In addition to payments for medical expenses, benefits for lost wages are available; however, the availability of these benefits is contingent on how your impairment is defined. There are four categories, and the corresponding payment computations are as follows:
- You are able to continue working but at a reduced capacity because of your handicap, which is known as a temporary partial disability. You will be eligible to receive two-thirds of the difference in pay that would have been due to your non-impaired work capability and the pay that would have been due to your partially disabled work status. Here, you need to also have a workers comp lawyer to help you in filling the claim.
- A temporary total disability means that you are unable to work in any capacity because of your medical condition. You will get compensation equal to two-thirds of your typical weekly wage, with the total amount not to exceed a statutory cap.
- Permanent Partial Disability: You are able to get two-thirds of your average weekly earnings, up to a legal limit, or to receive a lump sum. This benefit can be paid out in either weekly installments or as a one-time payment.
- You may be eligible to receive payments for the rest of your life equal to two-thirds of your weekly earnings, although these payments are once again subject to a legal cap. You can also be offered a one-time cash payment.
If you are eligible for compensation for missed wages, you will not be paid for the first three days that you are absent from work until you have been absent from work for a total of 14 days.
You are eligible for increased compensation if you have been diagnosed with one or more “occupational diseases attributable to hazardous exposure” and have been rendered fully and permanently handicapped as a result. Mesothelioma, and asbestosis, are some of the diseases that can be caused by exposure to asbestos and other forms of silica.
How to appeal a decision
There are multiple tiers in the appeals process that you can pursue if you feel that a decision regarding your benefits was made incorrectly or if your claim was rejected. In most cases, the first thing that should be done is to find a knowledgeable workers comp lawyer and file an appeal with the Workers’ Compensation Dispute Management Unit. The participation in this mediation procedure is entirely voluntary.
You also have the option of having a conference with a judge who specializes in administrative law (ALJ). In the event that this conference is unable to arrive at a consensus that can be accepted by all parties, the next step is to submit a Claim for Compensation, which will result in a hearing before an administrative law judge. The Administrative Law Judge has the authority to issue a Final Award, a Temporary/Particular Award, or an Award based on an Agreed Statement of Facts.
In the event that either the insurer or the claimant is unhappy with the decision made by the ALJ, they have the ability to file an appeal with the Labor and Industrial Relations Commission. After then, the only option left is to initiate legal action, first in the Court of Appeals and then, if necessary, in the Supreme Court, although it is quite improbable that the Supreme Court will hear an appeal on workers’ compensation.
Finding one’s way around the workers’ compensation system is rarely an easy and uncomplicated endeavor. It is not always as simple as submitting your initial notice and visiting a doctor in order to obtain the benefits you require and are entitled to under the system.