Frequently Asked Questions Regarding Workers’ Compensation Claims
What is workers’ compensation?
In Indiana, the Workers’ Compensation Board has exclusive jurisdiction to hear claims for personal injury or death by accident arising out of and in the course of employment. Therefore, you cannot sue your employer for any injury you received on the job and recovery will be at the control of the Workers’ Compensation Board, unless a person or corporation outside of your employment is responsible for your injury. That is considered a third-party claim, which will be discussed later.
What do I do if I get injured on the job?
One of the first and most important things that should be done is to make sure that your employer, preferably a supervisor or manager, is aware of your injury and how the injury occurred immediately after you were injured. The next step would be to discuss with your employer where you should go for your medical treatment.
What is considered an injury or death arising out of and in the course of employment?
This question is usually easy to answer if you are on the premises of your employer when you are injured. However, the question becomes a little bit more difficult when you are outside of the premises. If you are “on the job” and off the premises, you may still receive workers’ compensation benefits. It is even possible to receive workers’ compensation benefits if you are going to or coming from your job.
What do I receive as my workers’ compensation benefits?
If you miss seven or more working days due to your injury, you will receive Temporary Total Disability (TTD) benefits which are your wages. You will receive 2/3 of your average wage over the last 52 weeks. Your employer will also be responsible for paying your medical bills for any treatment you receive. However, due to the fact that the employer is paying your medical bills, they will likely control the doctor or medical provider that you see for your injuries. If a doctor feels you have received any type of serious impairment due to your injury on the job, you may also receive a lump sum settlement after the doctor releases you from his/her care.
Can I receive pain and suffering for my injuries?
No. If you are injured on the job, not by a third-party, you are eligible only for a portion of your lost wages, your medical treatment and settlement for any serious impairment.
What is a third-party claim?
If someone is injured or killed by an accident which arose out of and was in the course of your employment, and the injury or death was caused by a party that is not a co-employee or your employer, you may be able to sue the party under a third-party claim. This claim would not be under the jurisdiction of the Workers’ Compensation Board and you may receive additional damages from that third party.
What if I am totally and permanently disabled as a result of the injury?
If you are permanently and totally disabled as a result of your injury arising out of and in the course of your employment, you may be able to receive higher damages to compensate you for the seriousness of your injury.
Do I have to see the doctor or medical facility that my employer is demanding that I see?
Due to the fact that your employer is paying for your medical treatment, they can somewhat control with which provider, doctor, or medical facility you treat. However, you may be able to get an independent medical examination through the Workers’ Compensation Board or a second opinion from a doctor of your choosing; however, this requires approval by the Workers’ Compensation Board.
What if my company or the workers’ compensation insurance company is not paying my medical bills and I get a bill from the health care provider?
You should notify your attorney immediately. There is a statute in the state of Indiana that if the medical expenses were incurred as a result of a work injury, then the medical facility cannot proceed to collect against the individual. They must file what is called a provider’s claim with the Workers’ Compensation Board or submit their claim to the workers’ compensation insurance company. In other words, there is some protection in terms of the potential damage to your credit if there is some dispute on your workers’ compensation case or some delay in paying the medical bills on the part of the insurance company. This statute protects you in these circumstances.
Do I need an attorney?
Initially, if your employer is paying your wages as described above, and is paying for your medical treatment, it is probably not necessary that you employ an attorney to help you in the matter. However if at any time you disagree with any treatment you are receiving, any evaluation given to you by the doctor, if your employer is not paying the medical bills appropriately or if you feel that you are being taken advantage of, it is probably necessary that you retain an attorney to help you.
For more information, call Sachs & Hess, P.C., at 219-227-4259 or contact us online.