Worker's Comp - Part 2

Well, if you have unfortunately found out about worker's comp the hard way - my sympathies. If you are reading this out of curiousity, take mental notes, campers! Today, we are going to talk about the "compensation" end of workers comp.

Disclaimer & Bad Grammar Alert!: Compensation and it's governing laws will vary GREATLY from state to state. Please check in with your workers compensation commission to get the exact details of what you should be getting paid, and what your settlement or suit may consist of!

So, you've been hurt on the job and you'll be wanting a check. Now, ask yourself, prior to getting hurt, did you ever really give a rat's ass about workers compensation? Or were you just ho-hum, great, something else I'll never use...? Me, I was in the rat's ass category. It existed, and that's all I knew. My bubble was burst when Joe was hurt, and did I have a lot to learn. (See Worker's Comp Blog 1 for more info.)

Basic facts:

• The state you live in will guarantee you some form of worker's compensation payments
• The state will govern how often and what amount you get paid
• The state will govern what your settlement may (0r may not) consist of

Here in South Carolina, you are guaranteed 2/3's of your weekly pay up to the state average salary. Catch that last part - state average salary? To misquote Billy Shakespeare - there's the rub. Given that SC is one of the poorest state's in the nation, the state average salary is miserable. It is a mere $647 a week which totals $2,588 for the month. Now for some folks, that's quite a bit. For someone who makes the monthly total every week, WOW, so NOT covering the bills.

Now Worker's Comp is not taxed - you won't owe state or Federal taxes on it. (As an aside, when/if you settle, you will owe Social Security taxes on your settlement, but that's a tale for another day.) But that's all you get. And in South Carolina, the worker's compensation insurance company is allowed to average your salary over the last 18 months. Zowee, Batman! Talk about a further reduction!

So your workers comp check will come in specified intervals from the workers compensation insurance company. And the moon is made of green cheese which is harvested by little men from Mars. Do not count on your check being on time, particularly around the holidays, major economic events, or any time you really need it. Our lawyer advised us NOT to have it direct deposited - that has an even worse track record for timeliness. Supposedly, your lawyer (if you have retained one) could go after the WC insurance company for late payments, but it's not high on their priority list.

Now the next thing to understand is that there is a time limit to your workers compensation claim. In South Carolina, you are allowed to collect/be on workers comp for 500 weeks, or almost 10 years. That seems long, but for a major life-changing injury, it may not be enough.

I know, a lot to digest, so I am going to talk about settlement and suits in a different blog. I think I am due for a funny blog in between serious ones, so don't look for the next Workers Comp blog for a couple of days.

Living on Workers Compensation

Listen up campers, I'm going to blog on a topic that a lot of don't know anything about, but if it happens to us, we wish we knew more about. The subject, Workers Compensation Insurance - the point of view, the significant other of someone who is collecting. If you are a Workers Compensation person from the other side of the equation, you'll not be happy reading this blog.

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:

1. 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.
2. Do not be bullied by the workers compensation insurance company or your employer.
3. Do not meet with the workers compensation case manager nurse on your property if at all possible.

Look for more tomorrow on compensation.