The Day of Your Workers’ Compensation Hearing—Some Advice
If your initial application for workers’ compensation benefits has been rejected, you will need to attend a hearing to pursue your claim any further. Here are some tips for making the best impression at that hearing.
If you’ve been hurt at work, your first course of action will be to file a workers’ compensation claim. If you are one of the lucky few, your application for benefits will be granted without a challenge from your employer or the workers’ compensation insurance company. In most instances, though, your claim will be initially denied and you’ll have to ask for a hearing to determine the merits of your claim. What will your attorney need to prepare for that hearing?
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Permanently Partially Disabled or Permanently Totally Disabled?
When you’ve been hurt on the job, and your injury is clearly permanent, requiring ongoing treatment for the rest of your life, the workers’ compensation board will have to make a decision as to how you will be classified—are you permanently partially disabled, or are you permanently totally disabled?
It’s important to understand that, until 2007, when a person was classified as permanently partially disabled (the vast majority of permanently injured workers are classified this way), that worker would be entitled to a weekly check for the rest of his life. In 2007, though, the state legislature increased the amount of permanent partial disability payments, but put a cap of 10 years on the award.
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The Workers’ Compensation Board Ruled Against You—Now What?
You got hurt on the job and it seemed like an open and shut case—then the workers’ compensation board ruled against you. Now what do you do? What are your options?
If you receive a decision that seems inconsistent with the facts, that you feel is unjustified, there are a number of different levels of appeal:
Should You Hire an Attorney to Handle Your Workers’ Compensation Claim?
You’ve been hurt at work and it’s a pretty clear-cut case. You can complete and file the application for benefits, right? You don’t need a lawyer to help you, do you? At least that’s what the workers’ compensation insurance providers will tell you.
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What If You Have Been Found to Be Permanently Partially Disabled?
In the aftermath of a work-related injury, when you file a workers’ compensation claim, certain determinations will be made regarding the nature of your disability. Is it temporary or permanent? Is it total or partial? The benefits you received will differ based on these findings.
With a finding that you are permanently partially disabled, the workers’ compensation judge has concluded that your injury does not necessarily keep you from working at all, but that your medical condition is not expected to get any better, at least with respect to the injury you suffered. Because your disability is considered to be permanent, there’s a requirement under New York law that you continue to receive some level of workers’ compensation benefits.
You’ve been injured at work, notified your employer and filed a workers’ compensation claim. You’ve received notice that you must submit to a physical examination by a doctor chosen by the workers’ compensation insurance company or by your employer. What’s the best strategy for how to handle this exam?
First and foremost, it’s important to be as honest as possible. Don’t exaggerate or minimize the impact of the injury. Be specific about what limitations the injury places on you. If you are still able to perform many of the daily tasks in your life, admit that. If you overstate the impact of your injury and the workers’ compensation insurance company sends out a private investigator who videotapes you doing things you said you couldn’t do, your claim will likely be completely rejected.
Your Rights During a Workers’ Compensation Insurance Company Medical Exam
When you’ve been hurt on the job and you file a claim for workers’ compensation, one of the first steps you’ll have to take is to submit to a medical examination by a company-selected doctor. Based on that physician’s findings, your claim will generally be approved or rejected. So what are your rights with respect to such an exam?
Can You Refuse to Be Examined by a Company Doctor?
It’s a requirement that you be checked out by a doctor chosen by the insurance company or by your employer. That does not mean, however, that you cannot go to your own doctor or that you cannot get a second opinion. If the findings of the company doctor differ from those of your doctor, the workers’ compensation judge will have to make a decision regarding what evidence is most credible and may even have you obtain a third opinion.
Can You Videotape the Exam?
Beware of Insurance Company Investigators!
When you file for workers’ compensation, it’s not unusual for the workers’ compensation insurance company to send out a private investigator to videotape you without your knowledge. They’ll try to show you doing things that you shouldn’t be able to do with the injury you are claiming, including working on other jobs. It’s not uncommon for these investigators to confront you, ask you questions on camera and try to make it look like your claim is fraudulent.
Don’t Think That Your Injury is Too Insignificant for a Workers’ Compensation Claim
There’s a tendency, when you are injured on the job, to believe that your injury must be serious and catastrophic before you should contact a workers’ compensation lawyer or file a claim. That’s not necessarily true. You may have minor injuries that don’t keep you from doing your job that simply heal and go away. But there are also what are known as consequential injuries—injuries that do not occur at the time of the accident, but arise because of some injury you suffered at work. If those consequential injuries prevent you from doing your job or limit what you can do, you have a right to workers’ compensation benefits. Let’s look at an interesting case we handled.
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