Workers' Compensation FAQs
- Why Is Maximum Medical Improvement So Important?
- After Reaching Maximum Medical Improvement, How Long Will It Take My Case to Settle?
- Which Workers’ Compensation Doctor Should I Pick?
- What Should I Do if My Workers’ Comp. Doctor Won’t Make the Referrals That I Need?
- While on Workers’ Comp. Can I Quit My Job?
- My Doctor Gave Me Work Restrictions; Must I Go Back to Work?
- What Happens to My Health Insurance While on Workers’ Comp. Leave?
- How Long Until I Get My Medical Treatment or Workers’ Comp. Checks?
- Do I Have to Let the Workers’ Comp. Nurse Inside of My Appointments?
- Should I Apply for Unemployment During My Workers’ Comp. Claim?
- Should I Use Leave Time During My Workers’ Comp. Claim?
- Now That I Am on Workers’ Comp. My Employer Can’t Terminate Me, Can They?
- My Employer Wants to Place Me on Family Medical Leave (FMLA), What Should I Do?
- All the Employees Got a Raise After My Injury Occurred, Do I Get More Workers’ Comp. Money for That?
- What Will I Get for Pain and Suffering?
- How Much Am I Going to Get?
- Why Am I Getting Less Money on Workers’ Comp. Each Week Than I Got Paid Before My Injury?
- My Employer or My Boss Should Have Known Someone Would Get Injured From That, Do I Get More?
- What if I Can’t Work Again?
- What Is a Functional Capacity Exam or “FCE” and What Do I Do?
When you reach Maximum Medical Improvement (sometimes known as “MMI”), your doctor has determined that you are no longer improving. Your claim then moves to the final stage in which all temporary disability checks stop. You will get an impairment rating and your attorney can then place a value on your claim.
This really depends on the other side. Your attorney cannot force the other side to be reasonable or to be quick. The best thing your attorney can do if the other side is slow to negotiate is to push the claim towards mediation. Mediation is required by state law before your case goes to court. After that, if the case must go to trial because the other side is not negotiating, you have experienced Knoxville Workers’ Compensation lawyers in the trial attorneys at Brown and Roberto.
Do not pick a doctor under Workers’ Comp. without first consulting an attorney. Once you pick a doctor, you are largely stuck with that doctor and all other rights have been waived;
Your attorney cannot direct specific medical care for you; your Workers’ Comp. doctor must make the referral. Your Workers’ Comp. doctor is the one that writes referrals for treatment and diagnosis. If you feel the doctor should do more to address your pain, for example, or you believe that you need an MRI, or some other body part needs examination, you need to address this with your Workers’ Comp. doctor. Make sure your doctor is documenting your complaints in his or her records;
Do not quit or resign from your job or do anything that may get you terminated from employment. This can reduce or eliminate your rights to compensation including temporary payments before you reach MMI and some money at the end of your claim. It does not hurt your rights to benefits if the employer ends your employment because they admit that they cannot accommodate your work restrictions. In fact, if your employer admits that they cannot accommodate your work restrictions, that may raise the value of your claim;
If the Workers’ Comp. doctor provides that you may work under restricted or unrestricted duty, you must contact your employer immediately and ask them if they have work for you that is consistent with the doctor’s instructions:
- It is best to document in written correspondence this conversation with your employer;
- If you disagree with your work restrictions, then take that up with your doctor. Your attorney cannot take you off of work. If you are in a disagreement with your doctor about whether you can work, you may be without any payments until the disagreement is resolved.
You may lose your Employer provided health insurance while out on Workers’ Comp. This is legal under Tennessee law. It happens because you are being paid by an insurance company and not directly by your employer. During this time, your employer stops making contributions to your health insurance.
This is determined by the Workers’ Comp. insurance and the Court system. Your benefits are furnished fastest if the insurance company provides them voluntarily. If legal action is required, the Court system can take months before a judge issues a ruling.
Do not allow anyone from Workers’ Comp. inside your Doctors’ appointment. Often the Insurance Company will have a Nurse Case Manager. Do not allow this person to attend your appointments. Sometimes this person is only there to try to convince the doctor to end your benefits.
Generally, no. If you are granted unemployment and Workers’ Comp. is held responsible for payments during that same period, you may have to pay your unemployment back.
Generally, no. If you use leave time and Workers’ Comp. is held responsible for payments during that same period, you may have to pay your leave back. In some cases, this can leave you owing money instead of getting money from your claim.
There is no specific job protection under the Workers’ Comp. law. Instead, if you are terminated because the employer cannot work you within your restrictions or for reasons related to your claim, you may be entitled to additional Workers’ Comp. money. It is important to avoid being terminated “for cause” (meaning due to your own fault). A termination “for cause” may end some of your benefits. You may have a wrongful termination case if your Employer indicates that they are terminating you because you applied for Workers’ Comp. benefits. You will need direct proof of this.
They have the right to request that you go on FMLA. You should fill out the forms.
No. Your wages for the purpose of Workers’ Comp. benefits is based upon the wages you received in the 52 weeks prior to injury.
You get paid under Workers’ Comp. for the extent to which the injury disables you from work in what is known as an “impairment rating.” If the pain is disabling, it may add to your case. You do not get a separate amount for pain and suffering. Your Workers’ Comp. doctor determines your impairment rating.
The general rule is the impairment rating that the doctor gives you multiplied by 450 weeks of Workers’ Comp. Pay. So, if you receive a low impairment of 1%, you get 4.5 weeks of Workers’ Comp. Pay. You may get more than that if the Employer does not return you to work. There is wiggle room for the attorney to add more value to your claim than this formula if your impairment rating is 10% or greater. Our Knoxville Workers’ Compensation attorneys spot cases to challenge to get up to that 10% rating.
By law, Workers’ Comp. pays 66.2/3% of your average weekly wage. This should be non-taxable. Because income tax is not withheld and Medicare and Social Security Taxes are not taken out, it should get close to what you were making before injury.
The good and bad thing about Workers’ Comp. is that you don’t have to prove negligence to have a case. It is usually as simple as having got injured at work while performing a work function. You may be angry that someone else’s negligence or stupidity caused your injury. If you feel that the accident was preventable, you can contact OSHA about your complaints. Do not expect your attorney to be able to do anything about your employer’s negligence; it is not a factor in Workers’ Comp.
In order for the Court to find that you cannot ever work again, you must have very severe restrictions from a doctor and testimony from a vocational expert that there are no jobs that you could perform. If you have all of that, you may receive weekly Workers’ Comp. benefits until the age of full social security retirement. If you cannot perform your previous job, there is a range of awards that you may receive based upon your impairment rating, age, and education.
Some doctors will send you for an FCE. It is used to determine your permanent work restrictions. Some doctors even use it to determine your final impairment rating. It is important to go and try to do things asked of you.