Workers Compensation Blog by Gilpin Law Firm

Workers' Comp vs. Personal Injury Damages

Wed, 16 May 2012 17:13:45 -0500

Are damages that can be recovered different under Workers' Compensation vs. personal injury? The answer is "yes". Workers' Comp is about an on-the-job injury. Personal injury is about something that happens outside of work and a third party is responsible, like a car wreck or slip and fall. In Workers' Compensation there are no awards for emotional damages, punitive damages or pain and suffering. But, in Workers' Comp the injured employee gets his/her medical bills paid 100% up front; and, while off work under treating physician's work release, gets weekly temporary total disability checks (70% of average weekly wages up to a ceiling) and, when done treating, gets a lump sum payment for any permanent partial disability that resulted from the work injury (although its not very generous). In a personal injury, the related medical bills are not paid by the wrong doer (or his/her insurance) until the case settles or a judgment is achieved (then the bills are paid out of the injured person's settlement or judgment amount). But, in a personal injury, one can seek damages for actual losses (wages, out of pocket expenses, etc.,), temporary and permanent disability, medical expenses (past and future) pain and suffering (past and future) , emotional damages (past and future), punitive damages, etc.,.

Workers' Comp & Medical Bills

Sat, 28 Apr 2012 16:46:11 -0500

Do I pay any medical bills under Workers' Comp? The short answer is "no". In Oklahoma, if you suffer an on-the-job injury, all of your related medical bills, 100%, should be paid under Workers' Compensation, i.e., by your employer's insurer or your employer directly (if self insured). The bigger question is who can provide you medical care. Under current law for an on-the-job injury, the employer gets to chose the medical provider, i.e., doctor, specialist, clinic or hospital, that treats the injured employee. If the injured worker does not like the employer's choice of treating physician, he/she has one opportunity in the Workers' Compensation Court to request a "Change of Physician". So, if the injured employee simply goes to his/her doctor and treats without a Court order making that physician the "treater", they risk being responsible for that bill and harming their Workers' Compensation case.

Do all job injuries fall under Workers' Comp?

Tue, 03 Apr 2012 14:47:48 -0500

Are all work injuries covered by Workers' Compensation? For the most past, "yes". Workers' Comp is not about fault. It's about any injury or disease process that occurs in the work place. That includes single incident injuries (broken bone, torn muscle) or cumulative injury that occurs over time (carpal tunnel), or lung or heart disease linked to the work environment. Even if a third party (non employee) caused the work injury, it can come under Workers' Compensation. However, horseplay at work is not covered and if the injured employee was intoxicated or under the influence of illegal drugs, the injury would not be covered by Workers' Comp.

Workers' Comp & Light Work Duty Pay

Tue, 06 Mar 2012 09:34:31 -0500

Is my work pay the same while on Workers' Compensation light work duty? The answer is "yes". If you suffer an on-the-job work injury, seek medical treatment and that physician lets you go back to work with restrictions, then you are on what's called "light work duty". While on Workers' Comp light work duty your benefits, wages and earnings are supposed to remain the same as regular duty. Now, if your employer cannot accommodate your work restrictions/light duty, then you become Temporary Totally Disabled (TTD) just as if your physician had taken you off work completely. If you are TTD and off work, you receive only 70% of your average weekly earnings up to a maximum set by the state law.

What is Workers' Compensation

Fri, 17 Feb 2012 13:10:49 -0500

What is Workers' Compensation in Oklahoma? It is a system of laws that cover an employee who suffers an on-the-job injury. Exceptions are made for situations when the employee is intoxicated on drugs or alcohol or engaged in "horse play" when injured. Under Workers' Comp, an injured employee's medical bills are paid 100%; while the employee is off work under doctor's orders healing or recovering from the work injury he/she is paid Temporary Total Disability (TTD) instead of work wages; and, at the end of treatment the injured employee is rated for Permanent Partial Disability or Permanent Partial Impairment (PPD). The level of PPD equates to a lump sum of money to compensate the injured worker for his/her permanent disability associated with the on-the-job injury. There are other benefits under Workers' Comp, including the possibility of Vocational Rehabilitation (retraining or education) if the work injuries left the employee unable to return to his/her former job.

How & when to conclude a Workers' Comp case

Fri, 20 Jan 2012 16:47:11 -0500

How and when do you conclude or finish a Workers' Comp case or claim? Assuming you have a work place injury that falls under Oklahoma's Workers' Compensation system and have an injury serious enough to retain some degree of permanent "partial" disability, there are two (2) ways to conclude your Comp case or claim. First, after your medical treatment is ended and your doctor's have released you from regular care, your rate of Permanent Partial Disability (PPD) or Permanent Partial Impairment (PPI) must be "rated" on a scale established by the Legislature. This scale is reflected in a PPD/PPI chart from 1 percent to 100 percent. (100% on this chart does not equate to total disability and there are charts for the body as a "whole" and various body part charts). Next, with a rate for PPD/PPI established, you might be able to agree on a lump sum settlement with the employer or its insurer, assuming it agrees on the PPD/PPI rate. You could settle your case to conclude it. However, with a settlement you give up important future rights in a Workers' Compensation case, such as: 1) the ability to ask to re-open your case within three (3) years of the last court order due to a "worsening" of your condition (not a new injury, but a worsening of the same injury), 2) you give up the right to Vocational Rehabilitation (job retraining) if your permanent restrictions from the injury are such that you cannot do your old job, and 3) you give up the right to "medical maintenance" (like periodic visits to a physician to monitor your injury needs and possible prescriptions). Besides a settlement, the other way to conclude a Workers' Compensation case is to "try" your case to a Workers' Comp Judge (no jury in a Workers' Comp Court). The judge would decide your rate of PPD/PPI, (payment for it is paid out over time) and your rights to re-open for a worsening of your condition within three (3) years, Vocational Rehabilitation and medical maintenance are preserved.

Workers' Comp Choice of Doctor?

Tue, 10 Jan 2012 10:49:43 -0500

In a Workers' Comp case, work related injury, can I chose my own treating physician? The answer, in short, is "no". Under recently passed Oklahoma law, the employer/work comp insurer gets to chose the doctor who will treat you. Sound fair? Too often, that doctor knows that his/her patients (his "bread & butter") come from employer/insurance company referrals. That means you may not get the most straight forward, comprehensive and complete care that you really need to adequately treat your work injury. What can you do?? Hire an attorney and he can file a pleading with the Workers' Comp Court Judge for a "Change of Physician". At that point, the Judge most likely would appoint a new treating physician or a doctor to independently evaluate your injury & need for treatment. However, that new physician or evaluating doctor must be taken from a list of "preapproved" doctors and care providers. It gets complicated. An experienced Workers' Comp attorney should be familiar with the physicians on that "preapproved" list and know which doctor is likely best for your treatment and who will be honest about your injuries.

Workers' Comp If at Fault?

Tue, 20 Dec 2011 11:48:21 -0500

Will Workers' Compensation cover my on-the-job injury even if I'm at fault? The answer is most always "yes". Workers' Comp covers on-the-job injuries (for non-exempt employer/employees) regardless of who's at fault for the injury causing incident. The exception to coverage for on-the-job injuries is if the employee was engaged in "horseplay" or was intoxicated or on illegal drugs when the injury took place. Otherwise, why such broad coverage for injured employees?? Because the system was established as a "social compact" between employer and employee many years ago. The idea was that an employee injured on-the-job (irregardless of negligence by the employer or employee) would get coverage for the injury, treatment, partial pay while temporarily off work recovering, a lump sum payment at the end of the case for Permanent Partial Disability (if any) resulting from the injury and possibly even Vocational Retraining if the employee could not return to that job due to the injures. The trade off or bargain for both the employer and employee is that the Workers' Comp system is not generous and the employee cannot ordinarily sue the employer in District Court for a negligent or unsafe work place.

Workers' Comp Claim After Settlement?

Tue, 13 Dec 2011 12:03:37 -0500

Can my Workers' Comp settlement be re-evaluated afterwards? In short, "no". Once you have entered into a settlement of your Workers' Compensation claim (Joint Petition or Mutual Compromise Settlement, etc.,) that claim in over and done, forever. ( a new injury is a new case) However, if you instead "tried" your Workers' Comp claim to Judge in that Court and received an award, the current law allows a Claimant the ability to apply to "re-open" his/her case for additional treatment, PPD, Vocational Rehabilitation, etc., for a period of 3 years after the last substantive court order in the case (usually, but not always the PPD trial award order). The possible advantage of settling/concluding your case is that a Respondent/employer's insurer may pay a little more than the average court award on a case to gain the closing of the claim forever. Also, a settlement is paid in a lump sum payment, while a court award pays the accrued amount of the award w/i 20 days of that order (assuming there is no appeal) and the remaining amount (non accrued) on that award is paid out in weekly checks equal to the Claimant's PPD rate.

What You Need to Know About Workers Compensation

Thu, 04 Feb 2010 11:22:09 -0500

If you are injured on-the-job, regardless of fault (assuming you are not an independent contractor), Oklahoma's Workers' Compensation laws probably apply. You need to get medical attention and report the injury to your employer right away. If it's a work injury, do not keep it to yourself or depend on your family physician alone for treatment. That will make a bad situation worse. Your employer gets first pick as to the treating doctor for a work injury. Then, if you don't like the employer's doctor or need a specialist or a second opinion, the Workers' Compensation Court can order treatment by a different physician or specialist. It's important that you be evaluated and treated by a care provider whose primary interest is you, your recovery and your well being. And, you need a doctor with experience in treating your type of injury. When you are matched up against an experienced insurance adjuster or employer's lawyer (whose interest it is to make your claim go away or as small as possible) the situation becomes bigger, more complicated and hazardous to your rights. Are you seeing a doctor you can trust and getting your full Temporary Total Disability weekly payments while the doctor has you off work and recovering? What lump sum payment will you get once your doctor releases you entirely from care? That's called Permanent Partial Disability and its for what you are stuck with for the rest of your life. Don't try and go it alone on this one. Contact an experienced Workers' Compensation attorney right away.