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Workers' Compensation Claims

An on-the-job injury that results in the inability to work for an extended period of time can put the victim in a dire situation. And when most Americans only have a few thousand dollars in savings, the loss of a regular paycheck can quickly turn into an emergency. 

That’s why it’s so important for injured workers to receive the workers’ compensation benefits they’re entitled to.

There are two main components of workers’ compensation: the wage replacement benefit and the medical care benefit. The total amount of these benefits depend on several factors, including how much the worker earned and the severity of their injury. Understanding what affects the average workers’ compensation claim can help you prepare for the claims process. 

That being said, every claim is highly individual, and specific questions should be directed to our workers’ compensation lawyers. Morgan & Morgan attorneys are well-versed in the workers’ compensation laws for each state and have the resources to appeal your claim if it is denied, which happens far too often, and, in the process, fight for every penny you deserve.

Workers’ Compensation Lost Wages

Workers’ compensation provides a wage replacement benefit that covers some—but not all—of an employee’s wages. Each state’s benefits system is different, but generally, workers can expect the following:

  • Average weekly wage: The wage replacement benefit covers approximately 60 to 70 percent of a worker’s average weekly wage, based on the worker’s average weekly pay prior to the date of injury. Each state uses a different number of weeks to calculate the average weekly wage: some states look at a worker’s average weekly wage for the previous year, and some states use a smaller sample of the worker’s wage history.
  • Maximum Compensation: States cap the amount of compensation available per week. There is also a minimum amount. States regularly adjust their maximum and minimum wage benefits to keep up with changes in the cost of living. You can see each state’s maximum weekly benefit amount here.
  • Temporary vs. Permanent Disability: There are also benefit differences between temporary and permanent disability. When you are temporarily disabled but make a full recovery, you receive wage loss benefits until you return to work. But if you are considered permanently disabled, you can continue to receive benefits, even if you’re eventually able to return to some kind of work. The permanent disability rate is commonly based on the degree of impairment, but states use different approaches.

Due to the different state laws on workers’ compensation, you should speak to a local attorney. To consult with one of our workers’ compensation attorneys where you live, please schedule a free case review.

Workers’ Compensation Medical Benefits

You shouldn’t have to pay out-of-pocket for medical treatment for an occupational injury or illness. Workers’ compensation medical benefits are usually unlimited and have no deductible. Typically, nothing is billed directly to the worker. Payment is made from the employer’s insurance company to the healthcare provider. Your only responsibility is to attend all medical appointments and follow doctor’s orders.

Depending on where you live, you may not have the freedom to choose any medical provider you want. Around half of the states require their employees to use an “authorized” physician picked by the employer. In other states, you can choose your physician. Some states let you see a physician of your choice, with periodic consultation with an employer-authorized physician.

Types of medical bills covered by workers’ comp include:

  • Hospital visits
  • Nursing care
  • Medication costs
  • Surgical fees
  • Rehabilitation services, including occupational rehabilitation and modifications to the worker’s home, vehicle, and workspace
  • Travel expenses to and from medical treatment

Healthcare in the United States is expensive. A fall that results in hospitalization can cost more than $35,000, getting struck by a falling object $7,000 to $42,000, and a traumatic brain injury $40,000 - $45,000. A denied workers’ compensation claim could mean you miss out on this valuable benefit and are solely responsible for your medical bills.

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