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Workers’ compensation insurance helps employees manage the financial strain after suffering a work-related injury. While the main issue in determining eligibility is whether the claimant worked at a company at the time of an accident, an employee who files a claim for workers’ compensation benefits after leaving the company could face several issues. The bottom line in these situations is that if an employee suffers an injury while performing work-related duties, he or she is entitled to workers’ compensation benefits regardless of whether he or she remains employed by the company.
While some injured workers succeed in workers’ compensation claims after leaving their employers, these claims meet with increased scrutiny during the claims review process. Employers pay into workers’ compensation insurance plans to protect their businesses and provide employees with financial relief and job security after an injury. When an employee quits, the timing of leaving the company can complicate a workers’ compensation claim.
The timing of an employee’s departure from a company could impact his or her workers’ compensation benefits and may lead to denial of a claim in some cases. For example, if an employee quits his job and files a workers’ compensation claim for an injury sustained while still employed, the employer and the employer’s workers’ compensation insurance provider could assume the employee is simply trying to secure a substitute for unemployment benefits, which are unavailable to individuals who leave their jobs voluntarily. Injured employees must also keep filing deadlines in mind as they only have a limited time to file a claim after suffering a work-related injury.
Workers’ compensation claimants can secure various types of compensation through a workers’ compensation claim, but leaving the company can impact which benefits the claimant is eligible to receive. For example, a permanent injury that requires long-term care and prevents the employee from returning to the same position may entitle the employee to lost future wages. However, if the employee left voluntarily, he or she will likely be unable to claim those wages.
Many workers’ compensation claimants face significant financial strain after an on-the-job injury, and an attorney can help these individuals in several ways. First, the attorney can assist with the workers’ compensation claim filing process which can be confusing. Additionally, an attorney can advise the injured employee of any available alternative routes to compensation for his or her losses, such as personal injury claims or third-party claims against negligent parties involved in the accident. Attorneys are also accustomed to dealing with difficult insurance claims adjusters who may attempt to lower a claimant’s settlement amount or deny a claim.
When an employee leaves his or her position and then files for workers’ compensation, an attorney can help show the court that his or her claim is legitimate and justifiable. Without legal representation, filing a workers’ compensation claim after quitting a job can be a difficult process. An attorney can help clear the air and provide the reviewing body with the evidence and justification needed for approving a workers’ compensation claim after an employee has left a company.Read More
Workers’ compensation benefits exist to help injured employees manage their medical expenses and lost wages after suffering on-the-job injuries. Every state has unique laws for workers’ compensation, including which employers must maintain insurance coverage. When an employee suffers a work-related illness or injury, he or she may then file a claim to manage the financial issues resulting from the accident. Settlements fall into one of three main categories:
Also called a commutation settlement, a lump sum settlement provides an injured employee with one payment to cover all existing and future medical costs arising from the work-related injury. These settlements require the employee to waive rights to future benefits stemming from the same injury and instead aim to settle the matter with one large payment.
With these settlements, injured employees accept the settlement payment as full coverage for their claim. This also precludes employees from seeking future benefits for the same issue or seeking additional compensation for a claim. In some situations, an injured employee may attempt to sue his or her employer if workers’ compensation does not fully cover the associated costs of an injury. Compromise and release settlements generally contain verbiage restricting the employee’s future options for seeking benefits in exchange for a speedy lump settlement.
Similar to compromise and release settlements, the injured employee must waive any right to future benefits by accepting a structured settlement. The main difference between a structured settlement and a compromise and release settlement is that instead of one lump sum payment, the injured employee will receive smaller settlement payments over time on a structured schedule. This is common for employees who require long-term medical coverage due to their injuries.
After a work-related injury, an injured employee could face financial problems without workers’ compensation benefits. The aim of workers’ compensation is to provide employees with coverage for their losses after an on-the-job accident, which may include:
It’s vital for any injured employee to know their options for workers’ compensation benefits after a work-related accident. An attorney can be a tremendous asset and help navigate the claims process as well as assist with insurance issues or even personal injury claims against negligent employers. An attorney can also help an injured employee determine the best type of settlement to take.Read More
Marijuana rescheduling and legalization have been hot topics of public discussion for many years, and several states, as well as the District of Columbia, have passed legislation decriminalizing marijuana use and providing access to medical marijuana for qualifying patients. While this trend is helping grow a burgeoning industry and offering patients with various medical conditions alternative healthcare options, marijuana’s federal status as a Schedule I controlled substance has raised questions concerning reimbursement for medical marijuana under workers’ compensation laws.
Marijuana is still a Schedule I controlled substance under federal law, despite several states legalizing medical and even recreational use. This has caused confusion for some insurers when it comes to deciding whether to reimburse medical marijuana patients. Since marijuana remains a Schedule I controlled substance at the federal level, it cannot have a National Drug Code, so there is no standardized reimbursement rate for medical marijuana.
The federal government has thus far only mildly interfered with state’s marijuana laws and as more states turn to legalization and decriminalization, federal laws may change in the very near future. Unfortunately, federal restrictions have made it difficult for researchers to conduct thorough examinations of marijuana’s medical benefits. Some states have pushed legislation to make medical marijuana more accessible to patients that benefit from using it, and others have even decriminalized marijuana possession and use, issuing citations similar to traffic violations instead of conducting arrests for drug offenses.
Five states have introduced laws that state medical marijuana patients can receive reimbursement under workers’ compensation benefits: Connecticut, Maine, Minnesota, New Jersey, and New Mexico. Other states have laws expressly prohibiting reimbursement for medical marijuana, but few prevent workers’ compensation insurers from paying for medical marijuana treatment. Florida and North Dakota are the only two states that have passed laws prohibiting medical marijuana reimbursement through workers’ compensation.
The Maine Supreme Judicial Court recently began hearings for a millworker’s medical marijuana case to determine whether the state will require workers’ compensation benefits to pay for the medical marijuana or if the insurer should face charges as an accessory to federal drug law violations. In 2015, the Maine Workers’ Compensation Board ordered the millworker’s insurance administration to reimburse him for the cost of his medical marijuana.
The millworker, Gaetan Bourgoin of Madawaska, sought reimbursement in 2015 for medical marijuana he uses to treat back pain from a 1989 injury while working at what is now the Twin Rivers Paper Co.
Bourgoin had tried several opioid-based prescription pain medications over the years that provided little to no relief, and attorneys for the Twin Rivers Paper Co. and Bourgoin’s insurer appealed the Board’s decision stating that an insurer cannot be forced to pay for marijuana since it is still illegal under federal law, which supersedes state law. These appellants also argue that reimbursement for medical marijuana under workers’ compensation benefits would violate the Maine Medical Use of Marijuana Act, which states that, just because someone uses marijuana legally, neither government medical assistance programs nor private health insurers have to reimburse medical marijuana costs.
Mr. Bourgoin’s attorney offered the counterargument that state law entitles injured workers to appropriate medical services and medications. Since opioid-based medications failed and marijuana offered a better pain management solution for Bourgoin, his attorney argues that medical marijuana classifies as a medicine in this case. Hopefully, this case and others pertaining to medical marijuana reimbursement for workers’ compensation claims help injured workers obtain the medicines they need without facing legal penalties or excessive red tape.Read More