Workers' Compensation FAQ

Last modified: July 26 2021

Basics

This is usually not a good idea. You have a right to medical treatment in workers comp. But in most cases you are required to pick a doctor from your employer's "panel of physicians". If you go "off the panel" then the insurance company may refuse to pay for treatment.

The panel must be posted in a prominet location at your work place. The employer must provide the list as soon as you become injured. Typically, the panel must contain the names of at least 6 doctors, including one orthopedic doctor. The panel may contain no more than two "industrial clinics."

If your employer does not have a panel of physicians or the panel of physicians is invalid, you should consult a lawyer. You may be entitled to choose any doctor you want.

Workers Compensation coverage begins the first day of the job. Employers with three or more employees are required to have workers compensation insurance.

Workers' compensation laws define an on-the-job injury as one that "arises out of and in the course of employment". That means that that the accident was related to the time, place, and circumsatance of your employment (for example performing job duties during regular business hours). That also includes employees travelling for work, or performing a special errand for the employer outside work hours. It also means that the work was at least in some way a contributing cause of the injury.

The insurance adjuster does not owe you any duty of good faith or fair dealing. Even if they are nice on the phone, they are actively working to reduce the value of your claim.

And absolutely do not let the adjuster take a recorded statement from you. It may seem like an innocent interview, but the adjuster is on a fishing expedition to look anything they can use to deny your claim. You are not required to give them evidence to use against you.

It is very common for workers compensation claims to be denied, even based on weak legal arguments. You have a right to request a hearing with the State Board of Workers compensation if your claim has been denied. If you have been denied medical treatment, a weekly check, or even your entire claim, then contact a workers comp lawyer immediately. A lawyer will be able to file the request for a hearing, gather relevant evidence through discovery, and argue your case in front of a workers compensation judge.

These are benefits that are payable to eligible dependents when an on-the-job injury results in death. Eligible dependents include the spouse and minor children of the deceased. The benefits are paid weekly in the amount of 2/3 of the workers average wage at the time of the accident (but not to exceed the maximum allowed by law - currently $675). Funeral expenses are payable up to the maximum available by law.

We charge the industry standard 25 percent of any benefits recovered. You do not owe us anything unless we are able to recover benefits for you. There is absolutely no up front cost to hire a workers comp lawyer.

No. The only requirement is that your employment has to somehow contribute to the injury. For example, repetive motion injuries and even carpal tunnel syndrome can be covered by workers comp. Even an aggravation of an old injury is covered by comp if your employement caused the aggravation.

Sometimes, but you cannot sue your employer for personal injury. You may sue a third party who causes you an injury while you are on the job. It is possible to have a comp claim and a personal injury lawsuit at the same time. This most often occurs when an employee has a work injury while driving. If you have a car accident while working, you can sue the at fault driver and file a workers comp claim against your employer.

Maybe. Just because your employer calls you an "independent contractor" does not necessarily mean that you are considered an independent conractor for the purposes of workers comp. Generally speaking, you will be covered where your employer exercises control over the manner and time of your work.

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Yes, but only if you can show through medical evidence that the condition was attributable to the performance of your usual work duties

Yes. The insurance company is also responsible for paying the cost of your mileage to and from the pharmacy.