Oklahoma workers compensation can provide employees who suffer an injury at work with fixed monetary benefits and medical care without having to file a personal injury claim against their employer. Employers provide benefits without the employee proving the employer’s negligence contributed to the work injury, and employees accept less than they may have won with a personal injury claim.

Workers comp insurance does not pay for work injuries which are the result of intoxication, reckless actions or intentional actions which are meant to injure themselves or other employees. Most Oklahoma employers are required to pay for all other work injuries or occupational illnesses which occur while an employee is engaged in their normal job duties. Common injuries which may be covered include:

• Back and neck injuries
• Abrasions and burns
• Amputations of arms or legs
• Concussions
• Heart attack or strokes on the job
• Carpel Tunnel
• Diseases caused by inhalation of chemicals or other toxins

Oklahoma Workers Compensation Benefits

Work comp insurance was created to help the employee have easy access to medical benefits, temporary disability benefits, permanent disability benefits, vocational rehabilitation and death benefits. The following benefits are described below:

• Medical Benefits – Work comp insurance provides necessary and reasonable medical care for Oklahoma workers who are injured on the job. All medical costs are paid including: laboratory services, surgery, medications, hospital visits and physical therapy.  There is no cost or time limits for medical care.
• Temporary Total Disability – Oklahoma workers who are temporarily totally disabled and are unable to work, but will at some point return to work at full capacity, are eligible to receive 70% of their weekly wage (with a limit of $473 per week) for a maximum of 156 weeks. Benefits may be extended for additional weeks with authorization from the Oklahoma’s Workers’ Compensation Court. The first three days of incapacity are not paid.
• Permanent Partial Disability – Oklahoma workers who suffer a permanent partial injury must be evaluated to determine the extent of the injury and the amount of compensation they can receive. Work injury compensation is 70% of the employee’s average weekly wage, but the duration of the payment is determined by a set schedule. For example: A loss of a thumb entitles a worker to 66 weeks of disability payments.
• Permanent Total Disability – Oklahoma workers who suffer an injury at work and are unable to return to any type of employment may qualify for permanent total disability payments. Work injury compensation for a total disability is 70% of the AWW for the duration of the disability.
• Vocational Rehabilitation – Oklahoma employees who sustain an injury at work and need help to return to their job or to find new employment may be eligible for vocational rehabilitation.
• Death Benefits – Oklahoma spouses of a deceased worker may be eligible for lost wage compensation of 70% of the deceased worker’s average weekly wage and an additional 15% for each child up to 30% which is the maximum established by workers compensation law. Benefits may change if the spouse remarries. Funeral expenses are paid up to $10,000. Variations and requirements for death benefits can be complicated and should be evaluated by a work injury lawyer.

Do I Need an Oklahoma Worker’s Compensation Attorney?

Thousands of Oklahoma workers file workers compensation claims each year and depending on the work injury, the statutes and laws can be complicated. Work injury lawyers may be a good resource to help the employee file their work compensation claim and get the benefits they deserve. Oklahoma worker’s compensation lawyers can also help the injured worker if they have become the victim of workplace discrimination or harassment.

A Dec. 13 post at the Injury Board Blog Network by personal injury lawyer Alison De Villiers posits the question of whether an injured worker covered by workers’ comp can also qualify for a personal injury claim. For example, we’ve all heard of people who get injured in an auto wreck, a grocery store, or say, by hot coffee, and then their personal injury attorney helps them get some fabulous settlement.

Well, the short answer for on-the-job injuries is, no: if your employer carries workers’ compensation insurance, you are entitled to medical treatment and perhaps certain, specified disability benefits, if warranted.

But, in general, you can’t sue–unless you are denied proper treatment.

Basically, this is why employers take out workers’ comp insurance. In return for the overhead of the premiums, injured workers get treated and employers can’t be sued. It’s also why most states require most employers to carry workers’ comp policies.

However as De Villiers, a Cincinnati-based attorney, points out, it is possible at least in some states for an injured worker to receive workers’ comp benefits and to also have a case for personal injury–as long as the entity at fault is not the injured party’s employer. As De Villiers explains:

So how can an injured worker bring a personal injury claim? Although injured workers receiving worker’s compensation benefits cannot sue their employers, they can bring personal injury claims against a co-worker or other person/company, such as another company working on a jobsite. The injured worker must prove that the other party was negligent and the defendant is then entitled to present defenses. In a personal injury claim, the injured worker is entitled to more benefits than in worker’s compensation, such as pain, suffering, loss of earning capacity, loss of enjoyment of life, scarring and disfigurement, and loss of consortium.

In other words, let’s imagine an electrician at work on a construction site. The job is proceeding normally, that is, on time and within budget, so the electricians are the only tradesmen on the jobsite. Let’s say the electrician is working with heavy cable, and cuts one hand badly while attempting to strip insulation from a cable end. The injured electrician reports the injury, goes to the proper care facility and gets stitches and any other necessary treatment and follow-up. Neither the carrier nor the care provider (hospital, clinic, etc.) worries about “whose fault it was.” The employer has fulfilled its duty, and there’s no cause for further legal action.

Now, let’s imagine a different scenario. A small commercial job has gotten badly behind schedule, and the retail business is in danger of missing its opening. As a result, the client (the retail business) is exerting tremendous pressure on the general contractor, who in turn leans on the job superintendent. The super may go by several titles, according to region, industry, sector, and so forth.

Regardless, there’s always someone who’s “in charge” of the daily operations of the jobsite and all the trades. In a situation as described–and I’ve seen it happen–the “super” will convene a meeting that includes, or otherwise communicates to, all the subcontractors.

What happens next is all the trades show up, and suddenly you’ve got framers, drywallers, painters, plumbers, electricians, HVAC, pipefitters, and telephone/cable guys, and God knows who else (“I’m here to pick the fabric”) all on the same jobsite, everyone busting hump to beat the deadline.

Now, let’s suppose our good, honest electrician is working atop a 28-foot ladder, when suddenly someone knocks the ladder out from under our earnest electrician…such that the electrician bounces off structural elements in the building, then slams to the floor–a hard, concrete slab.

Maybe our electrician recovers fully. Or, the brain damage is bad enough that further work is impossible…

In a case such as this, the injured worker is obviously still due any workers’ comp benefits as apply. However, now a third party might be liable, apart from the direct employer.

These decisions and distinctions can be confusing.

That’s why De Villiers posts this: “It is important that you speak to an attorney to determine whether you are limited to the benefits available in a worker’s compensation claim, or whether you may be entitled to be ‘made whole’ with a personal injury claim.”

I agree–it shouldn’t be…but it is, most definitely, tricky stuff.

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Frequently enough, a worker’s compensation case may be so complex as to demand legal representation. However, sometimes what seems like a cut-and-dried situation to an injured worker may result in a smaller award than envisioned–or even a denial. Have you, a friend or a loved one been injured on the job? Whether you’re merely seeking answers about your rights or believe a lawsuit may be necessary, be sure to seek counsel with attorneys trained and experienced in workers’ compensation. Here’s some resources:

Workers compensation basics

Injury on the job

Filing a claim

We’ve covered changes effected and proposed in workers’ compensation systems in various states, including proposals not only from legislative, judicial and executive branches of state governments but also from electoral propositions.

However, private industry also comes up with new wrinkles, new products and programs that promise improvements in efficiency or costs.

Company Nurse Injury Hotline

One such is described in a recent press release from a 13-year-old company based in Scottsdale, AZ, announcing services available from its Company Nurse Injury Hotline.

According to the PR:

When a workplace injury occurs, client employees and supervisors call Company Nurse to report injuries and to speak with a triage nurse. Unlike nurse case managers, triage nurses get involved at the front end of the claims process, essentially on the day of injury — which is the earliest, most critical point at which to influence medical care, claims costs, return-to-work (RTW) outcomes, and employee satisfaction. Many organizations view nurse injury triage as a vital part of their corporate wellness, employee wellness, and employee health programs.

“Our nurses assess injuries over the phone and refer employees to the most appropriate level of care — whether it’s an urgent care facility, occupational clinic, or simple first aid,” said Paul Binsfeld, CEO of Company Nurse. “As a result, our Injury Hotline facilitates immediate, critical medical decisions that positively impact an employee’s medical care, as well as overall claims’ costs and outcomes.”

Decreases reported in costs, litigation

According to a November post at Risk & Insurance.com, “Since developing the company, [founder Paul Binsfeld] says employers have seen remarkable savings of 15 to 20 percent and up to 40 percent. The City of Little Rock, Ark., saw a 39 percent decrease in workers’ comp claims costs. And a hospice company with a mobile, in-the-field workforce and a decentralized injury reporting process reduced its lag time from an average of 17 days to two days, and litigation drop by nearly 40 percent. Most other organizations, he said, achieve virtually 100 percent same-day reporting.”

Improved referrals reported

Another satisfied customer, according to the company is the Boys and Girls Clubs of Metropolitan Phoenix, where Carol S. Sterling is the Human Resources Manager. “As an early adopter of the Company Nurse program, her organization experienced several key benefits. ‘First, we receive instant notification of injuries, so we can immediately file our first report of injury forms,’ said Sterling. ‘Second, Company Nurse is extremely flexible. We were able to include our local network of preferred providers in their referral process. Third, Company Nurse helps to control medical expenses, as triage nurses often refer injured workers to urgent care clinics, rather than the ER, which saves costs and still ensures quality care. Fourth, supervisors experience “peace of mind” in knowing injured employees are immediately assessed and referred for appropriate treatment, and we also experience smooth processing of claims and medical bills among the provider, insurance company, and employer.’ ”

Here’s a link to a brief .pdf file of a report by the company.

‘Pay As You Go’ program announced

Another company claiming to offer innovative services in various human resource areas, including workers’ compensation, is Unicorn HRO, a New Jersey-based company founded in 1982, with offices in four states.  Unicorn says it has more than 900 U.S. and international clients, with more than one million employees.

In a Dec. 12 press release, the company “announced today that it will begin offering ‘Pay As You Go’ Workers’ Compensation insurance as part of its suite of services. The . . . system for managing workers’ compensation insurance offers employers the compelling advantage of being able to manage workers’ compensation insurance payments in real time, thus allowing for simple, accurate and fiscally responsible cash flow management. The  . . . offering will eliminate the need for large installment payments and costly annual end of year workers’ compensation insurance reconciliation audits. The insurance premium calculations are automatically processed through Unicorn HRO®’s payroll solutions system.”

Highlights listed

On one of its Web pages, the company says the highlights of the system include the ability to:

• Maximize cash flow by eliminating large upfront installment payments
• Pay workers’ compensation premiums based on actual payrolls rather than estimates
• Obtain real-time evaluation of premium payment history and calculation
• Eliminate the need for costly year-end insurance reconciliation audits

The company also emphasizes that  the “offering of the ‘Pay As You Go’ . . .  payroll services is not the offer or sale of any insurance product.”

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Frequently enough, a worker’s compensation case may be so complex as to demand legal representation. However, sometimes what seems like a cut-and-dried situation to an injured worker may result in a smaller award than envisioned–or even a denial. Have you, a friend or a loved one been injured on the job? Whether you’re merely seeking answers about your rights or believe a lawsuit may be necessary, be sure to seek counsel with attorneys trained and experienced in workers’ compensation. Here’s some resources:

Workers compensation basics

Injury on the job

Filing a claim

As regular readers know, we’ve covered many cases demonstrating that it’s just not worth it to try to game the system, regardless of whether the schemer is a provider, carrier, employer or employee.

Today’s cases involve two companies, which naturally tend to involve larger sums, and two employees, whose backgrounds suggest they should know better.

Fifteen felony counts

On the West Coast, the owners of Granite Bay, California-based T.B. Concrete Company, Inc. have “been charged with 15 felony counts of payroll tax evasion and workers’ compensation insurance fraud,” according to a Nov. 30 account in this local news outfit.

According to the Central Valley Business Times, “The owners of a Placer County concrete company have been charged by the state with submitting false payroll reports and misrepresenting the status of employees as independent contractors. The company is accused of owing the state $230,000 in back taxes.

” ‘This company cheated the state out of hundreds of thousands of dollars in taxes and workers’ compensation premiums by submitting phony data and disguising wages as payments to independent contractors,’ says Attorney General Edmund Brown Jr.”

Another Nov. 30 account in the Sacramento Business Journal says, “Thomas Bernhardt, the founder and chief executive, and his wife Rachel Bernhardt, the company’s office manager, are scheduled to be arraigned today in Placer County Superior Court on 15 felony counts of payroll tax evasion and workers’ compensation insurance fraud. Both are free on bail. It was unclear whether the pair had retained counsel.”

Four counts of workers’ comp fraud

In Tennessee, “A Memphis business owner has been busted for Worker’s Compensation Fraud,” according to a local Fox affiliate, reporting on yet another case under-reporting employees.

“Richard Nobles, also known as Mike Nobles, the owner of several subcontract labor companies, was indicted on four counts of workers’ compensation fraud.
“According to the indictment Nobles underreported the number of workers on his payroll with intent to defraud four separate insurance companies of workers’ compensation premiums due to them.”

The story says that Nobles, who owns several subcontract labor companies, is alleged to have underpaid premiums of more than a million dollars.

Indirectly quoted in the Fox affiliate’s story, District Attorney Bill Gibbons said Nobles was difficult to track down and when taken into custody on Nov. 10, he was picked up with “packed bags.”

Facing 12 years on each count

However, according to a Nov. 13 piece in The Memphis Commercial Appeal, “His attorney, Jeffrey Jones, said his client has cooperated with investigators and that he was not trying to flee.

” ‘He understands he is facing serious charges, but flight from prosecution was never a consideration,’ Jones said.

” ‘The state executed a search warrant on his business in June and informed him that he was under suspicion. If he had wanted to flee, he would have done so months ago.’ ”

Nobles, 58, faces up to 12 years on each of the four counts of workers’ comp fraud over $60,000.

Former DOT worker in Connecticut

A Nov. 24 account from a Connecticut news site says, “Former state Department of Transportation employee Clint J. Verdone, 33, of Hebron, was charged with fraudulent claim or receipt of benefits Tuesday, according to a press release issued by the Connecticut Division of Criminal Justice [CDCJ].”

In that press release, CCCJ said:

Clint J. Verdone, age 33, of Hebron, was charged with Fraudulent Claim or Receipt of Benefits, a felony punishable by up to 20 years in prison.

According to the arrest warrant affidavit, Mr. Verdone collected more than $12,000 in disability benefits as a result of a work-related injury he supposedly suffered on September 22, 2009, while employed by the DOT.

The warrant alleges that during the time he was receiving benefits Mr. Verdone failed to disclose his work capacity and the income he earned while working at his business, Diamond Landscaping.

He was released on a written promise to appear in Rockville Superior Court, G.A. No. 19 on December 3, 2010.

Ex-corrections officer gets mix of jail, probation, fine

Apparently facing the least amount of jail time in any of these cases is a man who already pleaded guilty, a former “Attica Correctional Facility officer formerly from Batavia [who] was sentenced to four months in jail and five years of probation Monday in Genesee County Court” in New York, according to a Nov. 15 story in this local new site.

James S. Gibbs, who completed two months’ sentence, will serve two more before being released to probation and has had his share of other problems, according toa Batavia news site: “In May, Gibbs admitted to charges of grand larceny and attempted workers compensation fraud. He also agreed to more than $40,000 in restitution, with $20,000 payable before his sentencing.

“Since then he’s allegedly violated the terms of his presentencing release by getting arrested in Monroe County on a possession of a controlled substance charge, and he’s been through a divorce in which the couple lost their home.”

However, his attorney seems to have been successful in arranging more lenient payback terms. Of a $20,000 scheduled payment, Gibbs has paid about $3,000.

“Over the five years of his probation, his attorney Thomas Burns noted, paying back nearly $38,000 would work out to more than $600 per month, which Burns said seemed like a steep amount to expect Gibbs to pay back (among other expenses, Gibbs must pay child support). He asked for payments of $175 per month.”

The district attorney agreed that the payback term for such an amount in five years would be difficult and Judge Robert C. Noonan set payments at $200 per month, setting a review of restitution for summer 2011.

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Frequently enough, a worker’s compensation case may be so complex as to demand legal representation. However, sometimes what seems like a cut-and-dried situation to an injured worker may result in a smaller award than envisioned–or even a denial. Have you, a friend or a loved one been injured on the job? Whether you’re merely seeking answers about your rights or believe a lawsuit may be necessary, be sure to seek counsel with attorneys trained and experienced in workers’ compensation. Here’s some resources:

Workers compensation basics

Injury on the job

Filing a claim