The short, simple answer is, “Yes.” This is something that you need to do. Here is why.

Your employer’s insurance company cannot force you to have an independent medical examination. However, if you refuse to go to an IME, you may be forfeiting your rights to receive the workers’ compensation benefits that you are entitled to.

The insurance company’s right

Whenever the insurance company that is handling your workers’ compensation claim says that you need to have an independent medical examination, it is their right to have you do so. Generally speaking, when your employer’s workers’ compensation insurance company is asking you to have an IME, it is because they are contesting some part of your workers’ compensation claim.

The laws regarding an independent medical examination vary from state to state. It is a good idea to check on what the law says about an IME in your state. In some states, a workers’ compensation insurance company can ask you to submit to as many as three independent medical examinations with as many as three different health care providers.

It is very important that you are honest and straight-forward with the independent medical examiner. Be truthful about your injuries, and do not try and exaggerate them. Answer the questions that you are asked truthfully, but do not volunteer any information.

Many IME’s done each year

It is true that some independent medical examiners perform hundreds of independent medical examinations for the insurance industry each year. Their bias for the insurance company is notorious in some instances.

However, most of the doctors who do independent medical examinations are honest men who really do not want to be involved in the legal system. They often reluctantly do an IME as a part of their community service. Their reports are usually based on an honest evaluation of your condition.

In these cases, a legitimate dispute may arise over the extent and nature of your disability or the reason for your condition. There are times when doctors simply do not agree concerning the disability of a patient.

Not the final decision

If your workers’ compensation claim has been turned down because of an independent medical examination, do not give up hope. Your employer’s workers’ compensation insurance company does not make the final decision.

There is some kind of workers’ compensation board in the state where you live and work. If you are denied workers’ compensation benefits on the basis of an IME, you can appeal this decision to the workers’ compensation board.

If you have been asked by your employer’s workers’ compensation insurance company to have an independent medical examination, the best thing that you can do, if you have not already done so, is to have a workers’ compensation attorney on your side. A workers’ compensation attorney can help prepare you for you IME and an appeal before the workers’ compensation board if it is necessary.

As required by every state in the United States except for Texas, your employer has workers’ compensation insurance. You have done the things that your state says you have to do to apply for workers’ compensation benefits. You have followed the procedure, step by step.

Now, what you would like to know is, “Who determines disability in a workers’ compensation case? Who is it that determines whether my workers’ compensation claim will be approved or denied?”

Your employer’s insurer

In most cases, the insurance company that is providing your employer with workers’ compensation insurance is the one who will look over your claim and be the one who determines your disability and eligibility to receive workers’ compensation benefits. If your employer is self-insured, it is your employer who determines your disability and eligibility for workers’ compensation benefits.

If you can demonstrate that your illness or injury was a result of doing your job as an employee for your employer, you should be approved for workers’ compensation benefits. For example, if the conditions and environment that you work in are responsible for and have led to your illness, you should, in most cases, be approved for workers’ compensation benefits. If you are injured in an accident while doing your job for your employer, in most instances, you should be approved for workers’ compensation benefits.

What if your employer or your employer’s workers’ compensation insurance company turns down your claim for workers’ compensation benefits, even though you know that your illness or injury has been caused by your job? Is there anything that you can do? Can you challenge the decision of your employer or your employer’s workers’ compensation insurance company?

Things that you can do

The answer is, “Yes.” There are some proactive things that you can do when your workers’ compensation claim has been denied.

To begin with, you need to find out why your workers’ compensation claim was denied. It may turn out that you forgot to include some necessary paperwork, such as a statement from the doctor who is treating you regarding your disability. If this is the case, resubmit your application for workers’ compensation benefits and see if it is approved this time.

The next step to take if you are denied is to file an appeal with your employer’s workers’ compensation insurance company. This in-house appeal is where you start. The time limit that you have in which to make this appeal varies from state to state. You may have as little as 30 days after you receive your denial of benefits notice in which to file an appeal.

Workers’ Compensation Board

If your in-house appeal is denied by your employer’s workers’ compensation insurer, you need to contact the workers’ compensation board in your state. Each state has some kind of  workers’ compensation board, and one of the primary things that the board does is hear appeals of denied workers’ compensation claims.

Throughout this process it is a good thing to have a workers’ compensation attorney standing with you. A workers’ compensation attorney will ensure that all of your rights are protected.

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The good news is that your employer has workers’ compensation insurance, and you have been approved for workers’ compensation benefits. However, you do not know very much about workers’ compensation, and you are wondering about what benefits it will provide.

Specifically, you have been informed that you will be receiving temporary total benefits. You would like to know exactly what this is and what it means.

Compensation for lost wages

Temporary total benefits is short for temporary total disability benefits. You may also see it referred to as TTD. Temporary total benefits are the compensation that you get during the time that you are unable to work. You can think of it as being compensation for your lost wages while you are unable to work.

They are temporary because they will end when you are able to return to work, or you reach what is known as maximum medical improvement or both. They are referred to as total because you receive them during the time that you are completely unable to work and while you are receiving active medical care for your injuries or your illness that is keeping you from being able to work.

Maximum medical improvement is a term that will be used by the doctor who is treating you for your injuries or illness when you reach a point where the doctor believes that you will not improve any further. This may mean that you have achieved total recovery from your injuries or illness. However, it may also mean that the doctor may consider you to be permanently disabled. In this case, your temporary total disability will end, and you will probably be eligible for permanent total disability benefits or PTD.

What you will receive

The amount of the temporary total benefits that you receive varies according to the state that you live in. In most states it is equal to about two-thirds of your average weekly pay. This is determined by averaging your gross weekly pay over a period of so many weeks. However, there are minimum and maximum amounts that you are allowed to receive for temporary total benefits. Again, this varies from state to state and is based on your state’s average weekly wage.

In most states, you are only allowed to get temporary total benefits if you miss work for a period of more than seven days. In addition to temporary total benefits, all of your necessary and reasonable medical treatment for your injuries or illness will be paid for by workers’ compensation.

In order to make sure that you receive all of the temporary total benefits that you are entitled to, it is a wise decision to have a workers’ compensation attorney representing you. Things can get complicated, and disputes may arise. A workers’ compensation attorney will make sure that your rights are protected, and you receive all of the workers’ compensation benefits that are rightfully yours.

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One of the most important questions that you may have is, “How will I be compensated for my lost wages?  How will this be taken care of?”

The answer is that this is one of the benefits that are provided by workers’ compensation. As you probably may know, workers’ compensation is a form of business insurance that nearly all employers are required to carry in every state in the United States except for the state of Texas.

Fault is not an issue

Workers’ compensation insurance is a special type of insurance that an employer has. This is because when it comes to workers’ compensation, in almost all instances, fault is not an issue that is taken into consideration when a worker is injured in an accident on the job. As long as the accident happens while you are doing your job for your employer, it does not make any difference whether the accident that brought about your injuries was your fault or your employer’s. You are eligible for workers’ compensation benefits.

Almost all kinds of injuries are covered by workers’ compensation. Again, it just has to be an injury that you sustained while you were doing your job for your employer.

Being compensated for lost wages is one of the benefits that is provided by workers’ compensation. Although the amount may vary depending on the state that you live and work in, it usually amounts to about 2/3 of your regular weekly wage from your job.

You will receive checks for lost wages from your employer’s workers’ compensation insurance company. The insurance company is supposed to pay you at the same frequency as your employer pays you. If your employer pays you weekly, the insurance company is supposed to send you a check each week.

How long can you get lost wages

You may also ask, “But for how long will I be compensated for my lost wages?” This depends on how serious your disability is and the laws of the state that you live in. For example, in Massachusetts, if you have a temporary total disability, you can get a check for as long as three years. In California, you can get a check for temporary total disability for up to two years. In Georgia, it is 400 weeks, or over seven years. In Wisconsin, being compensated for lost wages will continue for as long as the doctor who is treating you says that you are not able to go back to work.

If your disability is a temporary partial disability, you can be compensated for lost wages for up to five years in Massachusetts. In California, it is two years. In Georgia, you can get temporary partial disability checks for as long as 350 weeks, or over six years. In Wisconsin, you can receive these benefits until your condition becomes stabilized, and treatment as well as convalescence is not likely to result in additional improvement.

This all may sound simple and straight forward, but it can be extremely complex and complicated. In order to assure that you will receive the maximum cash benefits that are rightfully yours, it is wise to have a workers’ compensation attorney working for you.

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Obviously, this will depend on how badly you have been injured in the accident at work. Your first concern is to get the medical attention that you need for your injuries. If your injuries are only superficial, they can probably be handled with a first aid kit. However, if your injuries are serious or life-threatening, you will probably have to be taken to an Emergency Room for treatment.

After you get the medical treatment that you need, there are really several first steps that you need to take. The first step is to inform your employer of your accident at work and the injuries that have resulted from it. In some states, your employer has the right to chose the doctor or medical care provider who treats your injuries in a workers’ compensation case. In other states, you get to choose the doctor that treats you.

Let your employer know

To repeat, if you have been injured at work in a way that requires emergency medical treatment, you do not have to be concerned about this. However, as soon as it is possible, let your employer know about your injuries that have been brought about by the accident at work so that all of the reasonable and necessary medical expenses that you incur will be paid for in full.

The next step after you have been injured at work is to make a written notice of your injuries. Again, how this is done varies from state to state. In some states, there are specific forms that have to be filled out as soon as possible after the accident at work that causes your injuries.

You also have a deadline for informing your employer of the accident at work that led to your injuries. If you let this deadline pass, you may not be able to get any of the workers’ compensation benefits that you are entitled to. This deadline can vary from a few days to several months or years before informing your employer. It all depends on the state that you live and work in.

The importance of the first steps

The reason why these are the first steps that you need to take after being injured in an accident at work is not only so that you will get the medical attention that your injuries require, but that you will also get all of the workers’ compensation benefits that are due you.

Hopefully, you know that in every state except Texas, employers, with few exceptions, have to carry workers’ compensation insurance. This is a no-fault kind of insurance. What this means to you as a worker is that if you are injured at work while you are doing your job for your employer, these benefits are yours, regardless of whose fault the accident was that resulted in your injuries.

One other initial step that you may need to take is to contact a good workers’ compensation attorney. A good workers’ compensation attorney will make sure that your rights are protected, and you get all of the workers’ compensation benefits that you have coming to you.

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On the other hand, you may not know what workers’ compensation is, or who pays for it. You may have heard it mentioned, but you would like to know more about workers’ compensation.

In every state except Texas, workers’ compensation is what you might think of as a mandatory kind or type of business insurance. It is something that all employers with few exceptions must have. These exceptions vary from state to state.

Workers’ compensation benefits

When you get hurt in an accident while doing your work for your employer or you develop some kind of illness that results due to the nature of your work, workers’ compensation pays you benefits that include payment of all of your necessary medical bills, lost wages and rehabilitation if needed to help you get back to work. If you were to die from injuries sustained on the job or an illness brought about by your work, these benefits are paid to your survivors or dependents.

There are three great things about workers’ compensation. The first is that these benefits are yours as a matter of “right”. You have a right to receive these benefits from your employer. There is no legal defense that your employer can turn to. In return for these benefits, neither you and/or your survivors or dependents are able to sue your employer for your injuries, illness or death.

You may say, “That all sounds great, but what if the accident or illness is my fault?” The second great thing about workers’ compensation is that it is a no-fault form of insurance. In other words, when it comes to workers’ compensation, it does not make any difference whether the accident that brought about your injury was your fault or your employer’s fault. As long as it happened in the course of, and arising out of, your duties as an employee for your employer, you are eligible to receive workers’ compensation benefits.

Who pays for it

You may say, “All of this sounds great, but who pays for workers’ compensation? Is it taken out of my pay? I don’t think I can afford it.” Here is the third great thing about workers’ compensation. It does not cost you a penny. Your employer pays for this business type of insurance. There are no deductions that are taken out of your paycheck for workers’ compensation.

What workers’ compensation costs your employer depends on the number and severity of illnesses and injuries that your kind of employer has. It also depends on what your employer’s gross payroll is. For instance, a professional consulting firm would not have to pay as much for workers’ compensation as a manufacturing company.

If you have been injured at work in an accident or become ill due to the type of work that you do and your employer has tried to keep you from getting the workers’ compensation benefits that are rightly due you, you need to contact a workers’ compensation attorney who will stand up for your rights.

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There are risks that are related to almost every type of work. There are injuries that can be brought about by an accident that takes place in the workplace. There are also illnesses and diseases that are work related.

If you have sustained injuries from an accident that was work related or you have illnesses or diseases as a result of your work, there is something that you would like to know. “Are my injuries, illnesses or diseases covered by workers’ compensation?”

Here is some good news for you. Almost all injuries are covered by workers’ compensation as long as your injuries result from an accident that occurs out of and in the course of your work. In other words, it is an injury that you sustain as you are doing your job for your employer. In fact, even if you get injured as you play a game of football at a picnic that is sponsored by your employer, your injury may be covered by workers’ compensation.

Also true of illnesses and diseases

The same is true in regard to any illnesses or diseases that are brought about by extraordinary or unusual risks that you face due to the nature of your work. Examples of this are people who work with computers getting carpal tunnel syndrome, or coal miners who get black lung disease. In fact, even if it is a preexisting condition that you have, which is made worse or aggravated by your work; this may be covered by workers’ compensation.

The key is that your injuries, illnesses or diseases are related to your work. There has to be a connection between your injuries, illnesses or diseases and the work that you do for your employer.

Although this seems pretty simple and straightforward, determining whether your injuries, illnesses or diseases are related to your work can sometimes get complicated. For example, as mentioned above, if your are injured in an accident at an event that is sponsored by your employer, such as a picnic or party; your injury may be covered.

Travel may be covered

Another example is travel. If you are injured as you go to and from where you work, that injury is not usually covered by workers’ compensation. However, if you go on a business trip for your employer and you are injured, that injury is probably going to be covered by workers’ compensation.

You may even be covered by workers’ compensation if you are injured when you do something your employer has prohibited, or you break a workplace safety rule. This is especially true if your employer is aware of what you are doing and allows you to continue doing it.

If you have sustained an injury, illness or disease at work and are not sure whether it is covered by workers’ compensation, or your employer is not wanting you to make a workers’ compensation claim, you need to have a workers’ compensation attorney working for you. A workers’ compensation attorney will look over your case and tell you the best way to proceed in order that you might receive all of the workers’ compensation benefits that you are entitled to.

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An accident that takes place at your work place is never a good thing. It may be that you were injured in an accident that was job related. You may have not been able to return to work for weeks or months.

While a job related injury from an accident is never a good thing, your employer was covered by workers’ compensation insurance. A workers comp claim was made, and you were approved by your employer’s workers comp insurance company. As a result, you began to receive workers comp benefits for your job related accident injuries.

For one reason or another a dispute has developed between you and your employer or your employer’s workers comp insurance company in regard to your claim. It may be that the primary doctor who is treating you for your job related injuries has said that you have reached maximum medical improvement (MMI) and has released you to go back to work.

Maximum medical improvement means that the doctor believes you have reached a point where your condition is not going to get any better. However, you may not believe that you are ready and able to do your job. Or, it may be that your employer‘s insurer is pressuring you to settle your claim, and you are not ready to settle.

Going before an arbitrator

At any rate, in order to resolve the dispute, your workers’ comp case has been taken to an arbitrator. In some states the arbitrator’s decision is final, and you are prevented from making any additional appeal in regard to your workers comp claim. However, in most states, arbitration is not binding. You are allowed to appeal the decision of the arbitrator or continue the litigation process, even though the arbitrator’s decision is in favor of your employer.

The question that you would like to have answered is, “What happens if your condition gets worse after the arbitrator makes his decision in regard to your claim? What can you do? What options do you have?

Lump-Sum Settlement

Again, this depends on the state that you live in. In some states if no lump-sum settlement has been made, you may be able to receive an increase in workers comp compensation and additional hospital, medical and surgical benefits.

A lump-sum settlement is where you agree to settle your case for one lump sum of money. When you do this, although there are some exceptions, it ends your claim for that particular job related injury. You are not allowed to change your mind.

Workers compensation attorney

Even before your workers comp claim goes to an arbitrator, you really should have a workers compensation attorney representing you. Especially if your condition gets worse after an arbitrator’s decision, you are more than likely going to need the advise and counsel of a workers’ compensation attorney.

You and your family’s future are vitally important. A workers’ compensation attorney will protect your rights and make sure that you get all of the workers comp benefits that you deserve.

You may have suffered a work-related injury in an accident at work. It is an injury that may require medical treatment in the future, possibly lifelong treatment.

An important thing that you need to know is, “Under what conditions am I able to ensure that I will be able to receive future medical treatment for my work-related injury?”

The best thing you can do

The best thing that you can do is to file a workers’ compensation claim for your work-related injury. In every state except Texas, employers, with few exceptions, are required by law to have workers’ compensation insurance. If you are injured in an accident while performing your job for your employer, almost all types of injuries are covered by workers comp.

Workers’ comp is a tradeoff. In return for paying for your medical care and other benefits, you are not permitted to sue your employer for your work-related injury that resulted from an accident at work.

The reason why filing a workers’ compensation claim is the best thing you can do to ensure that you will be able to receive all of the future medical treatment that you need for your work-related injury is workers comp benefits entitle you to get all of the reasonable and necessary medical treatment that you require at no cost to you. This is for as long as you require medical treatment for your work-related injury.

For the rest of your life

By filing a workers comp claim, you may receive medical treatment for your work-related injury for the rest of your life if your injury requires it. It all depends on the type of injury that you have and how long it will take to recover from it.

Some work-related injuries are resolved in a matter of weeks or months. Others may take years, and others may be of such a nature that they last for the rest of your life.

The important thing to remember is that if you do not settle your workers comp case, you leave the door open for medical treatment that you may need in the future. Once you settle your workers compensation claim, that usually ends all of the benefits that you will receive for that particular work-related injury, unless provision is made as a part of the settlement for you to receive future medical treatment if it is needed.

No one can force you to settle

There is another important thing to remember. No one can force you to settle your workers comp claim. Your employer’s insurer may try to pressure you into settling, but you do not have to settle.

Workers comp laws vary from state to state. One of the smartest things that you can do is to have a workers’ compensation attorney working for you. A workers’ compensation attorney will know the best course of action to take to ensure that you will be able to get all of the future medical treatment that your work-related injury requires. A workers comp attorney will help you to get all of the workers’ compensation benefits that you have coming to you.

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Accidents do happen at work. You may have been the victim of an accident on the job. The accident may have brought about serious injuries to you.

You are thankful that your employer had workers’ compensation insurance. Your claim was approved, and you have been receiving comp benefits.

You have hoped that you would be able to recover and go back and do your former job. However, you have reached a point where the primary doctor who has been treating your work-related injuries says that you have reached maximum medical improvement (MMI).

What is maximum medical improvement

Maximum medical improvement is a term that is used when you have reached a state where improvement is no longer possible. This may mean that you have fully recovered from your injury, or it can mean that your condition has stabilized to the point where no major medical or emotional change is expected. This is regardless of any additional medical treatment or therapy that you may receive. In plain English, maximum medical improvement means that you have reached a point where you are not going to get any better.

If you have fully recovered and are able to return and do your former job this is great. However, your primary doctor may have released you, and you tried to do your former job and were not able to do it. Or, your primary doctor may have told you that your injuries are of such a nature that you will never be able to do your former job.

Vocational rehabilitation benefits

So, now, what you want to know is, “ Am I entitled to any vocational rehabilitation benefits where I can be trained to do another occupation since my injuries will not allow me to do my former job?”

Although laws vary in different states, you are entitled to vocational rehabilitation benefits. Vocational rehabilitation benefits will usually include retraining and job placement that is necessary to get you back to useful employment. The treatment, service or training that is appropriate and necessary to do this is usually paid for by your employer’s workers’ compensation insurer, the state you live in, your employer or possibly a portion by each of the three.

If you are not able to do your former job because of injuries that you suffered in an accident on the job, a wise decision is to go to a workers’ compensation attorney. A workers’ compensation attorney will know what vocational rehabilitation benefits are available and what you may be eligible for in your state. Do not waste time. Contact a workers’ compensation attorney, today.

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