A brief summary.
What Is A "Workers Comp" Claim?
A workers compensation claim is a from of tort lawsuit. A tort lawsuit is a civil malfeasance by one individual (the tortfeasor) to another individual (the plaintiff) or victim, which results in physical, mental, or emotional detriment to the plaintiff. After the incident has occurred to the plaintiff, he or she may hire an attorney or, pursue on their own, and bring a claim against the insurance company of the tortfeasor.
In a workers compensation claim, it is imperative that the plaintiff hire an attorney because they are much more complicated than a standard tort claim. In the state of Pennsylvania, the plaintiff is required to notify a superior, manager, or employer within 30 days of the injury occurring. Once the superior has been notified, they should (but frequently do not) initiate the process of a workers comp claim to your employers insurance company.
What Will Happen If I File A Claim?
You need to be evaluated by a physician to prove that your injuries are severe enough to hinder your work performance. During the time you are out of work for your injuries, you are entitled to 66% of your standard wages. If you made $1000.00 weekly, the insurance company would be required to pay you $666.66 weekly. In addition to lost wage compensation, medical bills are to be compensated as well. The amount of medical compensation has the greatest degree of variance in workers comp claims. Insurance companies will try to grant you the lowest settlement possible, if any at all. This is why it is extremely important to hire an attorney. In addition to lost wage and medical compensation, the insurance company is also required to reimburse you for various miscellaneous expenses incurred during your recovery period, such as commuting costs to and from treatment.
Workers compensation cases can sometimes take years to settle. Every plaintiff in a workers comp case who receives treatment will eventually reach a point called "maximum medical improvement" or MMI. This point is different for EVERY plaintiff. In some cases you may resume work entirely, partially, or not at all. Once MMI is reached and all treatment methods have been exhausted, the insurance company will determine the best course of action from there. Typically, if you are unable to return to work, and your injuries cause you to be in a partially and permanent debilitated state, a series of pain management treatments are administered periodically. In some cases, if you are unable to return to work fully or partially, further compensation may result.