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How To Win Your Worker’s Compensation Case And Get Paid: Part II PDF Print E-mail
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Written by John K. Akapalu Esq. LLM (Harvard)   
Monday, 26 March 2007
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Source: socal-injury-lawyers.com
  5- SEE A COMPENSATION DOCTOR
Doctors are very important to your compensation case. These include chiropractors. They are assigned by Physical Therapists who all help you to get better. The first step in a compensation case is a report from a doctor or hospital stating that you were injured at work and giving a diagnosis of your injuries. This report is what lawyers call prima facie medical evidence or PFME.

It is only after you have presented this report that the Judge will give you a chance and a date to come and tell him what happened to you. If the Judge believes you, he or she will establish your claim and award you cash benefits. Without your doctor’s report, you do not have the medical evidence to establish your case.

6- TREAT REGULARLY WITH A COMPENSATION DOCTOR

To continue to receive weekly cash benefits, you must be under the care of a compensation doctor. The WCB allows only some doctors to treat injured workers on a regular basis. These doctors are coded by the board – that is, given code letters to represent their specialty. Chiropractors are also coded but they can only diagnose and treat neck and back injuries. Compensation docors do not bill you directly. They submit their bills to the insurance company for payment. These doctors typically handle hundreds of cases a year and know how to fill out the proper medical reports, to ensure that you continue to receive medical treatment and cash benefits. They also diagnose and treat injuries that the hospital ER may have missed. They can also refer you to other specialists who could help you get better.

7- HIRE A WORKERS’ COMPENSATION ATTORNEY

Sooner or later you will need a compensation lawyer to fight for you. The longer you stay out of work, the more expensive it is for the insurance company. They may want to see you back at work as quickly as possible-even if your own doctor says you are not yet ready to return to work. They may have one of their caseworkers contact you and even try to get your doctor to release you back to work. Hiring a lawyer will usually put a stop to this, since the insurance companies know that they cannot contact you without your lawyer’s permission. Remember, you do not pay your lawyer directly. He or She only gets a fee if the Judge awards you money. The more money the lawyer gets for you the higher the fee he or she may get. This provides an incentive to fight hard for you. You have a right to choose your own attorney and you are not limited to the one your doctor or union suggests.

You may also need a lawyer to fight for you to continue to receive medical treatment and get tests approved. If your doctor requests a test in order to properly treat you and the insurance company refuses to authorize or pay for it, you may have to have a trial. This is a chance for your lawyer to fight to get the test authorized by the Judge.

The insurance company may also try to cut or stop your payments and/ or treatment. They usually send you to one of their consulting doctors, called an Independent Medical Examiner (IME). The IME, will, most often, issue a report saying that you are less disabled than what your doctor states. You should not be surprised if the IME doctor finds you fit for work even though your MRIs shows that you have serious problems and your doctor finds you totally disabled. At that point, you need your lawyer to fight for continuing cash benefits and medical treatment for you.

8- FILE YOUR CLAIM WITHIN TWO YEARS

Usually, you have two years from the date of accident to file your claim. Even if you are not seriously injured, it is important to file your claim within two years, in case your condition gets worse and you need treatment or surgery in the future. Your regular health insurance may not pay for any test or treatment related to your work accident. Remember that reporting the accident to your supervisor and filling out an accident report is not the same as filling a claim. To file a claim, you need to complete a Form C-3 and mail it to the WCB. To show why it is important to file a claim within two years of the accident, let us say you are a nurse and you pricked yourself accidentally at work with a needle. You filled out an accident report but did not file a claim. Three years later you develop hepatitis as a result of the needle prick. You are now outside the two-year window and despite your serious condition, your claim may be disallowed.

 





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Last Updated ( Sunday, 06 January 2008 )
 
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