Getting hurt on the job or as a result of your job duties can leave you feeling frustrated, worried, and confused. Fortunately, you have a right to medical care and wage reimbursement through your employer’s worker’s compensation insurance. However, accessing these benefits and getting approval for a claim is rarely as simple as it should be. Let our dedicated team help you understand your options and walk with you through the process to ensure you get what you need to recover. In the meantime, here are some of our most frequently asked questions related to workers’ compensation benefits.
The rights and obligations of persons who suffer workplace injuries are described in state statutes known as the Workers’ Compensation Act. Under these workers’ compensation laws, both injured workers and their employers have to give up certain rights in exchange for obtaining other benefits.
Seek medical attention as soon as possible. You need to document your injury and your necessary treatment, both for your health and for purposes of supporting a workers’ compensation claim. You should also find a lawyer who can help you document how you were injured, such as by interviewing co-workers or other witnesses, and acquiring photographic and video surveillance from your workplace. An experienced workers’ compensation attorney can also help guide you to obtain appropriate, necessary, and timely medical evaluations and treatment.
The law requires your employer to post the workers’ compensation insurance carrier information in a public place at your place of employment. You can also request that your employer provide you with the contact information. If they are unwilling to provide this information to you, the Workers’ Compensation Commission can be of assistance to you in obtaining this information, and at that point, you should probably consult an experienced workers compensation attorney.
You need to notify your employer immediately if you sustained an injury while on the job. In addition, there is a workers’ compensation form called a Form 30C which can be found on the official State of Connecticut Workers’ Compensation Website which you should complete as soon as possible following your injury. It must be mailed, via certified mail, return receipt, to both your employer and to the Workers’ Compensation Commission. Instructions on how to complete this form are provided on the website.
You should file Form 30C as soon as possible. An employer’s accident report does not substitute for Form 30C for you to get benefits, and if your employer refuses to file a report, you need to document the injury and file Form 30C so you can get benefits.
Workers’ compensation is responsible for the payment of any reasonable or necessary medical treatment and weekly benefits you may be entitled to as a result of your inability to work due to your work-related injury. You are also entitled to mileage reimbursement for any medical appointments you attend. An award for permanent injury is available if you do not fully recover from your injuries. However, being entitled to these benefits and actually receiving them, on time, in the correct amounts, are separate issues. You will almost certainly need an attorney for any serious injury, such as a back or head injury, or for any injury that may require surgery or prevent you from returning to your usual occupation.
After you properly report and file a claim with your employer, if you have a note from a doctor and you are unable to work, you should receive a worker’s compensation check after your first week of compensation, but that often does not happen without the guidance and assistance of an attorney from day one. Employers often try to challenge, delay, or reduce workers’ compensation claims by questioning what happened and the severity of the injury.
Yes. Benefits can sometimes be temporary or less than what you are entitled to receive. Also, your employer may dispute your claim or the continuation of your benefits at any time, at which point you can be caught by surprise or unprepared unless you have an experienced attorney.
The judge is supposed to resolve disputes over workers’ compensation. So, while the administrative law judges employed by the state are supposed to help, they are not there to advocate for you and your case. Only your lawyer will advocate for you in a proceeding or hearing, and only your lawyer will know the relevant facts and issues, so in contested cases you will likely need one on your side.
The best thing to do is talk to an experienced workers’ compensation lawyer. Claims can be denied for various reasons, including an employer challenging whether an injury happened at work as opposed to somewhere else. A lawyer can help you bring together the documentation you need to fight a denial and obtain compensation and treatment.
Once you report an injury to your employer, you may be directed to a specific medical facility to obtain care for your injury. With some limited exceptions, such as in the case of your employer having an approved (by the Workers’ Compensation Commission) managed care plan, you are entitled to select a provider/doctor of your own choosing.
The weekly compensation rate is based on the average of the 52-week gross wages earned by you prior to the date of your injury. The net benefit to you is approximately 75% of the employee’s net pay, after federal and state tax deductions.
If you are unable to work following your work-related injury, you are entitled to the payment of weekly workers’ compensation benefits due to your inability to work. The weekly compensation rate is based on the average of the 52-week gross wages earned by you prior to the date of your injury. The net benefit to you is approximately 75% of the employee’s net pay, after federal and state tax deductions. An attorney can assist in confirming that your workers’ compensation benefit is correct by requesting the wages from the employer to ensure the accuracy of the calculated rate.
If you had more than one job at the time of your work-related injury, you may be entitled to an increase in your weekly workers’ compensation rate to compensate you for lost income from the second job. This is called concurrent employment. Notify the workers’ compensation carrier responsible for your injuries of all other employment you were engaged in at the time of the injury. The portion of your lost wages from any other jobs is funded by the State of Connecticut, and not the responsibility or your concurrent employment employers. However, you must be working both jobs during the same weekly pay period to be eligible for the additional benefit.
No. The law protects workers’ from being fired or discriminated against in the workplace for filing a compensation claim. Employers who retaliate against workers’ filing for compensation open themselves up to lawsuits from those workers, rather than being protected under the workers’ compensation system. Under Conn. Ge. Stat. Sec. 31-290a, employers are prohibited from retaliating against a worker for filing a claim.
Conn. Gen. Stat. §31-290c makes it a felony to make a fraudulent claim or receive benefits based on a fraudulent claim. Employers may also suspect that an injury is fake or did not happen at work and may try to investigate before paying out benefits. If this is a concern, you should immediately consult an attorney.
Surveillance can come from your employer or their insurer, or an investigation can come from the state’s workers’ compensation fraud unit. False compensation claims and receiving benefits based on fraud are felonies, and employers do not want to pay out benefits based on non-workplace injuries or exaggerated injuries.
The exact timeline for receiving workers’ compensation will vary considerably based on the injury, and numerous other factors. A free consultation with an attorney is the best way to get the best answer to this question.
Respondent’s Medical Examination (RME) is an examination by a physician of the employer/insurer’s choosing. The exam is used to establish that your injury is what you say it is and to evaluate whether it occurred in the workplace or in some other manner. Under the law, an RME can be requested by your employer, and refusing to attend the RME will likely result in the suspension of your benefits, without good cause.
Job Searches are required when your doctor indicates that you are not, or no longer totally disabled from work, and indicates that you have a work capacity with restrictions. If your employer is unable to accommodate you with a position within those work restrictions, you will need to perform weekly job search efforts to be eligible for continued weekly benefits. You will be required to make a real bona fide effort to find work that you are qualified for, within the work limitations imposed by your physician and your injury. These job search notes must document the date, name, address of the employer contacted and the result of the contact. Job search notes will also be required for the receipt of 308a benefits, which is available if it is determined by your doctor that you cannot return to your previous employment as a result of your injuries.
An Authorization for the release of your medical records will be required and you can sign an Authorization. It is not recommended that you sign any other forms without consulting with an attorney first to protect your rights.
FMLA protects the job of someone who is unable to return to work following a work-related injury. (job protection). In many situations, your employer may require you to complete FMLA paperwork if you will be out of work because of a work-related injury. This will protect your job during your absence, up to the allowable FMLA guidelines.
Under our Workers’ Compensation Act, injured workers do not have to prove that their employer was negligent to be entitled to certain benefits described in the Act. However, in exchange for this, an injured employee may not sue their employer in Court and is only entitled to the benefits described in our Act.
Yes. If someone other than your employer or a co-worker causes your workplace injury, you have a right to sue that third party responsible to recover damages for your injuries, such as if you are injured on the road due to the fault of another driver, or if an employee of another company, such as a subcontractor, is responsible for your injuries.
Yes, because workers’ compensation is a no-fault law, unless you were intoxicated, hurt yourself in clear violation of company safety policies, or while horsing around, you will likely to be entitled to workers’ compensation benefits. However, employers will often manufacture or make up reasons for contesting your claim, in which case, you will likely need an attorney.
If your employer wants to discontinue or reduce your weekly payments, it must file a Form 36 (Notice of Intention to Reduce or Discontinue Payments), sending it to both you and to the Workers’ Compensation Commission. The Form 36 must provide an explanation for its intent to reduced or discontinued payment, and proper medical documentation to support its claim must be provided. If you object to the approval of the Form 36, you must file a Request for a Hearing form indicating your objection, within 15 days of your receipt of the Form 36. If you do not file a Hearing Request form objecting to the approval, the Form 36 will be automatically approved.
In most cases, if an employer wants to contest your right to compensation benefits, and/or payment of your medical treatment, it must file a written notice to you, with the Workers’ Compensation Commission (Form 43) of its intention to contest your claim. If a Form 43 is filed, you should consider speaking with an attorney.
Very few people ever “get in trouble” for filing a valid workers’ compensation claim, or for hiring an attorney. It is against the law in Connecticut to terminate an employee for filing a workers’ compensation claim. Most employers do not penalize or punish their employees for pursuing a claim. You have every right to hire counsel to assist you and defend your rights as an injured worker. If you are worried, based on past experience about retaliation of any kind from your employer, you should consult an attorney before you decide what to do.