Workers’ Compensation Questions and Answers

Q. I got hurt on the job.  what should I do?

A. Inform a supervisor as soon as possible. If it is an emergency, seek medical attention immediately. make sure you fill out an accident report and then notify the injury counselor.

Q. I got hurt on the job but I dont think I need medical attention and do not plan to miss work. What should I do?

A. Inform your supervisor,fill out an accident report and then notify an injury counselor. If at a later time you feel that you do need to miss work because of the injury you must contact your injury counselor.

Q. What are the responsibilities of the injury counselor?

A. The most important duties of the injury counselor include helping you to get prompt,high quality medical treatment, and obtaining medical restrictions, so that you can return to work on transitional duty, or full duty, as quickly as medically possible.

Q. What are the steps of the insurance claim.

A. After filling out the injury report with the supervisor, it is the companies responsibility to send the report to the insurance company within 24 hours. After the insurance company receives and reviews the claim they have 14 days to inform you in writing if your claim has been accepted or denied. If accepted then the insurance company must, for 180days pay your claim with prejudice, meaning that within that time frame they have a right to have you be seen by there own Doctor for an evaluation. If for any reason the Insurance companies Doctor (IME) says that you can return to work full duty or Transitioanl duty, the insurance company is required to notify you by certified mail giving you a 7 days notice that your workers compensation payments are going to stop or be modified. If the IME returns you to work on transitional duty and you feel that you are unable to return with those restrictions, then you can apply for family leave so that you can remain off work until your own Doctor returns you to full duty without restrictions. At anytime during your injury, if the insurance company returns you to work and you want to contest that, you will need to file with the workers compensation department. If at anytime after the 180 days of paying your claim, the insurance company can not stop or modify your claim without having a consiliation hearing with you and an official from the state workers compensation department. 

Long Term Disability

Here is some information when filing a Long Term Disability claim.

You are eligible for LTD after being out of work for 6 months or more even if you are out due to an Injury on Duty(ID). Normally you should start the LTD paperwork around 4 months of being out of work so that when the 6 month waiting period is over you can start collecting your LTD benefit.

You are also entitled to collecting Social Security disability when out of work due to illness or Injury. You should contact your local Social Security department for the proper forms. If you are turned down for Social Security disability, you should always appeal the denial.

Here are some advantages of appealing the denial.

  • If the LTD policy contains the cost-of-living increase provision,your monthly LTD benefits will not reduce due to a Social Security cost of living increase.
  • If receiving Social Security disability, your earnings record will be frozen thereby protecting your old age benefit during the years that you are unemployed because of a disability
  • If you are receiving Social Security disability for more than 24 months you may be eligible for medicare.