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Workers' Comp Handout

Indiana Workers’ Compensation Law

A summary of the injured workers’ rights

A. What is “Workers’ Comp”?

1. Medical Treatment--your most important benefit by far

  • Employer has the right to direct your treatment. In other words, the employer or its insurance company will select your doctors.
  • Medical treatment provided until you reach “maximum medical improvement”
  • Employer or the workers’ compensation carrier may hire a Nurse Case Manager (“NCM”) to schedule and attend your doctor appointments. Cooperate with this person, but remember that the NCM works for the insurance company.

2. Weekly Disability Benefits--paid at 2/3 of your Average Weekly Wage up to a maximum of $508 per week (date of loss after 7/1/00), $548 per week (date of loss after 7/1/01) or $588 per week (date of loss after 7/1/02)

  • Average Weekly Wage is your average wage for the 52 weeks before the injury and includes overtime, bonuses, tips, and benefits
  • 7 day waiting period (i.e., you do not get paid for the first 7 days off unless you end up being off more than 21 days)
  • Terminate when you are released to light duty, and your employer can accommodate the light duty restrictions, or when you reach “maximum medical improvement”

3. Permanent Partial Impairment--Lump sum settlement for permanent injuries when the doctor releases you for good

  • Usually based on a doctor’s “impairment rating”
  • You have the right to have your own doctor give you a second opinion regarding your impairment rating (You must pay for this, but a second opinion can result in a higher settlement if your doctor thinks you have a higher impairment)

4. Permanent and Total Disability

  • Permanently and totally disabled means that you are unable to perform “any reasonable employment”
  • Extremely difficult to prove –it does not mean that you are“unable to return to your old job”
  • Benefit paid is 500 weeks of your of weekly disability pay up to a maximum of $254,000 (minus disability benefits already paid).

B. Summary of Your Rights

1. Right to a decision by the insurance company regarding your claim within 30 days

2. Right to file a “Request for Assistance” with the Workers’ Compensation Board if the insurance company or your employer is not fulfilling their obligations (See attached form)

3. Right to reimbursement for mileage traveling to doctor appointments outside the county of your employment at a rate of $0.34 a mile (send a record of your mileage to us periodically so that we can be sure you are reimbursed)

4. Right to have prescriptions reimbursed (send a record of your prescriptions to us periodically so that we can be sure you are reimbursed)

5. Right to ask the Nurse Case Manager to wait outside the exam room when you see the doctor

6. Right to written notice if your weekly disability benefits are terminated

7. Right to Independent Medical Exam (IME) when Work Comp doctor releases you

  • We must send back the “Report of Claim Status” form within 7 days
  • Entitled to 2 week’s disability pay pending IME

8. Right to a second opinion from your own doctor at your expense regarding your impairment rating

9. Right to file a Claim before the Indiana Workers Compensation Board if there is a dispute about your right to benefits

10. Right to have an Attorney represent you before the Indiana Workers’ Compensation Board

III. DO’s and DON’Ts for the Injured Worker

1. Don’t ignore a work injury hoping it will just go away

2. Do report work injuries to your supervisor immediately--no matter how minor

3. Don’t just go to the Emergency Room or your family doctor on your own

4. Do get authorization from your employer and go to their doctor—at least initially

5. Don’t refuse to cooperate with the workers’ compensation carrier--that’s what they want you to do!

6. Do give a recorded statement to the work comp insurance adjuster and sign a medical consent form (limit consent to 60 days)

7. Don’t lie or conceal a prior injury--that’s what they want you to do

8. Do be completely truthful with the work comp adjuster-an aggravation of a prior injury is covered under work comp

9. Don’t miss any doctor or therapy appointments--your obligation to go to physical therapy is the same as your obligation to go to work.

10. A missed doctor appointment could result in the termination of your weekly disability benefits.

11. Do call the doctor’s office and the nurse case manager ahead of time if you are unable to make a doctor appointment--just like you would with your job.

12. Don’t perform work in excess of your work restrictions.

13. Do tell the Doctor/Nurse Case Manager/Union representative immediately if your employer is forcing you to violate your work restrictions

Please note: An employer can decide not to pay for benefits such as health insurance if they choose while you are off work with a work-related injury. You will have the option of paying the premiums yourself. If your employer stops paying for your health insurance of other benefits, let us know right away as we may be able to use this fact to increase your weekly disability benefits.

Also, workers’ compensation benefits are not taxable and do not need to be reported on your state and federal tax returns.

If you have questions regarding your workers’ compensation claim, please call or e-mail us. If the attorney handling your case is unavailable, please ask for the workers’ compensation paralegal.

Stephen M. Wagner, Trevor J. Crossen and Judy W. Pippin

WAGNER REESE & CROSSEN, LLP

11939 North Meridian Street

Carmel, Indiana 46032

Ph. 317-569-0000

Fax. 317-569-8088

e-mail: SWagner@InjuryAttorneys.com

e-mail: TCrossen@InjuryAttorneys.com

e-mail: JPippin@InjuryAttorneys.com