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Workers Compensation Legal Framework Workers compensation laws are a way to provide a framework for protecting injured workers. They guarantee monetary compensation to workers for medical bills, lost wages, or permanent disability. They also limit the amount an injured worker can claim from their employer and eliminate liability of co-workers in most workplace accidents. This is done in order to avoid delays, litigation costs and anger. What is Workers' Compensation? Workers compensation is a form of insurance that provides medical treatment and cash benefits to employees injured while at work. In exchange for employees agreeing to waive their civil rights against their employers, the insurance is designed to protect them from large tort verdicts and settlements. Almost all states require employers with two employees or more to carry workers' compensation insurance. It is not mandatory for small businesses with less than two employees, and is generally not required for freelancers and independent contractors. The system is an open-ended public-private partnership. It was established to provide income protection as well as partial medical assistance to employees who are injured or sick on the job. Employers typically purchase workers' compensation insurance through private insurance companies or state certified compensation insurance funds. The payroll, industry sector and history of workplace injuries (or the absence of) are the primary factors that determine the premiums and benefits for each province. This is referred to as experience rating, and it is more sensitive to frequency of loss than loss severity, as insurance companies recognize that when accidents happen frequently the likelihood is higher that the business will have big losses over time. Employers must pay for lost productivity and cash benefits for employees recovering from injuries. workers' compensation law firm newton is the primary driver for the increasing cost of workers' compensation. The Workers' Compensation Board is the governing body of the program. It is a state-owned agency that evaluates all claims, and, if needed, intervenes to ensure that employers and their insurance carriers pay the full amount, which includes medical treatment. Its role also includes providing an avenue for dispute resolution, such as benefit review conferences as well as appeals. How do I make a claim? It is vital to submit a claim for worker' compensation as quickly as you can following an injury or illness. This is to make sure that your employer or insurance provider has all the necessary information in order to determine if you are qualified for benefits. It is easy to submit a claim. First, notify your employer in writing of the injury and provide information about your rights as far the workers compensation benefits. The next step is to have a doctor complete a preliminary medical report (Form C-4) within 48 hours after your accident. The doctor should also forward the report to your employer or insurance company. After completing the report, you can make an official application for workers' compensation with the New York Workers Compensation Board. This can be done online, via phone or in person. It is also recommended to consult an experienced attorney regarding your claim. They can assist you in obtaining evidence to support your claim, negotiate with the insurance company and assist you in hearings in the event that the insurance company denies your claim. If you are denied a denial, you are able to appeal it to the state Workers' Compensation Board or the New York Court of Appeals. An attorney can help in these appeals and represent your interests at any court or board hearings. They typically do not charge anything upfront, and will only receive the amount of benefits if you prevail. What is the next step should I do if my employer denies my claim? Your employer could decline your workers' compensation claim because they believe you did not meet the state's standards or that your injury was caused at work. Whatever the reason, you should take note of it and ensure that you have all the evidence and documents you need to argue your case. Contact your employer's workers' compensation insurance carrier to find out the reason for your claim being rejected. This will also help determine your chances of success in your appeal. If you receive a letter denial of your claim for workers' compensation, you should take action immediately. The law in your state will give you procedure for appealing. To find out more about your options, you should consult an attorney as soon as possible. A lawyer can ensure that your claim is properly handled and maximize the amount you receive for medical expenses, wage loss benefits, and other damages caused by the denial. What if My Employer is Uninsured? If you're an injured worker and your employer isn't insured, you have several options available to you. You can make a workers' compensation claim with the Uninsured Employees Benefit Trust Fund (UEBTF). This fund behaves like an insurance carrier and will pay for medical expenses and lost wages. If you decide to sue your employer for the cause of the injuries you suffered, the UEBTF benefits must be paid in any settlement. A skilled workers' compensation attorney is required to guide you through this difficult situation. Contact Jeffrey Glassman Injury Lawyers today for a complimentary and confidential consultation regarding your legal rights in this kind of situation. We'll talk about the options available to you and help you get the compensation you deserve. We'll also go over ways you can protect yourself from refusal or disagreement of your employer regarding your claims. We'll help you take the necessary steps to receive the medical treatment and other benefits you need. What happens if my claim is Disputed? If your claim is disputed If you have a dispute, it is important to contact an attorney. This is to ensure your rights are secured, fair treatment, and that you receive the correct amount of compensation. If a claim isn't in dispute, the Workers' Compensation Board (Board) is able to issue an administrative decision. This could include questions like whether your injury is work-related and your level of disability or the amount you are entitled to, and what kind of medical treatment is necessary. It is not unusual to have claims rejected even when they're valid. This could be due to financial concerns or personal animus toward your employer. Employers are legally required to purchase workers insurance for compensation. This means that employers could be subject to increasing monthly costs. This is why some employers may choose to deny your claim in order to reduce premiums. They might also be worried that your claim will cost them money in the long run which could result in a bad relationship with you. However, in most cases claims that are strong will not be denied , and benefits will be paid by the employer or its insurer. If there is a dispute you can appeal the decision to the Board. Oregon's workers' compensation law says that the presided Administrative Law judge during a formal Hearing will issue an official written decision. This is referred to as a “Finding and award” or “Finding and dismissal”. If either parties appeals, the decision is binding for both parties.