Construction Accidents: Workers Compensation
A Workers Compensation scheme is a system of laws providing for certain benefits to injured workers and the process a worker needs to follow to receive such benefits. Each and every state has some type of worker compensation regime codified in statutes. The statutes will vary from state to state and may contain special provisions for certain classes of workers such as railroad workers and Federal employees.
The main purpose of a workers compensation regime is to avoid having injured workers sue their employers and to some degree their fellow coworkers for damages in the event of an accident. To accomplish this goal, workers compensation pays out a fixed benefit to cover lost wages and medical expenses due to an accident. If the employee suffers permanent impairment of a body member e.g. leg, arm, a payment may be made to compensate this employee even if he or she never missed work or returned to work shortly after. The benefit is paid regardless of who was at fault for the accident. Once the benefit is paid out, the worker, for the most part, relinquishes his or her claims to sue the employer or fellow employee. Unless the employee can finger a third party such as a manufacturer of a defective product as the cause of the suffered injury, the employee will be considered compensated.
Workers compensation benefits are generally available to cover the following types of injuries:
1) Diseases that are caused by toxins the worker is exposed to as a result of normal working conditions
2) Physical and mental injuries caused by increased work duties or job induced stress.
3) Injuries that occur while a worker is on break, lunch, work sponsored activities, and at work injuries caused by company equipment or facilities.
4) A workers pre-existing condition that was made worse by the physical or mental strain involved in the job.
5) Loss of vision and hearing
6) Permanent impairment of a body appendage such as an arm or leg
Weaknesses of Worker’s Compensation
Many injuries suffered during construction accidents will occur because of employer negligence. If this occurs, an employee may experience physical and mental pain and suffering due to a grievous injury. Worker’s Compensation may cover lost wages and medical expenses but will not pay for one dime of the employee’s pain and suffering. In effect, the employer escapes paying for their negligence. If you have been injured due to employer negligence, it is important to contact a qualified personal injury attorney to explore other avenues of receiving compensation for your pain and suffering.
How to File
Note: we strongly recommend consulting a qualified personal injury attorney during this process.
1) Report the injury within 30 days - Report the injury in writing to your employer as soon as possible but no later than 30 days after the injury. Keep a copy of the report.
2) File a claim – Following notification of an injury at the workplace, your employer has the obligation to provide you a workers compensation claim form. Make sure to fill out the form accurately and completely. Consider speaking with a qualified personal injury attorney before completing the form. Make a copy and turn it into your employer. The employer should then turn the claim form into his or her workers compensation insurance company and arrange for medical assistance for you.
3) File the claim quickly – Time is of the essence. Failure to file the claim quickly could cause severe hardship for you and your family, raise suspicions about the validity of your case, and lead to other procedural problems. Keep in mind that doctors and medical providers are not allowed to bill you for any injuries that you suffer on the job. If an attempt is made to do so, you should demand that all bills be forwarded to your employer or your employer’s workers compensation insurance carrier (physicians must forward bills and reports directly to the carrier). You should receive your lost wage benefits within 10 days from the date the workers compensation carrier receives the proper paperwork from the employer.
How Lost Wages are Paid
In New York, lost wages are paid to the employee by the employer’s workers compensation insurance carrier. Payments are not made for the first 5 days of lost work unless the injury causes the employee to lose more than a total of 10 days. Lost wage benefits are based on a formula that takes into account the injured worker’s average weekly wage during the one year period preceding the accident. This wage is then applied to the disability at the following sample rates:
1) 2/3 of the average weekly wage if the worker is totally disabled
2) ½ of the 2/3 average weekly wage if the worker is 50% disabled
3) ¼ of the 2/3 average weekly wage if the worker is 25% disabled
All other benefits are calculated by multiplying the workers % disabled times the 2/3 average weekly wage.
The Workers Compensation benefit maximum is $400 per week. The benefit is paid out for as long as the worker cannot return to work even if it means for life.
Employer Responsibilities
In New York, employers are required to purchase workers compensation insurance for their employees from a licensed insurance carrier. When a worker is injured on the job, a claim is made with the insurance company. The company will then be responsible to pay medical and disability benefits according to a state mandated scheme. If an employer fails to secure workers compensation benefits, the owner may be subject to fines, incarceration, civil liability, and more.
The Workers Compensation scheme also places additional responsibilities upon the shoulders of employers.
These responsibilities include:
1) Posting a notice in a place clearly visible to workers indicating that workers are covered by the state’s workers compensation laws.
2) Providing emergency medical care to any employee who is injured at work
3) Provide medical care to an employee if he or she is not able to select a doctor or advises the employer that he or she does not wish to do so.
4) File a report of any injuries that occur in the workplace with the closest workers compensation board office and the employer’s chosen insurance carrier.
5) Complete a written report of any on the job injury that causes an employee to lose time from his or her regular work to a degree that lasts beyond the shift during which the worker was injured or required medical treatment past the provision of basic first aid.
6) Respond to all requests for information on injured workers made by the worker’s compensation board or the insurance company.
Disputes
If you do not agree with the amount of workers compensation benefits you receive or come against any obstacles during the process, there are procedures to lodge a dispute. The best measure is to contact the Worker’s compensation commissioner’s office for New York and seek the assistance of a qualified personal injury attorney such as The Law Offices of Jonathan B. Nelson, PC.
Exceptions to Workers Compensation
There are some exceptions to the workers compensation scheme. Injuries caused during any kind of horseplay while on the job site may be excluded. Injuries suffered while a worker was intoxicated or under the influence of drugs may not be covered. Injuries that occur while an employee is commuting to or from work are generally excluded unless the employer required the employee to travel, furnished the method of transportation, and paid for it. An injury that occurs while an employee is running a personal errand probably will not be covered.
Why you need to an attorney to help obtain Workers Compensation Benefits
Determining whether you meet the requirements for Workers Compensation benefits can be a complicated process. If you are wrong about whether you qualify, you may have wasted valuable time that could have been spent initiating a lawsuit. Filing for workers compensation benefits can also be time consuming and burdensome. The bureaucratic hurdles may be immense and the paperwork daunting. Having a qualified law firm such as The Law Offices of Jonathan B. Nelson, PC assist you with your claim may avoid lengthy delays due to paperwork inaccuracies or missed deadlines. Call us for a free no obligation case review.
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