Not all workers’ compensation cases end in a settlement. Workers’ compensation cases are determined on the merit of your claim and the evidence you provide to support it. If you can connect an injury to work-related activities and your employer has this coverage, then you may be owed compensation. However, you may also be denied benefits if, for example, there is insufficient evidence to prove causality between your injuries and your work.
A fixed, formula-based rating scale helps to determine your payout. It will take into consideration the nature of your injuries, the salary or wages you earned before your injury, and how long your injuries are expected to last. It will also evaluate how much of an effect your injuries will have on your ability to work and earn as compared to what you used to earn prior to becoming injured.
In some instances, you can seek a higher payout via a civil suit if you think the formula-based benefits your employer’s insurance company offers you are not commensurate to your injuries.
Workers’ Compensation Claims
According to the Centers for Disease Control and Prevention (CDC), there were almost nine million work-related accidents and injuries in the United States in 2017. Workers’ compensation is a type of insurance that provides coverage when a worker becomes injured at or as a result of work. It is mandatory for companies with at least three employees, whether seasonal, full-time, or part-time.
Workers’ compensation is typically used to cover medical bills, doctor’s fees, rehabilitation and therapy expenses, the cost of medicine, and other treatment-related costs. It also provides the injured worker with two-thirds of his or her weekly salary up to a limit of $675 per week, for as long as he or she is unable to work. It is a very common form of insurance coverage and is required in Georgia as per the State Board of Workers’ Compensation (SBWC).
Calculating Benefit Amounts
Permanent or life-changing injuries that limit the victim’s ability to perform basic tasks or work in a gainfully employed capacity may warrant lifetime benefits. These benefits are determined using a state-approved formula that calculates benefits based on the severity of the victim’s injuries and the impact that those injuries have on the victim’s livelihood and quality of life.
In some cases, the victim may believe that the benefits provided using the formula are unfair or inadequate to compensate for the bodily harm suffered. In instances such as these, the victim can seek a higher payout via discussions with the employer’s insurer. Whether or not the insurance company agrees to a higher payout depends on the evidence the victim presents and how he or she negotiates with the insurance adjusters. The victim may be able to receive a lump sum amount or a payment plan.
It is unlikely that the insurance company will accept all the terms of the injured worker with no strings attached unless there are compelling reasons to do so. If the insurance company refuses to offer a better workers’ compensation payout, the victim can seek a higher payout via a hearing. Hearings are also an option for those who receive a denial.
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In a workers’ compensation hearing, a judge evaluates the evidence presented to determine if the original payout or denial was fair. To win a workers’ compensation hearing, you must first show that you were injured as a result of work-related activities or in a workplace accident. You can prove this using:
- Eyewitness testimony.
- Photo or video evidence.
- Medical reports and test results.
- The statements of an approved doctor.
Basic workers’ compensation contains provisions for covering medical care expenses and a portion of a worker’s lost earnings. You must also provide evidence of costs or expenses beyond these covered categories if you are to win a claim for more benefits. Additional expenses can include changes you had to make in your home for accessibility or other incidental costs.
Seeking Legal Assistance
If you are not sure if your workers’ compensation claim will end in a settlement, you may want to seek out legal representation. An attorney can help you gather the evidence needed to support your claim and represent you in a workers’ compensation hearing.
Please contact the Bader Scott Injury Lawyers team today at (678)-562-5595. If your case warrants a claim, we can help you in negotiations and courtroom representation. Do not hesitate and call today.