When Does Workers Comp Start Paying Benefits?
Did you get injured in a work-related accident or lose a loved one through a wrongful death caused by another’s negligence? Are you waiting for your workers’ compensation benefits payments to begin?
At Rosenfeld Injury Lawyers, LLC, our personal injury attorneys represent injured workers to ensure they receive maximum workers’ compensation benefits and other monetary recovery opportunities when possible.
Call our workers’ compensation lawyers at (888) 424-5757 (toll-free phone number) or use the contact form today to schedule an initial consultation.
Workers’ Compensation Benefits
U.S Department of Labor analysis shows employers spend about $1 billion per week to get a workers’ comp claim benefits running nationwide.
The statutory obligation on employers to pay workers compensation benefits is fraught with confusion. Questions like ‘when does workers comp start paying benefits’ signifies this uncertainty, where the injured worker or their employer does not understand the process to obtain benefits.
Consequently, many claimants will consult a personal injury attorney before filing their workers’ comp claim to ensure the paperwork is well prepared for maximum recovery.
What are Workers’ Compensation Benefits?
Workers’ compensation benefits are payments imposed on an employer to pay workers for injury sustained in employment. However, workers’ compensation benefits are only available to salaried employees and not independent contractors.
Therefore, before agreeing to accept workers’ comp benefits, the injured employee should research the downside to receiving a check for damages. While the workers’ compensation program helps injured employees, it also protects the employer from civil liability.
Typically, injured workers forfeit their right to sue the employer for negligence once they get their workers’ compensation benefit. This situation protects the employer from expensive lawsuits and leaves the worker suffering from work-related injury without adequate compensation.
However, extenuating circumstances could create a liability issue for the employer paying their injured workers’ comp benefits. For example, one specific exclusion involves a negligent employer who fails to maintain a safe environment, leading to the worker’s injuries.
There are four major worker compensation types:
- Medical benefits
- Temporary disability
- Death benefits for dependents
Workers’ compensation benefits come from the employer’s funds, insurance company policy coverage, or the state fund.
Medical Disability Benefit
Medical disability benefits cover medical costs and expenses incurred on the injury sustained in the course of employment. It includes medications, medical equipment (if any), medical tests, therapy, and hospital stays.
Medical disability benefits arise when the injury sustained in the course of employment results in disability. There are four primary types, temporary total disability, temporary partial disability, permanent total disability, and permanent partial disability.
The conditions for eligibility to receive disability benefits include:
- The injured worker is entitled to temporary total disability benefits when the disability injury sustained is for a relatively short time. This benefit is usually two-thirds of the injured worker’s weekly wage.
- Temporary partial disability benefits arise when workers sustain a mild injury that reduces productivity but is not life-threatening.
- Medical professionals must declare injured workers as permanently having a disability and unable to work. In that case, they will be eligible to receive workers’ compensation for permanent total disability benefits. In addition, a worker must be suffering from a very severe work injury to qualify.
Permanent partial disability benefits are due when the injury sustained causes a mild disability. The mild disability will usually limit workers’ productivity for life but is not severe enough to stop them from working.
Rehabilitation and Death Benefits
Some injuries might be so severe that the worker will be unable to return to work. Rehabilitation benefits assist an injured worker with all forms of rehabilitation, including vocational.
In cases with a limited disability, the rehabilitation benefits can help the injured party return to work, usually in an occupation with different requirements based on their limitations.
In severe cases, a work-related injury may lead to death. The law imposes a liability on the employer to pay the deceased worker’s dependents, including spouses and minors.
The surviving family members can receive benefits such as lost wages, future lost earnings, funeral & burial costs, hospitalization expenses, medical bills, pain, suffering, grief, loss of consortium, and mental anxiety.
What Workers’ Comp Does Not Cover
In virtually every State, workers comp doesn’t cover stress, self-inflicted injury, and injuries sustained from fighting. Instead, the weekly, biweekly, or monthly payment typically includes medical bills, therapy expenses, and lost wages.
In most cases, injuries sustained when the worker committed illegality do not feature under a workers’ compensation policy.
What is the Cost of Workers’ Compensation?
Contributing factors like where the injury occurred, the damage sustained, the nature of the employee’s work, and the company’s finances determine the cost of workers comp claims.
For example, employees working in dangerous occupations like the construction and manufacturing industries typically earn more in workers comp than other injured workers.
Typically, the injured worker receives two-thirds of their weekly pay based on their average weekly wage.
Who Will Pay My Workers’ Comp Claim?
At some point, the injured victim will file a claim seeking workers’ compensation payments from the employer or their insurance company based on the insurance coverage.
Most states require employers to purchase workers comp insurance whenever hiring employees. However, in South Dakota and Texas, workers’ compensation insurance coverage is optional for employers.
In numerous states, the insurer is responsible for paying a claim, although it’s the employer’s responsibility to file a claim. However, in South Dakota and Texas, employers without employee’s compensation insurance coverage must pay the injured worker.
Some states require employers to purchase workers’ compensation coverage from state-owned insurance companies. Generally, private insurance companies and states pay through their insurance companies.
How Long Does it Take Before Workers’ Comp Start Paying?
The general rule to receive the first paycheck is that workers are entitled to benefits payment within 21 days of informing their employers of their work-related injury.
However, specific factors like nature and extent of damage, jurisdiction, and medical bills may vary between cases. In addition, these exemptions do not prevent injured workers from receiving some comp benefits immediately after the work injury.
Medical bills, for instance, are paid before a workers’ comp claim is either denied or accepted. In addition, before a worker is suitable to receive benefits, they must have been unable to work for seven working days.
When Should I Expect My Workers’ Compensation Check?
Several factors are crucial to determining when a workers’ compensation check will be paid, including whether the injury occurred and if the Workers’ Comp claim was accepted or denied. Typically, workers should generally expect their check when a lawsuit takes place.
A workers’ compensation claim goes directly to the employer, the insurance company, or the State. A well-crafted claim and the quality of annexed documents that serve as evidence will typically hasten the payment of the comp check hence the need for legal advice.
If the claim is unsuccessful, your attorney could file an appeal against rejection, thus prolonging payment. However, while you may win at the appeal level, the process is time-consuming and could take two to three months to determine an appeal.
The attorney will ensure that a comprehensive doctor’s report is attached to the claim during the appellate process.
The information includes the doctor’s detailed analysis of why the injured party requires temporary disability benefits when filling in their workers’ compensation claim.
The waiting period before receiving compensation varies from one State to another. In most states, injured workers wait for about one month before receiving their first paycheck. Later, they get weekly, biweekly, or monthly checks based on policy and State law.
Do I Get Full Pay On Workers’ Compensation?
In nearly every State, workers’ compensation benefits are not taxable. Because of that, the worker typically receives two-thirds of their weekly pay based on their average weekly wages.
Even so, the amount of taxable income is usually insufficient to pay for all the injured victim’s medical bills, hospitalization costs, and lost remuneration. Because of that, some personal injury attorneys will seek additional compensation by filing a lawsuit against other third parties liable for the injuries.
Is Weekly Compensation Paid?
Typically, the injured victim will receive a workers’ comp paycheck weekly, biweekly, or another form. However, in some cases, the injured victim resumes work before their first workers’ comp paycheck arrives due to the lengthy processing time.
In rare cases, a worker may get a structured settlement to resolve their workers’ compensation claim.
No Response After A Claim
It is common not to hear back from the workers’ compensation insurance company after filing an injury claim.
Sometimes, the delay in response results from administrative oversight or a deliberate attempt to escape legal responsibility, delaying telling the claimant that their share did not go through. But, again, seeking legal advice from a competent lawyer will eliminate this challenge.
Suppose the claim does not get the required response from the employer, workers’ compensation insurance company, or State. In that case, the victim’s attorney must take legal steps to safeguard the injured worker’s interest.
Has this happened to you? Was your workers’ compensation claim denied? Consider consulting an attorney for legal advice, your State’s workers’ compensation insurance agency, or an independent insurance company for assistance.
In addition, if you reside in a state with an online portal for checking claims, you may need to check online for your case’s status.
Why Do Workers’ Comp Claims Take So Long?
Payments are not made immediately within the first few days before the claim is approved. Instead, the insurance company will likely pay the medical bills first before sending the victim a check for lost remuneration.
The extended length of time might result from a complicated method for processing complex claims to transition into a weekly or biweekly paycheck.
Typically, every filed claim gets adequate attention to ensure the victim has actual damages.
However, once a claim has been successfully filed, the employer, insurance company, or State could begin an investigation. At this point, every annexed document, like a medical report, accident report, etc., is scrutinized.
In California, injured victims must give the liable party 90 days to respond to the claim. Failure to respond after 90 days may mean acceptance of liability.
Before concluding that the workers’ compensation case is taking too long, check the law provisions in the concerned State. Alternatively, you may consult a well-grounded attorney in this area of legal practice.
The case may well need to proceed to court. However, as previously stated, it may take more time before a claim is approved, especially when it gets to appeal.
Failure to Act Fast can Affect Compensation Benefits
Perseverance in the face of adversity may be a noble virtue outside the workplace. However, the ability to withstand pain and suffer in silence may be counterproductive in workers’ compensation claims.
The law has set limits on the length of time the injured workers must officially notify their company of work-related injuries. However, failure to formally report as required by law may be disastrous with far-reaching consequences.
The insurance company might invalidate the workers’ compensation claim if they wait longer than the restricted time limits.
Some states do not have a uniform time limit for reporting work-related injuries.
The State of California, for instance, requires an injured worker to file a claim within a year of sustaining the injury. Missouri also requires an injured worker to notify their employer within 45 days of sustaining a work-related injury.
Hire a Workers’ Comp Benefits Attorney to Ensure You Receive Maximum Compensation
Were you injured in a work-related accident? Are you expecting to receive maximum compensation for your injuries? Is your employer or their insurance carrier denying your claim?
At Rosenfeld Injury Lawyers, LLC, our accident injury attorneys can fight aggressively on your behalf so that you get the rightful compensation you deserve.
Call our law firm at (888) 424-5757 (toll-free phone number) or use the contact form today to schedule a free case evaluation. All sensitive or personal information you share with our legal team remains private through an attorney-client relationship.
We accept all personal injury cases and wrongful death lawsuits through contingency fee agreements. This promise ensures you pay nothing until we successfully resolve your legal matter through a negotiated settlement or jury award.
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