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]]>In most workers’ compensation cases, insurance companies play by the rules, but there are unfair tactics some often use to deny workers the benefits they deserve.
If you are being unjustly denied workers’ comp benefits after suffering a serious injury or illness at work, you need proper legal representation.
When injured workers file a workers’ comp claim, they rightfully expect their employer’s insurer to act in good faith. However, it is surprisingly common for these insurance companies to employ unfair tactics when dealing with and investigating claims.
Such tactics are unethical and sometimes even illegal. Some of the most commonly used by insurers include:
Insurance companies often take a chance with unfair tactics, especially when they realize injured workers do not have legal representation.
Perhaps the most commonly used unfair tactic in these situations is to outright deny a workers’ comp claim even though it is valid. Yet another is to approach an injured employee with a low settlement offer before he or she has had a chance to consult an attorney. Insurers do this to pay a sum that is much lower than what the claim is really worth, saving them money.
Unfortunately, a lot of workers assume the insurer actually has their best interest in mind when it is the other way around. If you are approached by your employer’s insurance company with an offer before you have talked to a workers’ comp lawyer, you should not accept until you get legal advice.
Another unfair tactic insurance companies turn to is to make unjustifiable delays during the claims process or when they must issue payments for a valid claim. When the claim is still in process and insurers realize they are bound to lose, they use this tactic to get injured workers to settle for less than they should.
As injured workers’ medical bills and other financial responsibilities pile up, they may well get so frustrated with these unfair delays that they end up accepting much less than they are entitled to. Do not let this happen to you. It is imperative that you turn to a qualified workers’ comp attorney who will employ legal means to keep insurers from dragging their feet.
Often, it is in an insurance company’s best interest to ignore certain facts in a workers’ comp case. For example, if a worker is injured outside of his or her immediate work area, it is usually held that workers’ comp benefits do not apply. However, there are clear exceptions such as when an employee has been ordered out of that area on an errand directly related to work. This is a fact that an incomplete investigation may choose to ignore altogether.
Insurance companies have a duty of good faith to conduct complete investigations and take all facts of a case into account. When they fail this duty they are acting in an unethical and possibly illegal way just to save money.
Insurance matters tend to be complex. So much so that injured workers are often confused by forms they are presented with by insurers. This allows insurance companies to use ambiguous language and legal terms to misrepresent facts.
Depending on the circumstances this can be considered illegal and lead to insurers getting into serious trouble. Unfortunately, when injured workers do not retain legal representation, they are often unaware they are being taken advantage of.
One of the most popular unfair tactics among workers’ comp insurers is Form 105. Injured workers who have been receiving benefits often get a form from insurers known as “Form 105, Agreement to Extend the 180 Day Payment Without Prejudice Period.”
Because of this form’s name, it appears that the insurer is trying to help out the injured employee by extending benefits, but that is far from the case.
Workers’ comp insurers employ this form with injured workers who do not have an attorney on their side to get them to sign without realizing the negative implications of doing so. Employees usually get this form 3 to 5 months after a work-related injury.
You have to be aware that signing this form means you are surrendering legal rights and this could open the door to the insurer terminating your benefits. Rectifying this by legal means could take several months without benefits.
If you have already gotten Form 105, do not sign it. Get in touch with a workers’ comp attorney for the right legal advice in this situation.
After a work-related injury, you might be wondering whether hiring a workers’ comp lawyer is something you should do. The answer is that it depends on the particular circumstances of your case.
Not every injured employee has to hire an attorney. Getting workers’ comp benefits is supposed to be relatively easy after a work-related injury or illness. If your injuries are minor, the process for you should be straightforward provided they did happen at work and you are an employee as opposed to a contractor.
Unfortunately, things are not always that simple. If your injury is significant and the insurer is using unfair tactics, you definitely need a workers’ comp attorney to obtain the benefits that are rightfully yours.
Other reasons to hire a lawyer who specializes in workers’ compensation cases include:
If you are dealing with unfair tactics from your employer’s insurer after an injury or illness due to your job, you need legal help. Having a workers’ comp lawyer on your side can ensure that your claim is handled fairly.
Reach out to us at the Law Office of Robert E Frawley at (617) 523-2929!
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]]>The post What to Do When Workers’ Comp will not Pay Your Lost Wages appeared first on Boston Personal Injury and Workers Compensation Lawyers | Law Office of Robert Frawley.
]]>But what can you do when workers’ comp will not pay your lost wages?
This situation happens more often than it should and the best course of action is to consult an experienced workers’ comp lawyer for help.
Most workers do not stop to consider whether workers’ comp will cover lost wages if they get hurt on the job until such an unfortunate incident happens. So, does workers’ comp cover lost wages?
The short answer is yes but it can be a complicated matter when an employer’s insurance company disputes the facts of the case and is unwilling to pay.
Normally, injured workers receive a percentage of their lost wages as disability income benefits. How much they get and for how long depends on the severity of the injury or illness which is determined by physicians and/or other qualified medical professionals.
Different types of disability categories or levels include:
Let’s have a closer look.
Injured workers who are 100% unable to perform their previous job duties due to their injury or illness for a minimum of seven days are entitled to temporary total disability benefits. Under this disability category, the benefits amount to two-thirds of weekly wages up to a predetermined maximum. Although these benefits take effect on the eighth day, benefits for the first seven days will be paid if injured workers remain disabled under this category for more than 21 days.
Temporary Partial Disability applies to injured workers who are still able to work but either not at the same job they held before or as many hours, meaning that they are making less money. These disability benefits amount to two-thirds of the difference between what was earned before and what is now being earned. For example, if you were making $1,200 a week before the work-related incident in question and your wages are now down to $600 a week, the difference is $600. In this scenario, you would receive $400 weekly from workers’ comp.
If it is determined that you are permanently and totally disabled because of your workplace injury and cannot go back to work as a result, you may be eligible for Permanent Disability payments. These benefits may be granted for life. Usually, injured workers under this disability category receive two-thirds of their pre-injury weekly wage, just as with Temporary Total Disability.
When there is a permanent disability to a certain degree but not completely, injured workers may be entitled to Permanent Partial Disability benefits. The amount of these benefits is, again, two-thirds of your pre-injury wages and a limit will be placed on how long benefits are granted. This period of time will be determined according to the body part that was injured and how severe the injury is.
Despite what workers’ compensation benefits you are entitled to, you may come across a situation where the insurer or even your employer will dispute facts to deny you what is legally yours. The wisest thing to do is to turn to an experienced workers’ comp attorney for legal counsel.
Insurance companies sometimes have valid reasons to deny workers’ comp claims, such as when fraud is an issue. However, they often unjustly deny valid claims as well. To ensure you get the medical and lost wages benefits you deserve, this is what you should do:
Getting the medical treatment you need is not just the right thing to do for yourself but also shows through professional records that there is an injury or illness. Ideally, you should go to an authorized clinic or hospital. Your employer should have a list of these medical facilities. However, if it is an emergency, you can go to the nearest medical care center for help. Ask for copies of your medical records, which will help your workers’ comp lawyer in case of complications with your case.
Once you have sought medical assistance, it is important that you notify your employer of your situation as soon as possible. Waiting too long to do this can cause the insurer to pause and suspect fraud. Although doing this verbally is acceptable, you should report the incident in writing to boost the evidence in your favor.
Keep records of how your injury or illness affects not just your ability to work but every aspect of your life. Even though these records are not as important as professional medical records, they can still help your case.
By far, the best thing you can do to ensure you get the benefits the law says are yours is to consult a workers’ comp attorney. A qualified lawyer will be able to examine all the facts of your case and advise about what benefits you are entitled to and what can be done to obtain them.
Depending on the circumstances and facts of your case, following these steps should enable your workers’ comp attorney to negotiate a favorable settlement for you.
If you have suffered an injury or illness due to job-related activities, you should not have to worry about the hassle of fighting against an insurance company to get the lost wages benefits you need to live a normal life. We are proud to say that we have extensive experience helping injured workers obtain the benefits they legally deserve.
Call the Law Office of Robert E Frawley at (617) 523-2929 for help with your workers’ comp claim.
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]]>The post How Much is a Workers’ Comp Claim Worth? appeared first on Boston Personal Injury and Workers Compensation Lawyers | Law Office of Robert Frawley.
]]>In this case, the employee will want to file a workers’ compensation case to take care of medical bills and lost wages. But how much is such a claim worth?
When in doubt about any aspect of workers’ compensation, it is best to get advice from a lawyer with extensive experience in these types of claims.
Workers who have been seriously injured or developed an illness because of work-related activities will quickly start to see their bills pile up. This brings up the question of how much can be expected in workers’ comp benefits to cover these expenses.
There are various factors that determine how much a workers’ compensation claim is worth. While some claims may only have a value of a few thousand dollars, others might have a settlement value of several hundred thousand dollars or even more. The most important determining factor here is the severity of the injury or illness in question.
It is important to note that every workers’ compensation claim must be evaluated according to its own facts and circumstances by an experienced attorney to determine what benefits might be obtained.
With this in mind, the only way to establish a reasonable expectation in medical care coverage and lost wages for your specific claim is to have a qualified attorney examine your case thoroughly.
Considering statistics, one comes to the conclusion that the average amount paid out in a workers’ compensation settlement is about $20,000. Some injured workers get a lot more and some a lot less depending on the circumstances of their cases.
Most worker’s comp cases are settled before the matter goes to court. This means that both sides negotiate and the insurer’s legal representatives go out of their way to pay as little as possible since this is in their best interest. Severe cases, such as where workers suffer brain injuries, amputations, vision loss, and other life-long injuries may merit much higher amounts with periodic payments.
The best advice when determining how much you might be entitled to due to an injury or illness suffered at work is to consult an attorney as soon as possible.
Workers’ compensation ensures injured workers will have the funds they need to pay for essential medical care they need to get back to a normal life. This government-mandated insurance program also grants a percentage of lost wages to employees who cannot return to work because of the severity of their injuries or illness.
But how much can you expect to get for these expenses?
Workers’ comp medical care benefits are intended for reasonable and necessary medical expenses. This means that any medical attention injured workers get has to be related to the injury or illness suffered on the job and approved by a physician and/or the insurance company
Employees also get access to medical professionals in case future medical care is needed after the condition in question has stabilized.
It is important to note that injured workers who settle for a one-time lump sum payment usually give up their right to re-open their case down the line.
A worker’s comp settlement usually covers the following medical costs:
Your possible settlement could include other medical expenses depending on the circumstances of your case. Your workers’ comp attorney can help you decide what other medical costs can be claimed.
Aside from having to deal with a serious injury or illness and the expenses associated with them, injured employees also have to worry about paying normal bills. This is why workers’ comp also takes lost wages into account when granting benefits.
How average weekly lost wage benefits are calculated depends on the severity of the injuries in question.
Temporary Total Disability benefits are given to injured workers who are completely unable to work because of their injury or illness for at least seven days. They get two-thirds of their previous wages up to a predetermined maximum.
Injured Employees who are still able to work but not performing the same duties as before or fewer hours are entitled to Temporary Partial Disability benefits. These benefits are calculated at two-thirds of the difference between the employee’s previous earnings and what he or she is currently earning.
For example, if your weekly wages amounted to $900 a week before the accident and your wages are now $600 a week, the difference is $300. You would be entitled to $200 weekly in workers’ compensation benefits.
Employees who are deemed completely unable to go back to work in any capacity are eligible for Permanent Disability benefits which could go on for life. These benefits grant injured workers two-thirds of their previous weekly wage.
Workers who suffer a disability that is only partial may be granted Permanent Partial Disability benefits. They will receive two-thirds of their pre-injury wages, usually with a time limit depending on the body part that was affected and how severely.
Deciding to what degree a worker is injured and how much a workers’ comp claim is worth is often a point of contention that can affect the amount of benefits they are given.
When work-related accidents are relatively minor, a workers’ comp claim can be easily handled without the aid of an attorney, but things can get complicated when injuries are major and insurers refuse to pay. Because of this, it is important to get legal advice and representation.
We know that dealing with an injury or illness due to job-related activities is not easy and we want to help. You deserve workers’ comp benefits and we can determine what your claim might be worth after examining all the facts of your case.
Get in touch now with the Law Office of Robert E Frawley at (617) 523-2929.
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]]>The post Light Duty Job Offers in Workers’ Comp Cases appeared first on Boston Personal Injury and Workers Compensation Lawyers | Law Office of Robert Frawley.
]]>How does a light-duty job offer affect your workers’ comp case and should you accept?
These types of offers can have serious effects on the outcome of your workers’ compensation claim, making it important to talk to an attorney as soon as possible to decide the best course of action.
A light-duty job refers to work that is less demanding physically and/or mentally than the job the injured worker was previously performing. Employers cannot make these types of offers to all employees receiving workers’ comp benefits. Work restrictions determined by a physician have to be taken into account.
Depending on the severity of the employee’s injury or illness, the primary treating physician can:
If the physician decides to allow the injured worker to return to work in some capacity, work restrictions that might be applied include:
Before making a light-duty job offer, an employer must carefully consider the restrictions in question. Whether the worker accepts the offer is entirely up to him or her. However, both decisions can have a significant impact so a workers’ comp lawyer should be consulted on the matter.
Accepting a light-duty job offer will affect the amount of lost wages benefits you receive depending on whether you are paid the same as before or less.
If you are paid the same, you will no longer be entitled to benefits for lost wages. However, if you are paid less, you will get partial disability benefits. That amount is two-thirds of the difference between your previous and current wages.
For example, if your weekly wages before your injury were $700, and you are now getting$400, the difference is $300. Your partial disability payment will be $200.
Injured employees who are getting workers’ compensation benefits may suddenly receive a light-duty job offer from their employer. This work offer can lead to a perplexing situation for the injured worker since it is often unclear whether it is in their best interest to accept or not.
Should you accept a light-duty job offer? The answer depends on the circumstances of your case and whether or not your employer is making an honest and decent offer.
To understand why light duty offers are made to injured workers it is important to understand that both employers and their insurance companies will benefit financially if employees go back to work.
Insurance companies are for-profit businesses. Paying out large sums of money in workers’ comp benefits puts a huge dent in their profits so they do everything they can to bring those numbers down. It is not uncommon for some of these insurers to act in unethical and even illegal ways to save money. Employers might be enticed to offer injured workers light-duty jobs by lower insurance premiums.
Of course, some light-duty job offers might be beneficial to injured employees. The employer might be interested in helping the employee get back on his or her feet and feel productive. If this is the case, the employee might want to seriously consider accepting the offer, but this decision must be made carefully and ideally with the help of a qualified workers’ comp lawyer to avoid a negative outcome.
The question of whether you should accept or reject a light-duty job offer is more often than not a confusing one. The most important thing to consider is that your benefits could be reduced or terminated if you reject a legitimate light-duty job offer.
So should you accept any light-duty job offer your employer throws your way to avoid losing any benefits?
Here is what you should do when you get a light-duty job offer:
If you are being offered an unsatisfactory light-duty job or have already been forced back to work duties that go against restrictions set by your physician, we can help.
Contact us ASAP at the Law Office of Robert E Frawley at (617) 523-2929!
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]]>The post The Going and Coming Rule in Workers’ Comp Cases appeared first on Boston Personal Injury and Workers Compensation Lawyers | Law Office of Robert Frawley.
]]>However, there are situations where injured workers may or may not be covered by workers’ comp insurance such as when they are going to or coming from work.
If you were injured while traveling to your job or back home from it and your claim for workers’ comp insurance is being disputed, you need to talk to an attorney right away.
Injured Workers Entitled to Workers’ Compensation Benefits
With few exceptions, employers in Massachusetts are required to provide employees with workers’ comp insurance. This insurance program is a safety net that ensures injured workers will be able to pay their medical bills and provide basic necessities for their families if they suffer an unfortunate accident or illness at work.
The two basic requirements to be covered under workers’ compensation are:
Most workers’ comp cases are straightforward. For example, if a warehouse worker is suddenly hit by an object which falls from a shelf and others witness the accident, there is no doubt that the accident happened and that it took place at work. In this case, if the worker is injured to an extent that he or she is unable to perform normal job duties, a workers’ comp claim will most likely be approved quickly.
However, there are many cases in which the insurance company will deny a claim and refuse to pay benefits. This often happens when the “Going and Coming” rule is a major factor in a workers’ compensation case.
A “workplace injury” seems easy enough to understand. If a construction worker falls off a ladder while at a worksite, the accident obviously happened at work. But what if an employee gets hurt while going to or coming from work? Do workers’ comp benefits extend to such a degree?
When filing a workers’ comp claim, serious issues come into play if the worker’s injury happened while traveling to or from work. In most related cases, the point of view has generally been that workers’ compensation benefits do not extend to employees who suffer injuries in an incident while going to or coming from work. This is known as the “Going and Coming” rule and insurance companies use it to great effect to deny claims.
This means that any medical bills and lost wages arising out of an accident while you are headed to work or going back home from it will most likely not be covered by workers’ comp. The argument here is that workers are not performing any job duties even though their commute is job-related.
However, there are exceptions to the coming and going rule. One such exception deals with workers who normally leave their workplace “base” to perform their job. This is often called the “traveling employee exception”.
For instance, if a health care provider is on her way to a patient’s residence to provide care and she gets injured in an accident, she will most likely be approved for workers’ comp benefits. This is due to the fact that she was “going” to a patient’s home in fulfillment of her normal job duties.
Another exception is when an employer orders a worker outside of the immediate work area on an errand. In this case, an employee who is sent to the store for office supplies and ends up seriously hurt in an unfortunate accident while doing so can claim workers’ comp benefits.
Also, it is important to note that even if a worker has signed off from work for the day if he is still on the employer’s property when injured, worker’s comp benefits can be claimed. Consider a worker who has punched out and is walking to his vehicle. He is hurt in the parking lot which belongs to the employer. This injured worker should not face any issues claiming benefits if his injuries keep him from being able to work.
Of course, insurance companies can still dispute such exceptions and they often do. An experienced workers’ comp lawyer knows how to deal with such cases effectively.
If your work-related injury or illness is serious enough to keep you from working, leading to high medical bills and considerable loss of wages, it is imperative that you are approved for workers’ comp benefits as soon as possible.
But will the Going and Coming Rule keep you from getting the benefits you need?
Even though this rule is upheld in most cases where workers get hurt while traveling to and from work, there are exceptions that are both obvious, such as the examples mentioned above, and others not so immediately obvious.
The fact is that there is no telling whether this rule will lead to your claim being denied until all the facts and circumstances of your case have been thoroughly examined.
On the other hand, if your claim has already been denied because of the Going and Coming rule, whether you choose to appeal or not is a decision that should be made after careful consideration of the facts.
The wisest course of action is to contact an attorney who specializes in workers’ comp cases as soon as possible for advice.
Workers’ comp cases must be filed and/or appealed in a timely manner, especially if your bills are piling up while you are being denied benefits due to the Coming and Going rule.
Act now and call us at the Law Office of Robert E Frawley at (617) 523-2929 for a free consultation!
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]]>The post Which Type of Workers’ Comp Settlement is Right for You? appeared first on Boston Personal Injury and Workers Compensation Lawyers | Law Office of Robert Frawley.
]]>Most workers’ comp claims are approved without much fuzz from insurance companies, but some are unjustly denied. If that is precisely what has happened to you or the insurer is offering a settlement that is much too low to cover your medical and other expenses, you might be wondering what type of settlement you are entitled to.
The most crucial thing to do after a workplace injury is to get medical attention. Go to the hospital and let them know you were injured at work. This treatment should be covered by workers’ comp insurance which most employers are required to provide.
Once you have gotten medical care, you have to notify your employer about your situation so they can file paperwork for a workers’ compensation insurance claim. You need to do this as soon as possible to avoid possible complications.
If your injuries are relatively minor, getting the workers’ comp benefits you are entitled to should be straightforward. But things can get complicated if your injuries are severe and the insurance company is facing the loss of substantial capital. You should talk to a lawyer right away at (or before) this point in the process. A workers’ compensation attorney will help make sure you file all required documentation properly.
Injured workers whose claims are approved will usually start getting benefits for medical care and lost wages within a month. However, if the insurer denies the claim, your attorney will work hard to reach a settlement that is beneficial to you. This can either be payments or a lump sum amount.
Conciliation is an informal meeting where all parties involved in your workers’ comp case meet to discuss what can be done. You and your lawyer will get together with the insurer’s legal representatives and a “conciliator” from the Department of Industrial Accidents (DIA) to try to come to a financial agreement.
An experienced workers’ comp attorney will present all the facts of your case to negotiate on your behalf and obtain all the benefits you are legally entitled to. Although this all takes time, your lawyer can file a form to request a fast conference. However, it must be shown that you have a hardship that makes it imperative for your conference to be as speedy as possible.
If your attorney is not able to obtain a favorable agreement from the insurance company’s lawyers, the next step is a hearing.
After the conciliation stage of your claim, there will be a hearing where evidence can be presented and witnesses questioned. Your Workers’ comp attorney will do everything in his or her power to argue your case to get you the benefits you rightfully deserve.
In the event that your claim is denied at a hearing, your case can be appealed to the DIA’s Reviewing Board. A panel of three administrative law judges will take a closer look at your case to decide whether the denial should stand or not.
If the DIA Reviewing Board upholds the denial of your claim, your workers’ comp attorney can turn to the Massachusetts Court of Appeals.
The workers’ comp claims process we just outlined can take months or longer depending on the circumstances of the case. However, most cases do not go that far since a settlement is usually reached.
If your employer’s insurance company has approached you with a settlement offer that is not in your best interest, you could choose to negotiate with them on your own, but the most advisable course of action is to hire an experienced workers’ comp attorney.
Your workers’ comp attorney can seek a settlement for a lump sum or weekly payments over a set period of time. But which of the two is best for you?
A lump-sum payment refers to a one-time payment made by your employer’s insurance company as a result of a settlement.
The benefits of this type of settlement include:
Such a settlement is usually with liability accepted or without liability. In Liability accepted lump sum settlements are more common in Massachusetts. These come with a legal obligation on the insurance company to pay for future medical treatment as long as it is deemed reasonable and causally related to the injury in question.
Weekly payments are paid out over a specified period of time. The benefits of this type of settlement include:
Which of these two types of settlements is right for you depends on various factors your attorney can help you consider.
Any injured employee who is denied workers’ comp benefits or offered an unjust settlement can benefit greatly from legal representation. This process can involve various complicated steps which can be daunting without a qualified lawyer to help.
Do not hesitate to contact us at the Law Office of Robert E Frawley by dialing (617) 523-2929!
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]]>The post Getting Medical Treatment Paid by Workers’ Comp appeared first on Boston Personal Injury and Workers Compensation Lawyers | Law Office of Robert Frawley.
]]>Most employers are obligated by law to provide employees with workers’ compensation. This insurance program provides injured workers with various benefits that include medical treatment, lost wages, funeral costs, and other benefits to qualifying family members when the employee dies as a result of a work-related accident.
Arguably, the most important benefit injured workers can claim from workers’ compensation is medical treatment since recovering is essential for one’s well-being and quality of life. But what medical treatment does workers’ comp cover?
Medical treatment covered by workers’ comp includes hospital or clinic visits, prescribed medications, surgery, and medical equipment such as crutches or a wheelchair. It is important to note that you have to opt for a hospital or clinic, and a physician authorized by your employer’s insurance company.
Whether your employers’ insurer is denying you payment for specific medical treatment you need, have already gotten, or denying all benefits completely, the best thing to do is to contact a workers’ comp attorney for advice and legal representation.
In Massachusetts, as in most states, workers’ compensation should pay for medical treatment that is considered to be “reasonable and necessary.” But it is important to understand that this does not happen automatically. Your physician or other medical provider must adhere to specific guidelines for the insurer to process payment.
These guidelines include the following:
The importance of medical treatment when employees suffer severe injuries on the job cannot be understated. Without this medical care, the injured worker will not recover properly and can even get worse. Unfortunately, insurance companies are for-profit businesses and always look for ways to avoid paying more than they have to and even nothing at all if they can get away with it.
It is not uncommon for insurers to unjustly deny payment for medical treatment injured workers have already undergone and are being billed for. So how do you deal with medical bills when workers’ comp is denied?
Some of the options injured workers in this situation can opt for include:
If medical treatment crucial to your recovery has been unjustly denied, you might be exploring other options to pay for it. You really should not have to pay for that treatment if you have a legal right to it through worker’s compensation. This might lead you to ask, “How can a workers’ comp attorney help?
An experienced workers’ comp attorney can help injured workers get the medical (and other) benefits they deserve. Although initially filing for these benefits after being injured on the job is an easy task, things get a lot more complicated when insurers refuse to pay.
Your workers’ comp lawyer can help you fill out important documents properly, avoiding unnecessary obstacles that will make the process longer and more frustrating. Your lawyer will also help you obtain critical documentation from doctors and others that can help you get a favorable outcome. Most importantly, a qualified workers’ comp attorney knows every single trick insurance companies use to deny claims and how to deal with them.
We believe that every injured worker who is entitled to workers’ compensation benefits deserves them. It is tragic when insurance companies outright refuse to pay for medical treatment workers need to get better.
If this has happened to you, it is essential that you contact us as soon as possible so that we can fully examine all the circumstances of your case and advice you accordingly.
Get in touch with us right away at the Law Office of Robert E Frawley by dialing (617) 523-2929.
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]]>The post Things You Should and Should Not Do with Workers’ Compensation appeared first on Boston Personal Injury and Workers Compensation Lawyers | Law Office of Robert Frawley.
]]>Regardless of the circumstances of your case, if you have been denied workers’ comp or want assistance to file a claim, the right thing to do is consult a workers’ comp attorney.
Although most workers have heard of workers’ compensation, they are not entirely sure about what it is or how it works. So what exactly is workers’ compensation and are you eligible for it?
Workers’ compensation is an insurance program designed to provide cash benefits and medical care for employees who are injured or become ill because of their work duties. Workers’ compensation is beneficial to both employees and employers. However, employees give up their right to sue, meaning that the employer is protected from lawsuits that might otherwise cost a crippling fortune.
Most employers in most states have the obligation to pay for workers’ comp and cannot ask or force employees to contribute to that payment. Although the cost to the business is taken into account when salaries or hourly wages are specified for employees.
If a workers’ comp claim is approved, the benefits are paid by the employers’ insurance company. This process is overseen by the Workers’ Compensation Board.
If your claim for workers’ compensation benefits was denied without justification, an experienced attorney can fight for your rights and get you the benefits you deserve depending on the facts of your case.
Workers’ compensation is a “no-fault” insurance program, meaning that neither the employee nor the employer is at fault when someone gets hurt on the job. However, there are many reasons for workers’ comp claims to be legitimately denied such as when employees are intoxicated on the job or get involved in horseplay or fights that lead to injuries. That being said, a lot of claims are turned down for unfounded reasons as well.
It is good to know that there is an insurance program in place in case you are ever seriously hurt at work, but do you qualify for it?
The two main requirements for workers’ compensation are that you must be an employee (not a contractor) and that the injury happened at work. Workers who meet these two requirements still should know about some Dos and Don’ts when it comes to workers’ compensation.
Most accidents at work do not result in serious injuries and workers do not always have to take a significant amount of time off from work to recuperate. When injuries are minor and the cost to the employer’s insurer is low, claims tend to be approved without much fuzz. But when injuries are severe and the insurer stands to lose a huge sum of money, things can get complicated and claims are often denied. Because of this, it is important to know as much about workers’ comp and the things you should and should not do.
If you are experiencing any issues with workers’ compensation benefits or your claim has been denied, we can examine your case thoroughly and advise you about what can be done. The first step is to reach out to us as soon as possible.
Reach out to us at the Law Office of Robert E Frawley by calling (617) 523-2929.
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]]>The post What to do When You Receive Form 105 appeared first on Boston Personal Injury and Workers Compensation Lawyers | Law Office of Robert Frawley.
]]>If you are getting workers’ compensation benefits because of an injury (or illness) you suffered at your workplace, you may suddenly get a Form 105 in the mail. You might be looking at that form right now and wondering exactly what it is.
Form 105 is an “agreement to extend the 180-day payment without prejudice period” which sounds just as confusing as it is to most people who get it.
To begin to comprehend what Form 105 is and the intentions behind it, you first have to understand that insurance companies, like most companies, are out to make a profit. Paying out large sums of money for benefits costs these companies much more than they want to lose. Because of this, insurers are constantly looking for ways to avoid paying benefits.
Insurance companies often send people on workers’ comp Form 105 during the 3rd to 5th month of their disability. Workers without an attorney are targeted in the hopes that they will sign this form without seeking legal advice. Bear in mind that insurance companies do not have your best interest in mind but their own. Signing Form 105 can have severe consequences and can lead to you losing your workers’ comp benefits altogether.
Before you even think about signing Form 105 or providing the insurance company with any information they can use against you, contact a workers’ compensation attorney for advice.
At first glance, Form 105 appears to be innocent enough and might even seem like the insurer is trying to help you extend the period of your benefits. Of course, that is far from the truth. To comprehend why signing this form will result in negative consequences it is imperative to understand what the 180-day payment without prejudice period is.
Most of the time, insurers will begin workers’ comp payments to injured workers on time. This being the case and if they determine that they have a valid reason, they can choose to stop payments during the initial 180 days after disability begins. Insurance companies often do this because they can get away with it without getting approval from the Department of Industrial Accidents (DIA).
Despite not having to have the go-ahead from the DIA, insurers do have to inform the injured worker of their intent to terminate benefits. This must be done with a written notice and at least 7 days prior to when benefits will end.
If you receive such a notice from your employer’s insurance company, act fast. Talk to a workers’ compensation lawyer who can examine all the facts of your case and get the process of reinstating your benefits going as soon as possible.
Once injured workers get past the initial 180-day period after disability begins, it becomes much more difficult for insurance companies to terminate benefits. Insurers have to follow more specific guidelines and one of the following things must happen:
If your benefits are terminated for these or any other reason, you will need an experienced workers’ comp lawyer on your side.
If you have already signed Form 105 but have not turned it in to the insurer, you should stop right there. If you mailed the signed form, what can be done depends on the circumstances of the case.
With a signed Form 105 from you, the insurer has the right to extend benefits without having to accept any liability and also to terminate them as long as they notify you at least 7 days in advance.
At this point, it is highly advisable to get the best legal assistance possible so that you can keep enjoying the workers’ comp benefits you deserve.
Workers’ comp benefits pay for medical care and make up for a percentage of lost wages, making them highly important for injured workers. If you have just received Form 105 and need help deciding what to do about it, do not hesitate to call us at the Law Office of Robert E Frawley.
Dial (617) 523-2929 now for a free consultation!
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]]>Workers’ compensation benefits can be claimed by workers who have suffered an injury or illness as a result of regular activities on the job. These benefits are meant to help with medical expenses and lost wages without having to go through the hassle of a personal injury lawsuit. The amount awarded depends on the severity of the injury or illness and other factors.
Normally, workers’ comp benefits are approved for a set amount of time, but workers can be awarded permanent disability benefits long-term or even for a lifetime if they have suffered an extremely severe injury such as paralysis or the loss of an arm or leg.
There are two permanent disability categories injured workers may be able to obtain:
Injured workers are assigned “disability ratings” when permanent disability is a factor. This percentage is determined according to the extent of the disability in question. A 100% rating applies to injured workers who are completely disabled because of a workplace accident. Those assigned a rating under 100% are considered to be partially disabled.
The permanent disability ratings an injured worker is assigned will go a long way when it comes to the benefits awarded.
The process of figuring out these disability ratings is complicated and often a matter of contention between injured workers and their employer’s insurance company. The steps in this process involve medical reports and conversions into permanent disability ratings.
When any type of accident occurs at the workplace and an employee is injured, the most important thing is to get medical assistance. If the injury in question is permanent, the worker will receive medical attention on an ongoing basis. The treating doctor will continue to evaluate the employee and deliver a medical report that details the employee’s disability.
These medical findings are taken into account when impairment percentages and ratings are assigned for any body parts that were injured directly as a result of the work-related accident. Ultimately, the physician bases the final ratings on “The AMA Guides” which is a book outlining a method to assign impairment ratings properly.
The final impairment rating will now be the injured employee’s “whole person impairment.”
The whole person impairment percentage delivered by the treating physician is converted into a permanent disability rating.
Some of the criteria involved to accomplish this include:
It should be noted that even the most experienced physicians will sometimes assign permanent disability ratings that are far from correct. This can have a significant impact on the workers’ compensation benefits you are entitled to.
A highly-experienced workers’ comp attorney will be able to determine the best course of action to get you the benefits that are rightfully yours depending on the specifics of your case.
Since permanent disability benefits are meant to help injured workers with medical expenses and lost income, their importance cannot be overstated. Most people in this situation are unaware of how much these benefits will help them economically. So how much are permanent disability payments?
Permanent Total Disability benefits are paid at a rate of two-thirds of the worker’s pre-injury wages. Injured workers awarded PTD benefits are paid on a weekly basis for the rest of their lives.
Permanent Partial Disability benefits are also paid at a rate of two-thirds of the worker’s pre-injury wages. Likewise, injured employees will get their benefits on a weekly basis. However, since this is a “partial” category, injured workers will not get benefits for the rest of their lives but for a set number of weeks which will be determined according to the severity of the injury or illness in question.
Permanent disability benefits cost insurance companies a huge amount of money. Because of this, they will often make it as hard as they can for injured workers to get the compensation they deserve. Sometimes they will even deny claims for unfounded and illegal reasons in the hopes that workers will not appeal the decision.
Whether your claim for permanent disability benefits has been denied, you have gotten less than you feel you deserve, or the benefits you were getting were unjustly terminated or reduced, contacting a workers’ comp lawyer is important.
An attorney with extensive experience fighting for the rights of injured workers will be able to examine all the facts of your case and advise you accordingly.
There is a limited time period within which you can legally go after the workers’ compensation benefits you deserve after an accident on the job so it is crucial to act fast.
If you have been hurt at work and want legal counsel about claiming permanent disability benefits, contact us today at the Law Office of Robert E Frawley at (617) 523-2929.
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