Our Answers to Frequently Asked Worker's Compensation Questions

Q: After I have been injured at work, how soon must I tell my employer about my injury?

A: In order to receive benefits, you must tell your employer that you have been injured within 90 days of your injury or the date you learn that you have been injured at work.(Example: A doctor tells you that an injury is related to work you do.)If you wait more than 90 days after your injury to inform your employer, you may forever lose your right to claim benefits.

Q: Am I entitled to see a doctor for my injury?

A: Yes. For the first ten days of your medical treatment, your employer has the right to choose a health care provider to treat your injury. After that time, you have the right to select a health care provider.

Q: After I have begun treating with my own health care provider, can my employer ask me to see another doctor?

A: Yes. Your employer or their insurance carrier is permitted to ask you to see another doctor of their choice for an independent medical examination. After they choose one doctor to examine you, they are not allowed to choose more than one more doctor without approval from the Workers Compensation Board.

Q: What medical benefits am I entitled to?

A: Under the Workers Compensation Act, you are entitled to payment for all medical treatment you receive which is reasonable, necessary, and causally related to your injury. You are also entitled to be reimbursed for prescription medications and for mileage to and from health care providers.

Q: Am I entitled to compensation if I am unable to work as a result of my injury?

A: Yes. If you miss more than seven days of work due to your injury, you are entitled to receive weekly compensation benefits from your employer or their workers compensation insurance company beginning on the eighth day of work that you have missed. If you miss more than 14 days of work, you will also receive payment retroactive to the date of injury.

Q: How much will I be paid if I miss time from work?

A: For injuries occurring after January 1, 1993, you will be paid 80% of your earnings after taxes. In most cases, your average weekly wage is calculated by averaging your earnings from your job during the 52-week period prior to your injury.

Q: I received a Memorandum of Payment indicating that my claim is voluntary payment pending investigation. What does this mean?

A: This means your employer is paying your claim without accepting it completely. By doing so, your employer retains the right to reduce or suspend your benefits unilaterally after providing you with the 21-day notice of their intention to do so.

Q: If I receive a 21-day notice from my employer indicating that they plan to reduce or terminate my benefits, is there anything I can do to retain my benefits?

A: Yes. You can file a request for a Provisional Order with the Workers Compensation Board asking a hearing officer to reinstate your benefits pending a final determination by the Board after your claim has been fully litigated. Within a brief period of time, the hearing officer may enter an order reinstating your benefits completely or partially, or may refuse to enter an order at all.

Q: I return to work following my injury but am earning less money than I was at the time of my injury, am I still entitled to receive workers compensation benefits?

A: Yes. If you return to work and your injury prevents you from earning your prior average weekly wage, you are entitled to receive partial incapacity benefits equal to the difference between 80% of your after-tax pre-injury average weekly wage and 80% of your earnings after you return to work.

Q: How long can I receive benefits for lost time from work?

A: You are entitled to receive benefits for the entire time you are unable to work. If your incapacity to work is partial, the length of time you can receive benefits depends upon your date of injury. If you were injured on or after January 1, 1993, and your incapacity is partial, you are generally entitled to receive benefits for a maximum of 520 weeks with some exceptions. You can ask the Workers Compensation Board to order the employer to continue paying you benefits after 364 weeks if you will suffer an extreme financial hardship without these benefits. If you were injured on or after January 1, 1993, and your injury has caused permanent impairment greater than the permanent impairment of 75% of injured works, you are entitled to receive incapacity benefits as long as your work injury prevents you from earning what you were earning at the time of your injury.

Q: What is the statute of limitations?

A: The statute of limitations is the amount of time you have to file a claim for benefits. The statute of limitations varies depending on the date of injury. At a minimum, you have two years after the occurrence of your injury, or the last time your employer made a payment on your behalf, to file a claim. If you do not file a claim within the specified time, you will never be able to assert a claim.

Q: I received a notice from the Workers Compensation Board regarding a mediation in my claim. What is this?

A: When there is a dispute regarding some aspect of your claim, the Board will schedule a conference in an attempt to resolve the dispute. A mediator will be present to discuss your case with both you and your employer and/or their insurance company to try and reach a resolution of the dispute without further litigation. If your claim cannot be resolved by the mediator, you will need to file a formal petition and proceed with litigation before the Workers Compensation Board in order to receive any benefits which have been denied.

Q: If there is a disagreement about a medical opinion, is there a procedure by which I can ask the Board to appoint a doctor to examine me and resolve the dispute?

A: Yes. Under Section 312 of the Workers Compensation Act, a party has the right to ask the Board to select a doctor to examine the employee. If the Board selects the physician, the doctors opinion is entitled to substantial weight, which means there must be clear and convincing evidence that the doctor was wrong in order for his or her opinion to be rejected. The parties can also agree on a physician to examine you. If both sides to agree to a physician, his or her opinion is binding on both parties.

Q: Does my employer have to give my job back to me?

A: If you can return to work and your job is still available, your employer must offer your job back to you. If your job has been filled, or you are unable to return to that job because of your injury, your employer must give you a job you can perform with your injury if such a job is available. Your employer must also make reasonable accommodations for your injury. Unfortunately, if your employer does not have work available for you, you do not have the right to force them to create a job for you. Your right to be reinstated is limited to one year after your injury unless your employer has more than 200 employees, in which case your right to be reinstated is limited to three years after your injury.

Q: Do I have an obligation to look for work once I have a work capacity following my injury?

A: Yes. As soon as your doctor releases you to return to work, you should check with your employer to see if they have any work for you. If they do not, you must begin looking for other work which fits any physical restrictions you may have. If you do not look for work, your employer or their workers compensation insurance carrier may reduce or terminate your weekly benefits.

Q: Do I need a lawyer to represent me in my claim?

A: Whether an injured employee needs a lawyer in a workers compensation claim depends upon several factors, including the severity of the injury; the length of time the employee will be out of work; the nature of the dispute, if any, between the parties; and the amount of benefits at stake. Most lawyers will consult with an injured employee free of charge and help determine whether representation is necessary.

If you are unable to obtain a lawyer, you will, in most cases, be able to obtain assistance from an Advocate at the Workers Compensation Board free of charge.

Q: Can my employer discriminate against me because I file a workers compensation claim?

A: The law specifically states that your employer is forbidden from discriminating against you for filing a workers compensation claim. If you think your employer has discriminated against you because you filed a workers compensation claim, you can file a Petition to Remedy Discrimination. If you prevail on that petition, your employer will be responsible for paying attorneys fees.