I am also going to write in a series, not just one. There is way too much for one blog to cover and give you enough information to help you muddle through the quagmire of workers comp.
Joe, my other half, got hurt quite seriously while on the job. It was a spinal cord injury that left him paralyzed for three days. After trying to work with the system for about 2 weeks, I got fed up and we retained the services of a lawyer. So please keep in mind the severity of your injury before you jump on the lawyer happy path. Severe injuries like a spinal cord injury or amputation or major burn will need legal assistance. A cut that heals normally with a few stitches and a few days, probably won't.
And as another aside, for anyone thinking they've hit it big by getting a workers comp claim, please do all the really injured people a favor, and jump off a bridge now. Seriously.
So here is some the information YOU need to know about workers compensation, what it is, what it isn't, and what you need to do to make sure you are getting the appropriate level of care.
Workers compensation has a long and checkered history in the United States. Check out Wikipedia for more on how it got started. But please note this from the opening line on the Wiki article:
"...is a form of insurance that provides compensation medical care for employees who are injured in the course of employment, in exchange for mandatory relinquishment of the employee's right to sue his or her employer for the tort of
negligence."
Did you catch that? Workers comp is for compensation medical care only. You have given up the right to sue your employer for negligence. If you understand that going in, it won't be such a big shock towards the end of your case or whenever you find out.
Let's take our case scenario, and work through it. Spinal cord injury, temporary paralysis due to swelling of the spine, discharged from the hospital without a whole lot of information, and sent home without further instruction from worker's comp. Week number one rolls by, and we finally get notified (in writing) from the workers compensation insurance company that a case manager nurse will be coming to visit.
Warning, warning! Workers Compensation Case Manager Nurses
Case manager nurses aren't your friend, and they certainly shouldn't be visiting at your house. Set the visit up for a public venue. You do NOT have to accept a dictated visit by the workers compensation insurance company. Remember, the case manager nurses are employed or third-party contractors who are being paid to get you off the workers compensation rolls as quickly as possible. Often, they will testify against you when you go to settle by claiming what they saw at your house could have been the cause of your injury.
Warning, warning! Workers Compensation Adjusters
Maybe I'm painting a whole industry with a tar brush, but these people are not your friends either. In fact, they are planning on giving you as little care as possible and back to work as quickly as they can. Do not talk to them any more than you possibly can; give them as little information as possible; and be prepared for lashback if you get a lawyer. Joe's workers compensation adjuster called him the first day, while he was in the emergency, on very heavy medications, paralyzed, and started reading him the company handbook on workers comp. Joe was in no way or shape able to digest this information or make any sense of it. As a little payback after we got our lawyer, he required that all of Joe's prescription medication be approved by him - something our pharmacist never heard of before in his career. Later, our pharmicist told us he would be happy to testify in court about this nonsense.
Okay, who is your friend?
One of the first things you need to do is figure out what laws your state has in place governing workers comp. Most states will have a workers compensation commission that oversees the rules and regs, companies and claims, claimants and settlements. Each state is structured somewhat differently. Here in South Carolina, we have a workers comp ombudsman who is a wonderful lady appointed to help the injured find out what their rights are, and help them understand the process. Above all else, find out what your rights are if you are severely injured.
Jury's Still Out - Workers Compensation Lawyers
As our case is in progress at this point, I'll refrain from too many comments on workers comp lawyers. We've all seen the ads on tv for a lawyer who will represent you if you are hurt and make sure your bills are paid. Well, point in fact, medical bills, and some portion of your weekly compensation. What the lawyer is good for is getting workers compensation off their ass and pointed in the right direction. IF there is a possibility of third-party suit, trust me, they'll sniff it out asap, and get busy finding out who else they can get $$$ from. By the end of our first visit with our lawyer, she had him in with the best pain management doctor in town, through our case manager nurse.
On the downside, workers compensation lawyers take a chunk out of your settlement. In SC, by law, it's 1/3 of your settlement. Gulp. That's a HUGE amount of money no matter what your settlement size is. You will sign a contract with the lawyer for their services, so don't think about trying to get around their system.
All right, this is a very small portion of what you need to know about workers compensation and how it works. Trust me, there is a lot more. Tons more. But take these away:
- As soon as possible, contact your state's worker compensation commission so you know your rights, what is owed to you under state law, and how the system works.
- Do not be bullied by the workers compensation insurance company or your employer.
- Do not meet with the workers compensation case manager nurse on your property if at all possible.
Look for more tomorrow on compensation.
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