What Qualifies as a Workers Comp Claim? | Johnson City
If an authorized treating physician determines that an individual has suffered a work-related injury, that person may be entitled to receive workers compensation for medical expenses, travel costs, wage replacement, and partial or permanent disability.
Workers’ compensation insurance protects workers who are injured in a workplace accident or by an occupational illness, regardless of who is at fault (even if the employee unintentionally causes the accident). Workplace injuries can occur suddenly and without warning, such as a broken bone, or they can occur over the course of time (such as hearing damage or carpal tunnel injuries).
Common workplace injuries include:
- Back, neck, and arm injuries, often as the result of lifting heavy objects
- Injuries and strains from repetitive actions
- Broken bones and lacerations
- Slips, trips, and falls
- Injuries from falling objects
- Exposure to toxic fumes and hearing loss
- Amputations and other injuries from equipment use
Over $7,000,000,000 in workers’ compensation benefits are paid out to injured workers across Tennessee every year. These benefits are not provided by the government; instead, they are disbursed by employers through insurance providers or third-party administrators. Tennessee companies with five or more employees (and those in the construction and coal mining industries with one or more employees) are required by law to carry workers’ compensation insurance. However, even when companies have workers’ comp insurance, they still often deny legitimate claims, making it difficult for injured employees to support their families and obtain quality medical care. Call us to schedule a free consultation!
Call Us for a Free Consultation about Your Workplace Injury
Were you (or a loved one) injured on the job and need to apply for benefits or appeal a denied claim? If so, we encourage you to call The Law Offices of Mark T. Hurt to schedule a free consultation. We represent injured workers on contingency, meaning you will not be required to pay any up-front costs, and you will only pay a fee if we are successful in obtaining compensation on your behalf. If a trial is necessary, we also advance all litigation expenses while a case is ongoing.
What Types of Benefits Can I Secure Through Workers’ Compensation?
Workers’ compensation is a no-fault system, meaning any worker who is injured on the job (regardless of whether they were partially at fault for an injury) may qualify for benefits. If you or a loved one suffered a legitimate job-related injury, you might be entitled to compensation for:
- Medical Treatment. Doctor visits, medical procedures, physical therapy, surgery, prescription drugs, and other medical expenses are generally fully covered, at no out-of-pocket cost to an injured employee while they are unable to work.
- Transportation. If an individual is required to travel more than fifteen miles for a medical appointment, their transportation costs may be reimbursable.
- Temporary Partial Disability (TPD) Benefits. If a worker is placed on light duty or restricted to working fewer hours than normal, he or she may be entitled to 66 2/3% of the difference between the gross light duty wages and the employee’s average weekly wage.
- Temporary Total Disability (TTD) Benefits. If an injured employee is taken off work by a treating physician, then they may be entitled to two-thirds of their average weekly wages (calculated based on earnings from the 52 weeks before the injury). Benefits typically start on the 8th day of disability.
- Permanent Partial Disability (PPD) Benefits. If an individual suffers a permanent disability due to a work-related injury but can return to a job, he or she may be entitled to 66 2/3% of their average weekly wage (subject to statutory limitations).
- Permanent Total Disability (PTD) Benefits. If an injured employee is unable to return to any employment, he or she may be eligible to collect benefits until the Social Security retirement age is reached.
- Death Benefits. If a work-related injury results in the death of an employee, the employee’s surviving dependents may be entitled to wage replacement and burial expense benefits.
When individuals are hurt at work, they (and their families) deserve the benefits needed to cover living and medical expenses. Workers’ compensation is supposed to partially replace lost wages and cover healthcare costs, helping injured workers focus on recovery. However, when a claim is denied, it can be devastating. Unfortunately, insurance companies regularly deny legitimate claims, and victims suffer as a result.
As a Tennessee workers’ compensation lawyer with over two decades of experience, Mark Hurt understands the financial impacts that a traumatic injury can have on a victim and their family. At The Law Offices of Mark T. Hurt, we represent injured workers on a contingency fee basis, meaning we only charge a fee if we are successful in recovering compensation. Further, if a trial is necessary, we advance all litigation expenses while a case is ongoing, and these expenses are typically repaid from a settlement or jury award.
When Do Workers’ Compensation Benefits Stop in Tennessee?
Temporary disability payments can cease if any of the following occur:
- An authorized treating physician releases an injured employee to return to work without restrictions;
- An injured worker refuses to comply with a reasonable request for medical examination or to accept treatment;
- An employer or their insurer discovers that payments were made in error; or
- An injured employee’s treating physician determines the worker has reached maximum medical improvement (MMI), and the compensability of the injury has not been contested.
What is Maximum Medical Improvement?
When an injured worker reaches the point where an injury or illness cannot improve any further, they are said to have reached MMI. However, this does not necessarily mean that a person is fully healed or recovered; rather, it simply means that treatment will no longer improve their condition.
Why is MMI so important? When an individual reaches MMI, a worker is deemed to have recovered as much as possible from medical treatment; thus, employers typically no longer will cover medical treatment, as it will have no further effect on a worker’s recovery. However, employers often prematurely push for or determine that workers have reached MMI (before they actually have), depriving them of much-needed healthcare treatment and rehabilitation. If this happens to you, we encourage you to call our office immediately, as we can help you seek a second medical opinion and tenaciously fight for the full and fair compensation to which you are entitled.
Can I Sue My Employer and Collect Workers’ Compensation Benefits?
If an employer does not have workers’ compensation insurance, it may be possible to file a lawsuit in civil court. However, having workers’ compensation insurance typically protects employers from being sued, meaning that an injured worker generally cannot file a lawsuit against an employer for a work injury. Instead, in most instances, an employee will be limited to receiving worker’s comp benefits from an employer.
Can I Sue a Non-Employer Company If They Were At Fault For My Injury?
While it may not be possible to sue an employer for a work-related injury, other third parties may be partially liable, including contractors, equipment manufacturers, property owners, and others. Therefore, you may be entitled to bring a lawsuit against such outside parties to hold them accountable.
For example, if a property owner fails to safely maintain their land, and workers are injured because of a hazardous condition on the premises, they could be liable for civil damages. Alternatively, if a piece of heavy machinery is defective and an individual is injured, the manufacturer and equipment sellers could also be liable. It is vital to identify all liable parties, as workers’ compensation does not typically cover the full extent of losses, including lost wages, pain and suffering, and other damages.
When you schedule a complimentary consultation with The Law Offices of Mark T. Hurt, we will listen to the facts of your case and identify all potentially liable parties to ensure the greatest chances of securing maximum compensation.
Why Should I Hire a Johnson City Workers’ Comp Injury Lawyer?
If you or your loved one suffered a work-related injury in Johnson City or elsewhere in Tennessee and you have not spoken to an experienced workers’ compensation lawyer yet, contact The Law Offices of Mark T. Hurt right away. We understand how to handle the legal issues that often arise in these types of cases and are committed to obtaining the maximum compensation possible.
When you hire The Law Offices of Mark T. Hurt, we can help lessen your burden and increase the chances of securing full benefits. We can handle tasks such as submitting documents, filling out forms, and representing you in court. We can also handle phone calls and emails from employers and insurance companies. Call our offices today to get started.