It’s important. Very important. Why? Because it represents the only income injured working folks usually have to survive on while they’re in a healing period, following a work injury. But it’s more than that. The eventual value (settlement and otherwise) of workers’ compensation cases is based heavily upon what the claimant’s weekly compensation rate is determined to be. Under law, the average weekly wage and corresponding compensation rate are to be based upon a worker’s contract of hire at the time the injury occurs. The alternate calculation, favored by insurance companies, is to arrive at a rate by analyzing how much an injured worker earned in the year prior to his work injury, and then dividing that number by 52 weeks. Insurance companies like this method, because it often makes the compensation rates lower (sometimes much lower) than they legally should be. This devalues the case, and saves the insurance carrier cash, at an injured worker’s expense. Competent workers’ compensation lawyers should always make accurately determining a client’s weekly compensation rate one of their top priorities.
“Do I have a case?” is a common question in Arkansas workers’ compensation law. Just being injured on the job is rough enough. But then an insurance adjuster comes calling, followed by “official” looking forms in the mailbox. Sometimes a benefit check in some strange amount arrives, and sometimes one doesn’t. Doctors’ appointments are scheduled, or the claim is just outright denied, without much explanation at all.
The answer is yes, you may very well have a case. In fact, it my be a significant workers’ compensation case that involves or has the potential to involve maximum damages under our Workers’ Compensation Law. It is doubtful, however, that an insurance company is ever going to tell you this.
At Hart Law, we will.
By: Neal L. Hart, Attorney at Law
In Arkansas, if an injured worker suffers an injury at work (regardless of whether or not it results in permanent impairment), the insurance company is obligated, under the law, to pay reasonable and related medical bills, and also to pay the employee temporary total disability benefits (a temporary wage substitute), until doctors are able to “fix” the injury to where it’s as good as it can get. During this process, which starts very early on in a claim, the insurance company has a right to control an injured worker’s medical care, and will routinely hire doctors known to working folks (and to Hart Law) as “company” doctors. These are physicians who the insurance company thinks might treat the claimant both cheaply, and for only a short period of time.
Injuries resulting in disability that’s never going away (ie: permanent impairment)can be pretty scary. Arkansas working folks are good at their jobs, and are justifiably proud of their ability to work hard, physically and mentally, to accomplish a bunch of things. When a bad work injury hits, it creates a multitude of medical questions for injured workers, because the body is complex, and made up of thousands of bones, joints, ligaments, vessels, muscles, discs, and all kinds of other things. Physicians try to explain it the best they can, while insurance companies shuffle injured folks from doctor to doctor, trying to find a way out of the claim. It’s pretty easy to feel lonely and lost, after being thrown into this scenario.
“What’s going to happen to me after all this?” is one of the most common questions asked by injured employees in the history of workers’ compensation law. It’s a really important question, because it potentially involves the rest of a working person’s life. It’s one of those questions that injured folks really need to be asking to someone who has a pretty solid grasp on the answer, and also a plan to get there.
Although the benefits outlined above (medical and temporary total disability) are routinely and voluntarily paid in claims, there are other benefits available to injured workers in Arkansas that an insurance company is less likely to just hand over. When a worker with a permanent injury reaches maximum medical improvement, the insurance carrier is often required to pay benefits for permanent impairment to that workers’ body. These permanent disability benefits are calculated by using tables in a book that the treating doctor is required to use, by law. This book was designed to be sort of fair to injured workers. The problem is that the folks who make our laws have told the doctor how to read and use the book, mostly to the detriment of injured Arkansans. Insurance companies, obviously, love this, and they use this book, along with their attorneys, to try to get doctors to give the lowest possible permanent impairment ratings allowed by the book and by law.
Once a disability rating is assigned, and the insurance company agrees to it, they will routinely try to pay out permanent impairment benefits to the injured worker, and then try to close their file. But the file isn’t legally closed. In fact, it potentially remains open as long as the claimant continues to seek timely and related medical care, possibly up until the time of his or her death.
A bunch of insurance carriers would clearly love to pay permanent impairment rating, and then just have the claim go away. The reason for this is that a large portion of the value of a claim involving permanent injury lies in what are referred to as “wage-loss disability” benefits. Wage-loss disability involves a comparison of what an injured employee was able to make before the work injury, and what he or she is able to make after the injury. Wage-loss disability benefits are awarded by a Judge, after a hearing, typically involving a lawyer making an argument for additional benefits, on an injured worker’s behalf. These benefits (along with vocational retraining) are absolutely vital to the lives and to the future of injured Arkansans, and are a big part of the answer to: ‘”What’s going to happen to me after all this?” Unfortunately, that’s a question many insurance companies would prefer never be answered.
At Hart Law, having the answers to difficult questions is our job. We care about what’s next for our clients.
By: Neal L. Hart, Attorney at Law
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