There are a lot of reasons why people fail to get the workers compensation benefits they deserve.
Some don’t understand what’s expected of them, others are tricked by their employer or the insurance company, and many try to go it alone.
By arming yourself with a little knowledge, you can make sure you receive all the compensation you’re entitled to under the law.
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6 Ways To Maximize Your Workers Comp Claim!
Here we are sharing six tips for maximizing your workers’ compensation claim in New York.
1. See Your Doctor
Most of the worker’s comp lawyers, the first and most important thing that they recommend to clients
in order to maximize their reward, see your doctor.
I don’t mean just seeing them one time.
I mean see them on an ongoing basis.
This also means that you should not be seeing them excessively.
Seeing your doctor is important because it creates a better medical record that the judge and the insurance company refer to while your case is proceeding.
The medical reports that are submitted following regular visits will create a more complete picture of your injury and the treatment you need to get better.
If your case has huge unexplained gaps in your medical records, it doesn’t look good, and it could prevent you from getting the maximum award possible in your case.
A lot of people contact with cases that are a few years old and have huge gaps in treatment.
They say, “Well, I was hurt. There was nothing I could do. So I sat home and watched TV for six months.” Well, that was a big mistake.
How can you know there is nothing that can be done unless you see your doctor?
Generally speaking, in the eyes of the judge, people who are hurt go see their doctor.
People who are hurt get treatment.
Another reason you want to see your doctor on an ongoing basis is that a medical report provides
evidence of an ongoing disability and, according to the law, is good for 90 days.
This means you need to show the judge a medical report indicating that you have an ongoing disability in order to support three months’ worth of awards.
That means if three months go by and you don’t have another medical report to justify extending your benefits, the insurance company will move to suspend your awards.
So you need to see your doctor at least once every three months while you’re out of work in order to maintain monetary awards for your lost time.
So go get treatment! Not only will it help maximize the benefits you receive, but it’s also the first step to getting better and going back to work—which is your number one goal!
*Also Read: How To Get Workers Compensation Insurance in New York
2. Keep Your Independent Medical Examination Appointments [IME’s]
The insurance company has a right to send you to see their doctor periodically, and they will take advantage of this in virtually every case— Oftentimes more than once.
If you want to maximize your workers’ compensation benefits, please keep these appointments.
Missing or rescheduling a whole bunch of them reflects poorly on your case, especially when it’s brought to the judge’s attention.
It’s okay to reschedule once or twice, but a pattern of avoiding them will not be looked at kindly by an insurance company or a judge.
And if you don’t go to see their doctor at all, it will definitely be used against you.
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3. Disclosing Previous Injuries & Claims
Disclosing previous injuries, accidents, and workers’ compensation claims will prevent you from losing your benefits entirely.
And failure to do so can be considered insurance fraud, and not only puts you at risk of losing your benefits, but it can also carry criminal penalties.
This is something that is becoming increasingly frequent.
When you’re filing a new claim for worker’s compensation, you MUST disclose any prior accidents, injuries, or claims to the same site of injury or body part.
If you received treatment for that injury, you must disclose the doctor and provide a medical release so records can be obtained.
If you had a prior worker’s compensation claim, you should disclose the date and the claim number as well.
You must disclose these prior accidents and injuries to your treating doctors, as well as the insurance company’s consulting doctors.
Make sure it is clear to all of these doctors you had a prior accident, injury, or disability to the same body part.
If they deny that you told them, then it’s your word against theirs, don’t let it come to this.
The insurance company will ask you about it, and if you don’t tell the truth, they will find out.
Insurance companies spend a lot of money on investigators and research to discover if you’ve had prior treatment or workers’ compensation claims.
It’s much safer to just be upfront and tell them about your history.
4. Keep Your Pay Stubs and Tax Returns
It is not uncommon for the employer or the insurance company to incorrectly report your earnings, which may result in fewer benefits for you.
However, if you save your pay stubs, tax returns, and any other records documenting your income, then you can provide the correct amount to the judge.
Not only that, if you have a lawyer, they can go after the insurance company for this behavior and get you the maximum amount you deserve.
If you’re a car service driver or cab driver—or drive for a rideshare service like Uber or Lyft—the New York State Workers Compensation Board will set your average weekly wage at $250 per week, which means you receive almost the minimum rate of compensation on your claim.
5. Safely Return to Work
You should safely return to work when you can.
A lot of people think that when they first get hurt, they need to stay away from work for a long period of time in order to show how injured they are and maximize the award that they eventually receive.
But in many circumstances, the opposite is actually true.
In cases known as schedule loss of use, which involve injuries to body parts like arms, legs, hands, and feet, any temporary weekly benefits you receive are deducted from your permanent disability award.
This means the longer you’re away from work, the less money you may receive at the end of your case.
For example, if your injury comes out to be worth $50,000, and you were out of work for ten weeks and got paid $1,000 per week, that $ 10,000 is going to get deducted from your payout—leaving you with $40,000.
But if you only took one week off of work and got paid $1,000 from workers’ compensation for the one week of lost time, at the end of your case, you’re going to get paid $49,000.
Also, the sooner you return to work, the sooner you start getting paid your salary.
So return to work as soon as it’s safe to do so, even if it’s in a reduced capacity.
You should always speak to your doctor and return to work when it’s safe.
6. Get an Attorney
When you file a worker’s comp claim the insurance company already knows the law and the judge knows the law, but you know the law?
If not, that’s like playing a game where the referee and the other team know the rules, but you don’t.
Worker’s compensation law has been around for a very long time, and much like the New York City subway system, it’s a patchwork of fixes to an antiquated system.
That’s why it’s so important to work with a lawyer who understands the law and can guide you to maximizing your benefits.
They know what your rights are.
They know about the hidden “gotchas” like work searches.
They know how to prevent your claim from getting denied by the insurance company.
They know how to report your injury correctly.
And they know when you’re getting ripped off.
They also know when it’s the right time to settle your case.
A lawyer also has a fiduciary, legal, and ethical obligation to get you as much money as possible and to do as good a job as they possibly can.
VIDEO: 6 Tips To Maximize Your Workers Comp Claim!
So these are some of the effective ways/tips you can follow to maximize your workers comp claim in New York.
Having any questions or need to share your experience please feel free to comment below.