Workers’ Compensation is a state-mandated insurance program that offers medical care and benefits to workers who become injured on the job. Workers’ comp functions smoothly most of the time, especially in cases of minor injuries and straightforward incidents.
(StockSnap / pixabay)
Workers’ compensation benefits may be all you need to make a complete recovery and return to work. However, there are many circumstances in which workers’ compensation is either denied, delayed, or insufficient to cover your injury or disease. If you feel that you are falling through the cracks of an impartial system, ask a lawyer to review your particular situation as an important part of your recovery process.
Say “no” to workers’ compensation and “hello” to a lawyer if . . .
● Your employer or the insurance carrier delays your claim or retaliates against you.
Whether your employer is disorganized and missing deadlines – or deliberately sabotaging your claim – you may need to hire a lawyer to receive full benefits for your workplace injury.
What kind of delays could cause you to miss out on workers’ compensation?
In all Las Vegas districts (Henderson, Summerlin, North Las Vegas, etc.), workers must report a workplace injury within 7 days of the initial incident. The initial injury is reported using a C-1 Form, which is completed by the injured worker and given to the employer. Your employer should always keep adequate supplies of blank C-1 forms for workers to use or provide the forms promptly when asked. If your employer makes it difficult for you to get this form or to complete the form within the required 7 days, it’s time to contact a lawyer.
Once you have seen a physician, the physician will complete a C-4 form and return it to your employer. Once your employer receives the C-4 Form from the treating physician, your employer has 6 working days to complete the following forms:
- C-3 Form (Employer’s Report of Industrial Injury or Occupational Disease). This form is to be filed with the employer’s workers’ compensation insurer.
- D-8 Form (Employer’s Wage Verification Form). This form is necessary in cases where the injured worker will miss 5 or more consecutive days of work or more than 5 days in a 20-day period.
If your employer postpones filling out these forms, you may need to hire a lawyer to press your case. Likewise, if the treating physician delays filing the C-4 Form or presents unusual obstacles, you may have a legal case.
How soon will you hear if your claim has been accepted?
Workers’ Comp must either accept or deny your Claim for Compensation within 30 days of receiving your completed claim. The decision must be documented with a certificate of mailing.
If you have filed your initial report (the C-1 Form) and your Claim for Compensation (C-4 Form) in a timely manner, Nevada workplace law dictates that you are entitled to a decision within 30 days. If it seems that either your employer or your employer’s insurance carrier is dragging its feet with your paperwork or ignoring your claim, you need a workers’ compensation lawyer.
What kinds of retaliation could an employer use against an injured worker?
If you have evidence that you have been fired because of your injury, you will need to hire a lawyer to receive any workers’ comp benefits. In addition, if you have lost workplace opportunities, had your hours cut, or been pressured to return to work before you have recovered, you may be receiving illegal employer retaliation.
Say “no” to workers’ compensation and “hello” to a lawyer if . . .
● Your employer or your employer’s insurance carrier denies that your injury happened at work.
If your employer denies that your injury happened at work, you will need a workers’ compensation lawyer to move your case forward. Some employers hesitate to sign-off on claims involving injuries or diseases that may have been caused by conditions outside of work. Also, some claims are refused when there’s a question about how the workplace injury is related to a pre-existing condition.
If your claim is denied (or never filed by your employer) because of a false assumption that your injury did not occur at work, then consult with a lawyer to get your claim back on track. Your employer needs to pay-up for injuries and diseases that happen at work, even if your injury is related to a pre-existing condition.
Say “no” to workers’ compensation and “hello” to a lawyer if . . .
● Your workers’ comp settlement is too small to cover your losses.
If you are offered workers’ comp benefits, but the benefits do not cover your injury-related costs, you may need to involve a lawyer to receive full compensation for your losses.
The algorithms and protocols of workers’ comp will always pressure the system to give you a minimum payment for your type of injuries. Expect your injury to be given the lowest rating that can be justified in the system. In some cases, your doctor may recommend a certain recovery plan, but the workers’ comp insurance has a different (and smaller) recovery plan in mind. If your settlement doesn’t cover your medical bills, lost wages, and all associated costs of a full recovery, then call a lawyer.
Say “no” to workers’ compensation and “hello” to a lawyer if . . .
● You have suffered permanent disability, either partial or full.
If your claim involves permanent disability that will prevent you from ever returning to full employment, there is a high chance that your claim will be contested. Disability claims are the most expensive for the insurer and have the most long-lasting consequences for the injured worker.
If you plan to file for Social Security disability benefits in addition to your workers’ comp benefits, a lawyer can help you structure your settlement for your maximum benefit. Without a well-structured settlement, your Social Security benefits may be reduced because of the workers’ comp benefits.
Web Story
Video
