If you have ever sustained an injury or caught an illness because of your work, then you are legally entitled to avail of the Workers Compensation Benefit. It provides injured workers with extra financial aid to help cover any medical expenses or lost wages. Upon the establishment that the condition was ultimately work-related, the employers or insurance carriers are mandated to furnish indemnification as well as provide a paid leave.
In filing for a workers compensation claim, the goal is always to get a fair amount that covers all incurred expenses as well as future ones. There are specific steps in the whole process to help you get what you are rightfully entitled to. But first, here is an overview of what a workers compensation claim is.
The Utah Labor Commission establishes specific guidelines as to who can claim workers compensation. These benefits cover almost all employers from the majority of the industries. However, certain types of workers are excluded, such as insurance brokers, domestic workers, agricultural workers, as well as sole proprietors. But this does not prohibit companies from extending the benefit to them.
If the type of industry falls under compensable workers, then the next step is to determine the nature of the disability. It is important to determine where the disability falls under so that the employee knows how much damage is sustained and how long it will last.
Four types of disabilities are recognized under the benefits.
• Temporary Total Disability Compensation – covers the condition wherein a worker is unable to do any work because of a curable injury.
• Temporary Partial Disability Compensation – covers the condition in which a worker is prevented from working or earning his full wage because of the curable injury. This means that the worker is still able to work but only for fewer hours than his regular time or is tasked with a light-duty job.
• Permanent Partial Disability Compensation – the damage caused by the work-related injury is permanent, but it does not leave the employee unable to work permanently.
• Permanent Total Disability Compensation – covers the benefits given to an employee who sustained a permeant work-related disability, and such injury prevents the worker from returning to his work or any other related gainful employment.
Most of the time, insurance companies would have an initial offer on the amount of money with an already predetermined payment set-up to settle your claim for benefits. It is entirely up to you whether you want to accept it or not; however, if you are not satisfied with the offer, you can always resort to these two options.
If all the parties do not seem to enter into an agreement and the possibility of reconciliation is absent, then the employee can always take the matter into the court’s hands. A trial is set into motion, which is similar to that of a regular civil case because there needs to be a presentation of evidence and witness to establish or, for the employer and insurer’s part, counter a claim.
On the other hand, if you want to settle things amicably, it is essential to note that an insurance company’s offer is not absolute because the Labor Commission allows a settlement between the employer, employee, and the insurance company. There are two types of settlement agreements that may be entered into.
The question for this kind of settlement is whether the worker is entitled to the benefits afforded to a work-related injury. At this point, an employer will deny that it is responsible for furnishing compensation benefits. Still, any amount may be offered to prohibit further action on the part of the employee.
On the other hand, a commutation settlement is entered into when the employer admits that the worker is entitled to the benefit, but there is a disagreement as to the amount and payment set-up. Generally, a commutation will consist of all the future possible reimbursement and expenses that the company will incur.
The Utah Labor Commission will then determine if the amount is fair and whether the agreement is equally favorable to all parties.
In choosing the latter option, it is crucial that you must already have an idea of how much you want to be compensated. This ensures that the settlement will not only favor the other party, and you will not be burdened with any possible future medical expenses and debt. To know how much you want, here are some things to take note of.
An injured employee must keep all evidence on the costs that were shelled out due to the injury. This includes not only medical expenses incurred but also legal fees that were spent to forward a claim.
The total of these expenses is a right base settlement amount; this means that these expenses will serve as the minimum amount that an injured employee should get. To get a fair amount, make sure that you can provide this evidence.
Not only should you consider the money that you have spent, but you also have to take into account any future bills. Foreseeing how long the injury or illness is essential since this can quickly turn into a mountain of debt. To determine the amount of future expenses, you should get a doctor’s recommendation and prescription and inquire about the time where the injury will fully heal.
In addition to the expenses, you must also provide proof of lost wages by virtue of the work-related injury. This is extremely important, especially for those who are claiming compensation under the permanent total disability type. If you get a valuable sum, it can vastly help in covering your daily needs until the employee can find another field of gainful employment.
One of the reasons why it is not recommended for the injured worker to accept the initial offer is because the whole amount is not precisely what you will take home. The following are some of the deductions that the government or other organizations take out of the settlement amount.
Under federal law, state and federal taxes are not charged on an award of workers compensation settlement. This tax exemption, however, does not apply for those who receive benefits from the Social Security Disability Insurance. This avoids a situation where an employee acquired indemnification for the same cause twice.
What happens is that you can either avail of one of the benefits, or you could combine them. When you choose to combine both, and they are unjustifiably high, then the Social Security Disability Insurance may be reduced, and you are then mandated to pay the taxes on the reduced amount.
In addition, the settlement can also have an effect on your tax credits because the Internal Revenue Service may consider the award as an income.
Medicare does not cover expenses that are sustained under the workers compensation. However, it can be used to pay medical expenses when undergoing the whole claiming process initially. If a settlement is agreed upon, then the advances of Medicare will be deducted from the total amount.
Utah federal law also provides that any overdue child support must first be taken out of any settlement proceedings, whether for workers compensation or not. This is by virtue of the state’s interest to always place a children’s welfare first.
For these reasons, it is essential that neither one should take a settlement proceeding lightly nor accept an initial offer. Through the processes, the employee can advance his concern, which can help increase the amount of the initial offer, and it can then ease any financial burden caused by the illness or injury. As such, one should seek a piece of advice from a professional that knows and prioritizes the welfare of the claimant.
Davis & Sanchez has been at the forefront of fighting for the rights of injured workers all around Utah. They have been in the industry for 20 years and are firmly equipped with all the know-how of a workers compensation claim. Solely specializing in the workers compensation law, they can give you the best amount in which you are entitled out of the settlement.
If you want to get the best value out of you or your loved one’s workers compensation claim, contact Davis & Sanchez, PLLC so that they can help you get what you deserve. You may contact the firm at (801) 746-0290 or (208) 258-7000, or visit their office at 655 E 4500 S #120 Murray, UT 84107, or 4696 W Overland Road, Suite 162 Boise, ID 83705.
*The information provided on this website does not, and is not intended to, constitute legal advice; instead, all information, content, and materials available on this site are for general informational purposes only.
Davis & Sanchez
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