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Workplace Accidents And Workers’ Compensation Claims

Nov 20, 2017 | Workers' Compensation

According to a report by the Bureau of Labor Statistics (BLS), in 2016, private industry employers reported roughly 2.9 million nonfatal workplace injuries and illnesses, occurring at a rate of 2.9 cases per 100 fulltime equivalent workers.

Nearly one-third of occupational injuries and illnesses that are nonfatal were more serious in nature and resulted in days away from work. The same year, 892,270 occupational injuries and illnesses occurred in 2016, resulting in days away from work in the private industry – this is essentially the same number reported for 2015.

Man Dies in Construction Accident in Alabama

According to authorities, a man died after he was hit by a bulldozer at a northwestern Alabama construction site. A 55-year-old resident of Carthage, Mississippi, David Thornton was working on a new apartment complex in Florence, AL.

Emergency personnel present at the scene reported that Mr. Thornton was struck after walking right behind a bulldozer, and was pronounced dead on arrival, at Eliza Coffee Memorial Hospital. The police said that the accident did not cause injury to any other workers. According to Florence police Sgt. Cobb, the incident is being investigated by the Occupational Safety and Health Administration (OSHA).

Death Benefits in Workers’ Comp

If a member of your family dies as a result of a workplace accident, you may be able to obtain death benefits through workers’ compensation. In most cases, such benefits are limited to spouses, children and other relatives who lived with the deceased worker and were dependent on his or her income for financial support.

Although the exact requirements to be eligible for death benefits varies from one state to another, this benefit is usually – not always – reserved for people who were related to the deceased worker by marriage or blood and depended on the deceased to pay their living expenses. Individuals eligible for death benefits are typically referred to as “dependents.”

In a number of states, spouses, regardless of their own incomes, are presumed to be dependents. However, spouses in other states whose incomes exceed a certain amount are not necessarily considered dependents.

There is a wide variety of circumstances in which death benefits are available and not just when the employee dies on the job. In order to receive death benefits, the employee’s death must have been caused by an occupational disease or workplace injury, at least in part.

Even if he or she had other diseases or conditions that were not related to work, you may still be eligible to receive death benefits if the disease or injury contributed to or accelerated the death. For example, if your husband suffered from a serious heart condition unrelated to his work, but a workplace accident caused his condition to worsen and ultimately his death, then you may still be able to make a claim to obtain death benefits.

When to File a Death Benefits Claim

When it comes to filing a claim for death benefits, you should keep in mind that the time limits are very strict. In many states, the limit is 1 or 2 years from the date of death, or the last date that disability benefits were paid. However, the laws in your state might have longer or shorter time limits, which is why you should make a claim as soon as possible.

Spirit AerosSystems Employee Seriously Injured in Workplace Accident

In Wichita, Kansas, a Spirit AerosSystems employee was critically injured in a workplace accident. According to a Sedgwick County 911 dispatch supervisor, the agency received a call about a man suffering a chest injury. The victim was taken to a hospital in an ambulance.

Spirit AeroSystems, a company that makes aircraft parts, released a statement in which the injuries suffered by the employee were described as “serious” and also added that an investigation into the incident that caused the injury has begun.

Procedure in Contested Workers’ Compensation Claims

While filing a claim for workers’ compensation, some employees can get a rude awakening as they learn that the company that employs them is disputing the validity of their claim.

There is an incentive for employers to dispute claims that they feel are not proper as the number of claims paid on their behalf has an effect, to some degree, on the rates they pay into the system. Once disputed, the workers’ compensation board in the state will investigate the claim and then decide if the claim is valid.

During this process, a doctor who performs evaluations on the state’s behalf will examine the employee. While this doctor must maintain an impartial role, employees should bear in mind that in their case, there is no doctor-patient confidentiality. Any statements that you make during the evaluation can be used by your employer to argue that you were not injured in a work-related incident, or that your injury is less severe than you claim it to be.

If the board rules that the claim is not covered, there is an appeal process that you can try. First, the officers within the workers’ compensation department will hear the matter. In most states, this means that an administrative law judge will conduct a hearing, and if further appeal is taken, you will need to present your case to a review panel. Once you exhaust these administrative remedies, you can appeal your case in state court.

Why Workers’ Compensation Can Be Denied

Many legitimate workers’ compensation claims are denied by insurers, forcing a large number of innocent and honest employees to hire an attorney to help them go through the workers’ compensation system in order to enforce their rights. Why are these rightful claims denied? Some of the main reasons that insurers deny claims include the following:

·         There were no witnesses to your injury. In many cases, insurers do not like workplace injuries that occurred without witnesses. But regardless, you should report your injury immediately to your supervisor and co-workers.

·         You failed to report your injury immediately. Insurers also do not like claims in which the accident was not reported immediately. They assume that you were not really hurt if you did not report the accident as soon as it occurred.

·         There is a discrepancy between the report you made about your accident and initial medical records. If your statements about how the accident occurred are not consistent, workers’ compensation insurers will likely deny your claim.

·         There is an indication of the presence of illegal drugs in your system in the initial medical report. In this case, you will almost definitely not be paid workers’ compensation.

·         You filed a workers’ compensation claim after being laid off or fired. Insurers will assume that yours is a revenge claim for being fired or laid off.

·         You refused to sign medical authorizations or provide a recorded statement to the insurance company.

Tips to Make Sure You are Paid Your Workers’ Compensation Benefits

Workers’ compensation insurance companies are always looking for ways to minimize the amount of money paid on claims. If you sustained an injury in your workplace, you are entitled to receive benefits from workers’ compensation until you are ready to return to work. To make sure that there are no chances of having your benefits denied wrongfully or terminated prematurely, there are a few general rules you should follow, including the following:

·         Report your injury immediately: Workers’ compensation laws require you to report any injuries sustained at work within a short time period, in most cases, 30 days or less. Although not reporting a work-related injury immediately may not legally prevent you from bringing a claim, it is best not to wait. If you delay reporting your injury, workers’ compensation insurers will attempt to deny your claim.

·         Get witnesses’ information: If there were witnesses when you sustained your injury, make sure that you get their names, addresses, phone numbers, etc. In a close case, witnesses might help in proving that you were actually injured while you were working and not anywhere else.

·         Get medical treatment if necessary: If you sustain a work-related injury, be sure to make an appointment to visit a physician. If it is an emergency, ask to be taken or go to a local emergency room. Make sure that you do wait. If you do, the insurance company might assume that you were not seriously hurt if you did not seek medical attention immediately.

·         Explain how you were injured: If your initial medical records do not have an adequate description of your accident and injuries, insurance companies will deny your workers’ compensation claim. This can be a bit of a problem as your medical records are prepared by your doctor, not you. You should make sure to clearly describe how you got hurt to your doctor and mention that it occurred in a workplace accident.

·         Fill out accident report forms accurately: In many cases, injured employees need to fill out and sign accident report forms. It is critical to make sure that you do this accurately. If you are too medicated or too ill to fill out the form when your employer asks you to, do not fill it right then. Make sure to do this only when you feel better and can concentrate more.

·         Be consistent: If your statements about how your accident took place are not consistent, your workers’ compensation claim will likely be denied. So, it is vital to make sure that you are always consistent with your statements whether you are making it to your supervisor, your physician or the insurer.

·         Sign a limited medical authorization: You may be asked by the insurer to sign an authorization that allows them to get copies of your medical records. As long as the request is limited to your work-related injury medical records and bills, this is reasonable, and the insurer is entitled to get a look at those documents. However, make sure that you consult your workers’ compensation attorney before signing such an authorization.

·         Do not give the insurer a recorded statement: In many cases, insurers ask injured employees to give them a tape-recorded statement describing the accident and the injuries they sustained. You should avoid giving an insurer, such a statement, especially if you do not have a legal professional. Giving such a statement will not be a benefit to your claim.

·         Attend your medical treatment: It is crucial to make sure that you do not ever miss medical appointments. If the insurer notices a pattern that you miss appointments with health care providers, they will assume that your injuries are not serious or that you are perfectly fine, and will start to look for ways to stop your workers’ compensation benefits. If you are injured and cannot work, make sure that you make it to all of your appointments with your doctor.

·         Hire a legal counselor: If you are having any problems getting workers’ compensation benefits after sustaining an injury at work, you should consider hiring a lawyer experienced in workers’ compensation cases. Having an attorney will help ensure that your rights are protected and that you receive the benefits you are entitled to. Insurance companies, as mentioned earlier, are always looking for ways not to pay injured employees, so having a professional will your best interest in mind is beneficial. Additionally, a workers’ compensation lawyer will know how to present your case in a way that the amount of money and other benefits you receive are maximized, helping you get through rough times while you are unable to work.

RMFW Law Can Come Though For You

If you or a loved one has been injured in a workplace accident, you should immediately consult a profound and remarkable workers’ compensation attorney and there is none better than Rosenberg, Minc, Falkoff, & Wolff of RMFW Law. Call them now 212 697 9280! You can make sure that your rights are protected and that your employer and the insurer do not prevent you from receiving the benefits you are entitled to when you sustain a serious injury while on the job.

RMFW Law will make sure that every step of making a workers’ compensation claim work for you is done properly so that you do not face any problems and you receive the compensation you deserve.

We know how to get the done! We know this arena. RMFW Law has won big cases for past clients and continues to do so. We know how to attack the other side and we know the legal system in NYC. Call us now so we start down on this road.