If you are seriously injured in an accident on the job, there are probably several questions that you have. What am I going to do? How badly am I injured? How much work will I miss? How am I going to get by?

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.

Related articles

• Workers’ Compensation and Who Pays for It (usworkerscomp.com)
• Lump-Sum settlement for Being Permanently and Totally Disabled From Employment (usworkerscomp.com)
• Third Party Claims for Injuries on the Job (usworkerscomp.com)

‘Lump-sum’ a major sticking point in Washington state

We’ve been following legislative battles over workers’ compensation system in several states, especially Washington, Montana and Illinois, and also in West Virginia.

Around the nation, workers’ comp impasses abound

An April 22 piece at Huffington Post picks up on the topic, focusing on a battle in Maine over psychological injuries received in the line of duty (a particular concern for first responders), but concluding with an overview of nationwide perspective:

There’s a flurry of legislative activity around the country — notably in Maine, North Carolina, Illinois, and Montana — geared towards reining in the costs to employers of workers compensation claims. Maine Governor Paul LePage (R), who’s already sparked a high-profile battle with the state’s labor groups, went so far as to mention workers comp reform in his inaugural address. Illinois Governor Pat Quinn (D) recently told his state’s enthusiastic Chamber of Commerce that workers comp reform will happen “this year.”

While some bipartisan efforts exist, Republicans generally push the reforms, which business groups and insurance trade associations support. And though many of these discussions have been brewing for years, the ongoing efforts seem to dovetail nicely with the anti-labor zeitgeist fostered in Wisconsin and Ohio, as stories of able-bodied workers gaming the system now abound in legislative halls.

Evergreen State battles over budgets and ‘lump-sum’ proposal

In Washington state, legislators are struggling with three huge, interrelated issues–the state’s operating budget, its construction budget and workers’ comp reform. House and Senate leaders are so divided that they failed to reach agreement last week when the regular term ended, so Gov. Chris Gregoire has called a special session to revisit the issues beginning April 26.

A ‘permanent battleground’

An April 23 article in the Seattle Post-Intelligencer had this to say about the longstanding feud:

A permanent battle ground for organized labor and business groups, the fight to reform the state’s compensation system for injured workers is heading into overtime after Gregoire deemed it a special session issue and the Senate backed that by putting a bill they want to move forward in their budget. Indeed, business groups and the Senate aren’t giving up a measure that would establish the option of lump sum settlements to the system — a move they will save hundreds of millions of dollars in costs. But labor remains opposed any kind of settlement, saying it undermines the point of the system — one created in 1911 to provide injured workers with money as they heal. The House has proposed its own package of bills that nip-and-tuck the system to streamline it, and they say those changes would add up to about half a billion in savings in the next six years.

Workers’ comp system faces insolvency

As we wrote in earlier in the year, “The Seattle Times calls “one of the most contentious issues in the legislative session.” In February, an emergency rate hike was pushed through, and in January the governor was being praised for a ‘bold plan’ to revamp the system.

“Now, despite progress on different bills, officials are saying hard choices loom ahead, with chances of having a bankrupt system within five years, according to a Feb. 26 piece in the Seattle Post Intelligencer, which reports that the governor, ‘the head of the state Department of Labor and Industries and the state auditor have all said the system is heading toward bankruptcy. In a December report, the auditor’s office said the state’s fund for workers compensation has a 95 percent chance of becoming insolvent in the next five years.’ ”

According to the DLI, about 8 per cent of workers’ comp claims account for nearly 85 per cent of costs, due both to injuries requiring longterm recovery and rehab and also for those awarded lifetime pensions.

Editorial calls for letting workers decide

An editorial in today’s Tacoma News Tribune argues that organized labor has stubbornly drawn a line in the sand and that the lump-sum option has plenty of worker safeguards:

Unions’ attacks on the proposal have a decidedly paternalistic tone. Critics essentially argue that workers don’t know what’s good for them and if given the option of settling their claims for about 80 cents on the dollar, they might just foolishly take it.

Lump-sum settlements would no doubt prove popular here, just as they have in the 44 states that offer them. Many injured workers prefer to get their money upfront rather than have it dribble out in regular checks. In some places, labor has embraced the choice as a worker benefit, which it is.

The settlements would be strictly voluntary, and several safeguards are built into the proposed system to ensure workers make the decision with their eyes open.

The new House proposal improves worker protections even further. Workers would have to wait six months to settle their claims to ensure that they weren’t pressured into premature decisions. Settlements couldn’t be offered to workers who already have pensions, and lump-sum settlements would be allowed for lost earning power only, not medical claims.

Those changes reduce the possible savings to the workers’ compensation system while still retaining a settlement option that would lend the system greater predictability.

Doing nothing should be out of the question. The status quo – a system in which Washington grants lifetime pensions at an unrivaled clip and where about 85 percent of compensation costs come from only 8 percent of all claims – is not sustainable without huge increases in payroll taxes.

Maybe the Governor can push the lege to finally reach consensus and get this problem solved for the workers of Washington State.

Next time: an update on other battles around the country.

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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

A report from the National Council on Compensation Insurance, Inc. (NCCI) is generating some industry buzz about the “precarious position” of the workers’ compensation insurance industry. But a speech at the same symposium by the executive director of the Workers Compensation Research Institute (WCRI) frames the problem in language the rest of us can understand.

Workers comp insurers in ‘precarious position’

Here’s a typical trade press take, from a May 10 post at the Web site of Workforce Management:

“The state of the U.S. workers’ compensation insurance industry is in a ‘precarious position’ following a trying 2009, while economic uncertainties remain ahead, said NCCI Holdings Inc.

“The pace of economic recovery and unknown factors related to health care reform and financial regulation are among uncertainties facing the U.S. industry, NCCI said Thursday, May 6, in its annual ‘State of the Line’ market analysis.

“Meanwhile, workers’ comp insurers’ 2009 combined ratio rose to 110 percent from 101 percent the previous year—the largest single-year increase since the mid-1980s, said the Boca Raton, Florida-based unit of the National Council on Compensation Insurance Inc.”

NCCI: ‘largest data base’

According to the “About” section of its Web site, the “National Council on Compensation Insurance, Inc., based in Boca Raton, FL, manages the nation’s largest database of workers compensation insurance information. NCCI analyzes industry trends, prepares workers compensation insurance rate recommendations, determines the cost of proposed legislation, and provides a variety of services and tools to maintain a healthy workers compensation system.”

The NCCI 2010 report is worth looking at, even if you don’t follow the stats, graphs and industry terminology–the so-called “3D” twist on the .pdf-style document is pretty cool. If you want even more stats and graphs, there’s also the chief actuary’s outline for the symposium. We’ll be referring back these and other related documents in the months ahead, but for now let’s focus on the remarks of Richard Victor, WCRI’s executive director.

WCRI exec says remove unnecessary costs

Another trade-press Web site, in a May 7 piece at P&C National Underwriter, indirectly quotes Victor as saying, “As states exit the recession with a focus on saving money in the new economy, workers’ compensation systems will have to strip out as many unnecessary costs as possible to be successful.”

That may sound like jingo–ism, especially when coupled with Victor’s defining ” ‘unnecessary costs’ as costs borne by the employer in a workers’ comp system that do not improve the outcomes for injured workers.”

But, for anyone hoping for the voice of reason, the examples Victor cites are reasons for encouragement.

Fears of injured workers

“After a workers’ comp claim is filed, Mr. Victor said, the worker generally has three fears: that the worker will lose his or her job; that the worker is distrusted by the supervisor, and a perception that claim denial has occurred or will occur.

“Those with job loss fears are twice as likely to hire an attorney, Mr. Victor said. Those who feel distrusted are 50 percent more likely to hire an attorney.

“Mr. Victor said perceiving that a claim denial will occur is easy for a worker that is not getting money or receiving communication from the employer or insurer.”

Sounds as though he’s paying attention.

So much so, that he recommends all states should do a better job of communicating with workers, as in what to expect if they’re injured,  and how to go through the process. “He said states should have a way for workers to call and find out what will happen with a claim and when. If the claim process deviates from the information given, workers should be able to call back and get further guidance.”

What do higher costs achieve?

And this part is really good: Victor urges states with high claim costs to analyze their systems–not merely to see where costs can be lowered but more important to see whether those extended costs are leading to better results for injured workers. Even better, he uses examples of states with different systems to argue against the adversarial system common to many states. Injured workers who run into balky insurers–and their attorneys–the workers are more likely to need attorneys of their own.

This results in what the article refers to as “dueling docs,” in which “the worker gets a lawyer, who in turn gets a doctor, and the [insurance company] gets its own doctor and they testify against each other . . . .”

Wisconsin system lauded

To get the point across, Victor compares “the systems in states like New Jersey and Maryland with Wisconsin, noting that defense costs are around 40 percent of payments in the former states and 14 percent in the latter state.

“Wisconsin has a higher incidence of voluntary partial permanent disability (PPD) payments, he said, while such payments are virtually non-existent in New Jersey and Maryland. Workers in Wisconsin are also less likely to hire attorneys, he noted.”

Victor cites Wisconsin’s system as possible model because the adversariel model “is discouraged in favor of a system more akin to salary arbitration in baseball.

“In Wisconsin, he said, there is no ‘splitting of the difference’ when dueling docs are used, he said. Instead, the workers’ comp director picks one side or the other.

“This, he said, encourages both sides to make their most reasonable offers, as each side strives to make a more reasonable case than the other.

“ ‘It’s a whole different dynamic . . .’ that leads to both sides coming closer together rather than moving further apart, he said.”

Wouldn’t it be nice if all states workers comp systems were more intent on ensuring that proper treatment of injured workers were the focus of the process?

We’ll be looking for data or studies that delve into the Wisconsin system.  It would be interesting to know how satisfied those workers are with the “arbitration model” as well as any quantifiable health improvements following treatment.

Stay tuned.

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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

Choosing an attorney