The FIVE Benefits Available to Injured Employees Under NH Worker's Compensation Law
If you're an employee hurt at work, you are entitled to protection under the Worker's Compensation statute, but what does that really mean? Well, it comes down to Five Basic Catagories of Protection and here they are:
1). Lost Wages.
The law says, If you are hurt at work during the course of your employment, you are entitled to compensation for your lost wages which you suffer as a result of your injury. That's great, right? Well, sort of. The reality is, there are all sorts of exceptions and limitations to the law.
First off, your lost wages are based upon your average weekly wage earned over the 26 to 52 weeks before your date of injury. The bad news is, you will not be compensated for that raise you were just about to receive as future raises aren't taken into account. The good news is, The law entitles you to use the highest average weekly wage within that 26 to 52 week time period. That means, if you worked a lot of overtime in weeks 36 through 52, for example, there is a way to take that into account and to use those weeks to your advantage when calculating your highest average weekly wage. A worker's compensation attorney can help you get the information you need and to communicate with the Worker's Compensation carrier to get you the highest compensation rate to which you are entitled.
This is really important because you will be compensated for your lost wages at a rate of 60% of that average weekly wage. That's 40% less than what you were earning when you got hurt! This sounds like quite a blow, but it's not quite as bad as it sounds because your Worker's Compensation benefits are tax-free. While it's doubtful injured employees are being taxed at a rate of 40%, once you calculate in your employer's withholdings for federal income tax, Social Security and the like, many employees find that their Worker's Compensation benefit is really only about 10 to 15% below their actual take-home pay. Still, that's a heck of a hit for most people, who need every penny of their paycheck to make ends meet.
Another surprise to many injured workers is the fact that lost wage benefits are limited in time. Although employees are entitled to receive 60% of their average weekly wage for the time period that they are out of work due to an injury, if the injured employee is given even a partial return to work, those benefits will likely be limited to five years. So, for example an employee who has significantly lost the use of his right hand as a result of a work injury, may be released to work light duty in a job that doesn't require the use of his right hand. For mechanic or an iron worker that may mean the end of a career, but the Worker's Compensation carrier will argue that there are other jobs that this employee can perform and therefore the carrier will seek to reduce benefits upon return to work and may seek to terminate benefits at the end of five years, even if the employee still has limitations after that time period. A good worker's compensation attorney can explain these benefits in greater detail and work with you to maximize both your compensation rate and the time period for which you are eligible for ongoing pay.
2). Reimbursement for Medical Expenses
Injured employees are entitled to receive reimbursement for medical expenses which are reasonable, necessary, and related to the work injury.
The key to receiving this benefit is twofold; first employees have to make sure that they explain to their medical provider how they were hurt and do this in the very first appointment and every appointment thereafter. Second, employees must be sure that each medical provider completes the required Worker's Compensation medical form accurately and completely.
The fact is, medical reimbursement is not automatic, employees are only entitled to medical reimbursement where the medical records demonstrate that the treatment is reasonable necessary and related to the work injury. This means your doctor must document how you got hurt, indicate if your condition is caused by your work injury, and explain how he comes to that conclusion. It's your job to help make sure that this information is included in your records, if you hope to get your medical bills paid by the insurance company.
Every medical provider in the state of New Hampshire is required to complete a Worker's Compensation medical form for each employee treated as a result of a work injury. These forms provide basic information about how you got hurt, whether you can go back to work, and if so, whether there are any limitations placed on you as a result of your injury. These forms also ask the doctor whether your condition is related to the work injury which you suffered. This last piece of information is absolutely critical to an employee's ability to get Worker's Compensation coverage. Unfortunately, doctors are busy and sometimes forget to fill these forms out completely, which results in inaccurate and/or confusing documentation which can hurt an employees claim.
You can increase your chances of getting bills paid and avoiding a denial if benefits by simply reviewing that form after every appointment. You are entitled to a copy of that form and most offices provide it to you on your way out the door. Just take a moment to look it over before you leave the office to be sure that it has been completed in its entirety and that it accurately reflects what you and your doctor talked about. If the doctor forgot to fill in the description of your injury or markdown limitations which he described to you during the office visit, you need to bring this to the attention of his staff and ask for a correction BEFORE you leave the office. For some people, this might feel uncomfortable, but remember, filling out these forms completely and accurately is as important to the doctor and the insurance company as it is to you. Simply be direct, clear and polite in bringing the omission to your doctor's attention. In most cases, the staff will immediately and happily correct any oversight or errors on that form. The fact is, in order for the doctors to receive payment for your visit, they need those forms to be filled out correctly and they will likely be pleased that you brought any omissions or errors to their attention. You're helping the Worker's Compensation insurance company as well. The insurance company must rely entirely on how that form is filled out to determine if you are entitled to reimbursement for the charge. So remember, If The Worker's Compensation form doesn't accurately reflect your appointment, it's your job to ask the doctor to complete or correct that form so that it does!
3). Job Protections
The third category of Worker's Compensation coverage is job protection. In New Hampshire, employees who were injured during and in the course of their employment, are entitled to temporary alternative duty and reinstatement.
Temporary alternative duty is work that takes into account your physical limitations as a result of your injury. Your employer is required to provide you with this sort of accommodated work during the course of your recovery as you transition back to your regular duties. If, for some reason, your employer is unable to provide you with transitional work within your restrictions, then you should be entitled to ongoing Worker's Compensation benefits for your lost wages.
In addition to these accommodations during your recovery, your employer is obligated to keep your job open for you for a period of 18 months from the date of your injury; this is true even if your employer had to hire somebody else during the period of your recovery to take over your position! That's right, once your doctor releases you to perform your former duties, with reasonable accommodation, you're entitled to return to your job. If you run into resistance, once it's time to return to work, based upon the fact that you still need some limited accommodations, it will be very important that you have an attorney who will help you to assert this right to reinstatement. You'll need someone who understands your rights under workers compensation as well as under State and federal disability laws, such as the FMLA and the Americans with disability act. An employer who refuses to reinstate an injured employee may be in violation of more than the workers compensation laws; atate and federal disability laws also provide rights to reinstatement and require employers provide reasonable accommodation to make that possible. If you've been seriously injured it's vital that you have a Worker's Compensation Attorney who can counsel you about your rights and protections under the ALL the available employment and disability laws such as The ADA, COBRA, wage and hour laws, family medical leave, laws preventing discrimination on the basis of age race religion nationality gender marital status pregnancy veteran status and the like, as well as unemployment and Social Security disability benefits. You may also have other insurance available which you will want to consider as well, such as private disability insurance or retirement benefits which may be available upon a determination of disability.
4). Permanent Impairment Awards
Some employees are also entitled to a one time payment for suffering a permanent injury at work. This is called a permanent impairment award. Not all employees who were injured are entitled to a permanent impairment award. Only certain injuries are eligible for this payment and you may need an attorney's assistance to determine if you are eligible for this benefit.
If you do have an injury which qualifies for a permanent impairment award you will need to have a medical a evaluation (exam) whereby your doctor indicates that you have reached maximum medical improvement (MMI) and then performs a very specific type of examination to document the limitations which you have as a result of your work injury.
Each time you were treated, your doctor is asked to indicate on the Worker's Compensation form whether you have reached maximum medical improvement (MMI) and whether your doctor believes you have a permanent impairment.
5). Vocational Rehabilitation
The last major category of coverage offered under New Hampshire's worker's compensation law is vocational rehabilitation. If you have suffered an injury that is so serious and lasting that you are unable to return to your previous job, you may be entitled to vocational rehabilitation services, i.e. some sort of assistance in finding new work or even retraining, if necessary.
In such cases, you may be assigned a vocational rehabilitation counselor, who will want to meet with you to gather information about your education and work history in order to determine whether you have an ability to return to your previous employment. If it appears you cannot return to your past employment, based upon your physical restrictions, The vocational counselor will then try to determine whether you any transferable skills which would allow you to transfer into other jobs available in the economy. For example, while your last job may have required heavy lifting, if you have a work history that included computer skills, you may be able to transition into a desk job which would not require heavy lifting. If this isn't the case, you might need some additional training, in order to enter into a new profession that better suits your physical limitations.
Vocational counselor's are like any other professional and they vary with respect to style and approach. Often kind and capable resources, these folks are none the less hired by the Worker's Compensation carrier who has a vested interest in finding that you are capable of returning to some sort of work as fast as possible and in the least expensive way possible. Employee should always keep this in the back of their mind as they work with the vocational rehabilitation counselor. Attorneys can help balance the system as they represent the employee and not the insurance company. Vocational rehabilitation has its limitations with respect to the amount of time and money the Worker's Compensation carrier is required to spend in order to assist as injured worker towards rehabilitation and an attorney can assist in maximizing this benefit.
However, there are also other vocational rehabilitation services available through the state which can be used in combination with, or instead of, the Worker's Compensation vocational rehabilitation process. This is something your workers compensation attorney can discuss with you.
In addition, If you are eligible for unemployment benefits, the New Hampshire Department of employment security is a terrific resource for vocational benefits that would help you find new work after your injury.
The more serious your injury, the more likely you will qualify for protection under not just Worker's Compensation laws, but under other employment laws as well. It's important that you ask your workers compensation attorney about these other benefits early on, as some of these benefits cannot be combined with others. If it is likely that you will be out of work for a significant period of time or that you may not be able to return to your old job, it is absolutely vital that you understand your rights with respect to job protection, ongoing health insurance benefits, disability discrimination, accommodation, and other disability benefits which might be available to you. Your attorney will be an invaluable resource for this information.
If you have been seriously injured and have questions about your rights or the benefits to which you might be eligible, you can call Rice Law Office PLLC, for a FREE phone consultation at 603-528-5299. You can also visit our website at WWW.ricelaw-office.com for more articles, frequently asked questions and links to resources.
