Common Sense to Guide Your Comp Case

Sunday, September 15, 2002 | 0

When you enter the workers' compensation system most feel a loss of connection, disorientation, and a resignation that the system will take care of you. The fact of the matter is that you are responsible for yourself, and taking charge of your claim is the best way to ensure that your claim comes to a successful, expeditious end. Following some common sense guidelines can make a big difference in the success of your workers' compensation case:

After reporting your injury to your employer, make sure that the employer actually filed the First Report of Injury with the insurance company, and get a copy of it.

If the insurance company denies your claim, move quickly to file for an administrative hearing with your state workers' comp board. Most states have web sites where you can download the appropriate form with instructions on where to file it, and other related procedures.

Review your file periodically at the work comp board. These are public records and you are entitled to see what is in it. Make copies of documents that you don't have. If there is something that should be in the file, but isn't, get it filed.

Ask friends, family, work acquaintances, or other injured workers at the state board for an attorney referral. The legal morass that is workers' compensation isn't for the impatient, and you are better spending your time trying to get back to work. Attorneys fees in most states are limited by law, typically to just 12% of your final award, and often it isn't calculated on all of the benefits you would otherwise receive, like medical treatment, unlike a personal injury settlement.

It is extremely important that copies of all of your medical reports are in your possession and that you read each and every one to ensure that your medical history is accurate. This is extremely important, because your award is determined by the medical evidence - and in the case of workers' compensation, that means medical reports. If the medical reports are not accurate, then they cannot support an award, and a favorable medical report may not be relied upon by a judge if the history is incorrect or flawed.

Stay in contact with your attorney's office. You probably will not speak to the attorney very often - they have too many cases to take care of to make a living at only 12% fees, but they very likely have knowledgeable and capable paralegals and assistants who are specifically trained to ensure that your problems are taken care of. Use this great resource. These people care about your case because the better they take care of you, the better the award is, and the greater the ultimate fee is. Listen to them, cooperate with their requests, but never hesitate to question why they want what they want - you have the right to stay informed.

If you have a question, and want an independent opinion, contact the local work comp board information or assistance office. Most states maintain a program or department of specially trained people whose job it is to provide information and assistance to injured workers. There is no charge, and these people know the local jurisdiction. They can often step in and resolve situations and problems when others can't. In the lease they are a good resource for periodic reality checks.

Finally, don't be unrealistic. You need to return to work. Work comp benefits aren't intended to replace work. They are only intended to be a stop-gap, and most often not a very effective stop-gap either. Remember that when it comes time to settle your case, most likely you have already received thousands of dollars worth of medical treatment, temporary disability benefits, and maybe even vocational rehabilitation. And you typically received these benefits up front, unlike a PI case where you get nothing until the end of the case, and all of these "benefits" are deducted leaving you with very little net dollars.