Martin Kane Kuper
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Martin Kane Kuper
Consultation is Free
1.877.NJLAW4U
(732-214-1800)
Legal and Medical News Blog

What is Workers Compensation?

January 12th, 2012 | Author: | Category: worker's compensation

Workers compensation is a form of insurance provided to employees who are injured on the job. It exists primarily to provide medical care for those individuals who are injured during the course of employment. In those cases where permanent debilitating injuries are suffered, additional compensation may be awarded. Worker’s compensation is therefore similar to an HMO or managed care program. The actual insurance company (also known as a “comp carrier”) controls or manages the injured employee’s medical care. This means that the comp carrier retains the discretion to accept or reject any medical treatment it deems unnecessary. Therefore, the job of the comp attorney (as least initially) is to ensure that the injured employee is receiving all of the necessary and appropriate medical treatment and that the comp carrier is not denying or otherwise stonewalling such treatment. If the comp carrier is improperly blocking treatment, the comp attorney can file for relief known as a “need for further treatment” evaluation.In addition to providing medical insurance for employees, the other primary aspect of worker’s compensation is to ensure the injured employee is paid his disability wages while he is out of work and under a doctor’s care due to the work-related injury. Generally, injured employees receive approximately 70% of their salary from employers as determined by an average of the employee’s preceding 26 weeks of payroll. The balance of the employee’s wages may be supplemented by state disability. Moreover, the injured employee must begin receiving his disability wages within 7 (or 10 days) of the accident, and will continue to collect those wages until the employee reaches his or her Maximum Medical Improvement point (or MMI), or is cleared to return to work. The MMI is the point at which the employee’s physician cannot reasonably anticipate further recovery or improvement from those injuries.The third aspect of worker’s compensation involves monetary awards for permanent injuries. This might generally be referred to as the litigation-aspect of a comp case, which cannot begin until the injured employee’s treatment has concluded. Once treatment has concluded, counsel for the injured employee can hire a physician to assess what, if any, permanent damages were suffered. This evaluation is known as “permanency evaluation.” Based on a finding of permanency and, in particular, the degree of loss or function of the specific injured body part(s), there are worker’s compensation tables which set forth statutorily controlled dollar amounts which may be awarded to injured employees. Note: there is no “negligence” in a comp case; worker’s compensation only considers the resulting disability of an injured employee – not that individual’s pain and suffering, loss of enjoyment of life or any of the other types of damages otherwise available in a normal personal injury action. Therefore, if the injured employee suffered a significant and devastating injury, it is vital for counsel to thoroughly investigate the facts and circumstances surrounding the accident in order to determine if any third-party(s) might also be responsible. If yes, counsel might be able to maintain a third-party action against those other (non-employer) defendants for which all remedies at law are available.