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ANSWERS TO THE TEN MOST
COMMONLY ASKED QUESTIONS ABOUT INDIANA WORKER'S COMPENSATION
ALLEN, ALLEN & ALLEN JAY D. ALLEN DAVID P. ALLEN
#12 PUBLIC SQUARE P.O. BOX 485 SALEM, INDIANA 47167 (812) 883-4171 1. I GOT HURT AT WORK. WHAT DO I DO NOW? It is important to know that an "accident" does not necessarily mean that there is specific point in time when you were injured. An accident means an "unexpected injury" and can include injuries which occur over a period of time such as carpal tunnel syndrome or a back injury which results from repeated bending. REPORT YOUR INJURY IMMEDIATELY ! ! ! 2. WHAT ABOUT WEEKLY BENEFITS? Weekly benefits are commonly called TTD and are calculated on what your average pay per week is. Most of the time your paychecks for the last year are added together and divided by 52 to get your average paycheck. This figure is then multiplies by 662/3%. This is the amount of TTD you are entitled to receive each week. Most employers will pay TTD benefits every two (2) weeks and should be paid during the entire time the doctor says that your condition will improve. 3. THE INSURANCE COMPANY SAYS THEY ARE GOING TO STOP MY TTD. WHAT NOW? Before your weekly benefits can be stopped, you must receive a notice from your employer or your employer's insurance carrier. Your benefits can only be stopped, you must receive a notice from your employer or your employer's insurance carrier. Your benefits can only be stopped if 1) you have returned to any kind of employment; 2) you have died; 3) you have refused an independent medical examination; 4) you have already received 500 weeks of TTD OR 5) you are unable or unavailable to work for reasons unrelated to your work related injury. The notice that the employer should give you is called "Report of Claim Status/Request For Independent Medical Examination". This form will tell you why the employer thinks your TTD benefits should be terminated. Under the heading entitled "Independent Medical Examination Request", there are three (3) boxes that you can check. If you disagree with the proposed termination of TTD benefits you should not only check the "yes" box, but, in most cases, you should also check the "yes" box to request an independent medical examination. YOU MUST SIGN AND CHECK THE APPROPRIATE BOXES WITHIN SEVEN (7) DAYS OF RECEIVING THIS NOTICE. FAILURE TO DO SO WILL CAUSE YOU TO LOSE VERY IMPORTANT BENEFITS YOU ARE ENTITLED TO UNDER THE INDIANA WORKER'S COMPENSATION ACT. This notice is then sent to the Indiana Worker's Compensation Board who will arrange for a neutral doctor to exam you and determine whether you are still entitled to TTD benefits or require additional treatment if you checked the box requesting an independent medical examination. 4. MY EMPLOYER SAYS I HAVE TO GO TO THEIR DOCTOR. IS THAT RIGHT? In most instances, your employer has the right to choose who will treat you. There are some instance when you can refuse to be treated by the employer's doctor; however, it is important that you consult with an attorney before taking this drastic step. On the other hand, if you have notified your employer that you need medical treatment and your employer has refused to give you the medical treatment needed, you may then choose your own physician. 5. WHAT BENEFITS AM I ENTITLED TO RECEIVE OTHER THAN TTD? During the time period when you are being treated and while you are receiving TTD, your employer must furnish to you free of charge the following: 1. An attending physician 2. Hospital services as ordered by the physician or the worker's compensation board 3. Nursing services as ordered by the physician or the worker's compensation board 4. Supplies as ordered by the physician or the worker's compensation board 5. Artificial limbs, eyes, etc. which are medically required 6. Repair and\or replacement of broken teeth 6. THE DOCTOR HAS RELEASED ME. WHAT NOW? If, because of your work related injury, you have some impaired used of your physical functions, you are entitled to a partial permanent impairment rating (PPI). This is what is commonly called as a settlement. You will not get rich from a settlement. Additionally, you do not get any recovery for your pain and suffering. The doctor will most likely use the AMA Guidelines to Permanent Impairment, Fourth Edition, but not necessarily. The Indiana Statutes specifically tell how much you are entitled to receive based on what PPI rating the doctor gives you. For instance, if the doctor says you have a 3% of the whole body impairment, for each percentage of impairment you would receive $500 or a total of $1500. The higher the percentage, the more you are entitled to. You have the right to disagree with the doctor's PPI rating and may seek the opinion of another doctor; however, you must pay this bill yourself. 7. WHAT IF I CANNOT GO BACK TO MY JOB? The law does not require that you be physically able to return to your job only that you be as well as you can be before the TTD benefits are terminated. There are times when the doctor will release an employee as being at "maximum medical improvement", but the employee will not be able to return to his or her job. You may have some rights available to return to under the Americans with Disabilities Act, and should consult with an attorney in this event. There may also be some instances when you may qualify for Total Permanent Disability which could be weekly benefits for the rest of your life. Of you believe that you are entitled to these benefits, you will most likely need an attorney to help you get them. 8. I GOT HURT BECAUSE MY EMPLOYER WAS NEGLIGENT. WHAT CAN I DO? In most cases you cannot sue your employer. The exceptions to this are very rare and the courts have strictly limited when this can occur. On the other hand, there may be other Persons or entities who may be liable for your injuries. A consultation with an attorney can help determine the answer to these questions. 9. WHAT ABOUT THE TREATMENT OR MEDICINE THAT I WILL NEED IN THE FUTURE? You are entitled to treatment by a physician or other medical services (including pain medication) that will limit or reduce your impairment. Future treatment that a doctor says you will need should be addressed at the time you make a PPI settlement. In most cases, you will need an attorney to assist you in this area. If future medical expenses are not addressed in the settlement, you only have a very limited time period to contest it. 10. I HAVE FILED THE "APPLICATION FOR ADJUSTMENT OF CLAIM" SO THAT I CAN GO TO A HEARING. WHAT HAPPENS NOW? If you and your employer disagree about what you are entitled to receive under the Indiana Worker's Compensation Act, an Application for Adjustment of Claim must be filed within two (2) years of the date of the injury or two (2) years from the last date you were paid weekly benefits. Before a hearing can be held, you must receive the treatment that you need, reach maximum medical improvement, and have the doctor give you a PPI rating. In other words, you must let your body heal as much as it can before you go to a hearing. This may mean that you will be without income for a period of time. Consultation with an attorney can help uncover various avenues available to you. Hearings are set by the Administrative Law Judge who oversees a particular region which contains several counties. The Administrative Law Judge usually schedule hearings for all worker's compensation cases for one county at a time. There will usually be 2 or 3 hearings a year for each county. There is very little that either you or an attorney can do to get a hearing other than wait for the administrative law judge. Again, patience is a must. DISCLAIMER THIS PAMPHLET DOES NOT CONSTITUTE ADVICE OF AN ATTORNEY OR REPRESENTATION BY THIS LAW FIRM. THIS PAMPHLET IS PROVIDED FOR INFORMATIONAL PURPOSES ONLY.
ALLEN, ALLEN & ALLEN #12 PUBLIC SQUARE P.O. BOX 485 SALEM, IN 47167 (812) 883-4171 |