What is Workers’ Compensation and How Does it Work? | Johnson City
In Tennessee, workers’ compensation is designed to compensate individuals who are injured at work, without regard to fault. This means that regardless of whether a person is partially at fault for an accident, they are entitled to workers’ compensation benefits. When an employee is injured on the job, a company (and its insurer) are legally liable for providing compensation for medical treatment (including transportation to medical appointments over 15 miles away) and partial lost wage replacement, as well as other compensation in some instances, such as for permanent disfigurement or loss of a limb.
Workers’ compensation law was designed to be self-executing, meaning that employers should provide compensation regardless of fault, avoiding the need for legal proceedings. However, while companies are generally liable for paying injured workers, they (and their insurance companies) often do not comply with the law. Instead, they utilize various tactics to circumvent their legal obligations, including:
- Alleging that a worker was not injured at work or that the employee had a pre-existing condition,
- Selecting physicians who are known for giving company-favorable determinations (e.g., downplaying injuries, clearing an employee for work before they can perform their job duties, etc.), and
- Prematurely determining that “maximum medical treatment” (MMI) has been reached, depriving injured workers of vital medical treatment.
As an experienced Johnson City workers’ compensation lawyer, Mark Hurt provides tenacious and dedicated representation for injured workers by seeking to hold all liable parties accountable, including employers, insurance companies, and any responsible third parties. If you (or a loved one) suffered a job-related injury, call our offices today to schedule a free consultation.
We Represent Injured Workers on Contingency— No Fee Unless You Recover!
Do I Need a Workers’ Compensation Lawyer to File a Claim?
Workers’ compensation law is highly complicated, making it extremely challenging to navigate claims involving complex injuries without the assistance of an experienced workers’ compensation attorney. While it may be unnecessary to hire a lawyer for minor incidents involving minimal costs, employers and insurance companies will do everything possible to avoid making full and fair payments when there are severe injuries and significant expenses involved.
Debilitating work injuries often place injured workers and their families in financially compromising positions. As such, many injured victims are reluctant to reach out to a lawyer, fearing they will incur exorbitant fees. However, when you hire The Law Offices of Mark T. Hurt, this is not the case, as we represent workers’ compensation clients on contingency, meaning there are no upfront fees, and there is also no fee if compensation is not recovered. If and only if we are successful, we are typically entitled to a fee of 20% of the compensation recovered (our fee is based upon Tennessee workers’ compensation statutes).
How Does the Workers’ Compensation Claims Process Work in Tennessee?
Over 7 billion dollars in workers’ compensation benefits are awarded to injured workers across Tennessee every year. If you were injured at work, it is critical to provide written notice of an injury to your employer within fifteen days after an accident so the proper forms and paperwork can be submitted. An employee’s supervisor is required to timely complete all required forms from the Department of Labor and Workforce Development’s website.
Once a claim is initiated, an employer must provide a list of a least three doctors, from which you will be required to select an authorized treating physician (and submit a form detailing your selection). The physician will administer the medical care needed to return to health and your job. Medical treatments and tests should be provided at no cost if the treating physician determines the injury is work-related.
Unfortunately, many physicians are aware that if they minimize the cost to an employer, they will be utilized more frequently for workers’ compensation claims. Thus, doctors often incorrectly attribute injuries to pre-existing conditions or prematurely rule that an injury has reached Maximum Medical Improvement (meaning an employee’s condition has reached a state in which the injury is not expected to improve, even with additional medical treatment). If you encounter a similar situation, we encourage you to immediately reach out to our office, as there are ways to challenge such determinations. Specifically, we can file a request for review through the Tennessee Bureau’s Utilization Review Program.
What Types of Workers’ Comp Benefits Can I Receive?
Employees who suffer a compensable injury (meaning the authorized treating physician determines the injury to be work-related) may be entitled to the following benefits:
- Medical Treatment, At No Cost to the Employee. Employers are required to fully cover medical treatment as long as required by an authorized treating physician.
- Travel Expenses. If travel to and from medical appointments exceeds 15 miles (one way), an injured worker may be entitled to mileage reimbursement.
- Temporary Disability Benefits (Wage Replacement). Temporary disability benefits are generally awarded on the eighth day after a treating physician takes a person off work. These benefits are designed to partially replace lost wages and typically amounts to two-thirds of an employee’s average weekly wages (earned during the 52 weeks before an injury.
What Should I Do If My Workers’ Compensation Claim is Denied?
Nearly 70% of workers’ compensation claims that are initially denied are successfully appealed, meaning that they turn into paid claims. Therefore, if you are denied benefits and have a valid work-related injury, it is vital not to give up, as odds of securing compensation are in your favor.
If an insurance adjuster denies your claim, you have the right to challenge the decision. At The Law Offices of Mark T. Hurt, we can represent you in seeking a favorable outcome for you through your insurer, the Bureau, or an appeal. Further, if you believe that you are receiving less than you deserve, we can also assist in submitting a Petition for Benefit Determination in seeking to increase the benefit amount.
Our Experienced Johnson City Workers’ Compensation Law Firm Can Fight for the Full Compensation and Medical Treatment You Deserve!
At The Law Offices of Mark T. Hurt, we tenaciously advocate for injured workers and strongly oppose insurance company tactics to minimize liability. For example, if an insurer specifies that you have reached MMI (which means that further medical treatment is unlikely to improve an injury) when your doctor believes that further treatment will be helpful, we can fight for your rights and the medical treatment needed for optimum recovery.
If you were injured on the job, we invite you to call us to schedule a free consultation to learn about the benefits to which you may be entitled and how we can assist in seeking to get you the full and fair compensation and treatment you deserve!