Over the last several years, wages have increased some, and medical bills have increased even more. However, workers’ compensation benefits are on the opposite track. Since 2013, wage replacement benefits are down 17%, and medical bill payment benefits are down 20%. Since workers’ compensation is no-fault insurance, insurance company lawyers cannot deny liability. But, they can and do challenge the amount of benefits.
A Marietta personal injury lawyer works hard to ensure job injury victims get the victims they need and deserve. These benefits are available to both trauma injury victims, like falls, and occupational disease victims, like hearing loss. Both kinds of injuries are often difficult to diagnose and treat. Job injury victims in Georgia usually have the right to choose their own physicians. So, these victims get the treatment they need, as opposed to the treatment a company doctor is willing to provide.
Lost Wage Replacement
This benefit hinges on the AWW (average weekly wage). When a school computes a student’s grade point average, the school only looks at prior grades. When a Claims Examiner calculates a job injury victim’s AWW, it is backward-looking as well as forward-looking. This calculation includes future lost wages, such as irregular overtime opportunities.
Several kinds of wage replacement benefits are available, usually depending on the nature and extent of the victim’s job-related disability.
- Temporary Total Disability: Since they cannot work as they recover, TTD victims usually receive two-thirds of their AWW for the duration of their temporary disabilities. A brief waiting period may apply in some cases.
- Temporary Partial Disability: Sometimes, as they recover, job injury victims can go back to work. But they must accept lower-paying light duty assignments or reduce their hours. To even things out, workers’ compensation pays two-thirds of the difference between their old and new incomes.
- Permanent Total Disability: Disabled usually means “unable to work.” It does not mean “bedridden.”Additionally, this D-word has more than medical implications. Some injuries or illnesses are disabling to some people. For example, a severely damaged knee is disabling to most workers but not to writers.
- Permanent Partial Disability: Similar to PTD victims, PPD victims are usually entitled to lump sum payments. Frequently, a permanent partial disability is a trauma injury, like a broken shoulder, that never fully heals.
Usually, lost wage benefits are retroactive to the filing date, especially in trauma injury cases. In occupational disease cases, they could be retroactive to the date of diagnosis.
Medical Bill Payment
Workers’ compensation also pays all reasonably necessary medical bills, from the first moment of emergency care to the last day of physical therapy.
Frequently, insurance company lawyers challenge the “reasonably necessary” requirement. As most of us know, insurance adjusters eagerly approve the cheapest fixes. However, they do not always approve the best fixes. In the end, bills are reasonably necessary if an Administrative Law Judge, not an insurance adjuster, designates them as such.
ALJs do not make this decision until after a full hearing. This hearing allows a Marietta personal injury attorney to fully advocate for job injury victims.
Incidentally, injuries are usually work-related if the injury-causing activity benefited the employer in any way. Assume Tom hurts his knee in a company softball game. That injury is work-related. The free advertising benefits Tom’s employer. Furthermore, happy and healthy employees are usually harder-working employees. Once again, the boss benefits.