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Do I Need a Lawyer - 5 Secrets About Workers' Compensation Claims


This is an excerpt from one of the recent episodes of 'Do I Need a Lawyer?' hosted by: Gary Martin Hays.

Rather than take a question in this segment, I'd like to reveal to you:



Did you know that if you are receiving or have received workers' comp wage benefits in the last 120 days, you may be able to have a one-time exam with the doctor of your choice?

The insurance company even has to pay for this exam! Wouldn't it be nice to get an opinion from someone other than the company doctor?

As with any law, there are certain hoops you have to jump through to request this free exam. Make sure you comply with the law in requesting this evaluation, or the insurance company will deny your right to the exam.


Did you know that your employer is required by law to post a panel of doctors for you to see if you are hurt on the job?

According to the rules of the State Board of Workers' Compensation, this panel has to be pink, on the most current Board form, and in most situations it has to have at least 6 physicians listed on it.

The panel must have an orthopedic surgeon listed not just an orthopedist. It also has to have a minority physician. If the Employer does not have a panel posted, or if the panel is not a proper one as defined by law, the injured worker is free to go see any doctor of their choice. If the Employer does have a valid panel, it is still the worker's right to choose the doctor he/she wants to see on that panel.


Did you know the employer has to pay you your mileage to and from your doctors, your physical therapy appointments, and to get your prescriptions filled? All you have to do is keep an accurate and detailed record of all of your trips, including date, time, where you went, the purpose of trip, and the number of round trip miles. Your mileage can add up in a hurry. Keep a record of it so you can get paid.


Did you know you generally have up to thirty days to report your accident to your employer?

A lot of employers and insurance companies may try and tell you that if you didn't report the accident on the day you were hurt, they will not accept your claim because the law requires you to report your accident immediately. This just isn't completely true.

The smart thing and the safest thing to do is to report the accident right away, even if you think it is something that will get better in a short period of time.

We have helped a lot of clients that had what they thought was a minor back injury, that later resulted in back surgery when the condition did not improve. If they had waited to report the accident, chances are the insurance company may have denied the claim. It would have taken a lot of time and expense to get the benefits started.

The law gives you thirty days to report the accident. You must report the injury to your foreman or supervisor within this thirty day time period.

Do you really know how much the employer and the insurance company are supposed to pay you in weekly wage checks?

Most people don't.

By law, you are entitled to 2/3 of your average weekly wage. But the most the insurance company is obligated to pay you right now is $525.00 per week. It doesn't matter if you were making $2,000.00 per week. The most the insurance company has to pay you is $525.00 per week.

Here are a couple of examples:

(1) If you average $300.00 per week in gross pay for the 13 weeks before your on- the-job injury, the insurance company is only obligated to pay you $200.00 per week, which is 2/3 of the $300.00.

(2) If you average $900.00 per week in gross pay for the 13 weeks before your on- the-job injury, the insurance company only has to pay you the maximum weekly rate of $525.00, even though 2/3 of $900.00 is $600.00.

And this drastic cut in pay can be especially tough on injured workers and their families when they are used to receiving a full pay check.

Insurance companies don't always pay the correct amount.

And if they are paying you less than the maximum amount of $525.00 per week, they are required by law to file a form that lets you know how they calculated the amount of your weekly check.

Insurance companies often fail to count your overtime pay and they hardly ever include tips, bonuses, or other benefits from your job. But they get away with it every day because injured workers don't know about their rights.

Injured workers have rights that must be protected. Don't be a victim.

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