitled to.” However, that is not always the case. The adjuster, keep in mind, works for the insurance company and while the adjuster in order to comply with the law must provide the minimum benefits available under the Act they rarely tell injured employees about other benefits they may be entitled to. Generally insurance companies want to pay as little as possible. For example, injured employees are entitled to mileage at the rate of 58 cents per mile for trips to and from medical appointments and physical therapy appointments and further the employee is entitled to compensation for time missed from work in order to attend medical appointments.
An injured employee is also entitled to his or her own treating physician specializing in the particular area of medicine relating to the employee’s injury such as an orthopedic physician for a back injury. He or she is not required to seek treatment with the doctor picked by the insurance company as long as the physician he or she chooses specializes in treating the employee’s injury. In many cases, adjusters will simply authorize medical treatment at a walk-in type facility like Concentra without advising an employee that if his or her symptoms are not resolving he or she would be entitled to see a more specialized provider for the particular injury in question.
An employee may not know he or she is entitled to weekly benefits for periods he or she is unable to work because of the work injury. An adjuster may also not advise an injured employee that if his or her physician releases him or her to light duty assignments and the employer has no light duty jobs available that the employee can obtain weekly benefits still by undertaking job searches.
At a certain point after treatment has been rendered an employee’s physician will determine that the employee is at maximum medical improvement and be in a position to assess a permanent partial impairment of the injured body part. Once that determination is made the injured employee is entitled to an award of specific disability benefits statutorily prescribed, the amount of which depends on the employee’s wage rate, injured body part and percentage of permanent partial impairment. The insurance company adjuster may not reach out to the unrepresented injured employee to make sure he or she obtains that benefit nor might the insurance company adjuster advise the injured employee of his right to obtain additional benefits thereafter if he or she is unable to earn the same level of wages following the injury that he or she was earning at the time of the injury.
Lastly, an adjuster may ask an employee if at some point he or she wants to fully and finally resolve his or her claim with a lump sum cash payment ending the case. An employee should never close out a case without first consulting with an experienced workers’ compensation lawyer to make sure the proposed settlement is fair and factors in all of the future benefits he or she may be entitled to.
The lesson here is that if you are hurt at work, contact an attorney who specializes in workers’ compensation law to make sure you receive all of the benefits you are entitled to. A simple phone call to John Maxwell at Brown Paindiris & Scott, LLP at (860) 659-0700 may make a world of difference for your claim.