It is really important for every worker to know that not all the disabilities are covered under employee compensation insurance. Disabilities which happen as a result of accidental injuries or occupational diseases at a workplace during one’s employment are compensable. One should not hesitate from filing a claim for workers’ compensation in order to enjoy all of its rights to benefits as well as medical care.
You can also hire a lawyer, if the case and its specifics become too complicated for you to handle. Remember that you have to pay your lawyer from your claimant’s reward instead of paying him/her directly. Now, here are some common FAQs about employee compensation which you should know:-
How are cash benefits paid to claimants?
Cash benefits (weekly) are paid by evaluating the two-thirds portion of an employee’s average income earned on weekly basis in a year just before the accident occurred. Even if you don’t make any claims for these benefits, necessary medical care will still be provided to you.
What are the requirements for getting an advance authorization to obtain medical care?
Advance authorization must be acquired in cases of surgical procedures, X-rays, special diagnostic tests, specialist consultations and physiotherapeutic procedures. However, there is the cost factor, which you have to consider here. In different countries, there are different cost limitations for getting an advance authorization for these special services. Claimants must acquire diagnostic tests like CT scans, X-rays, and MRIs from their respective facilities and show them to their insurance carriers.
What to do when your insurance carrier contests your claim?
It is essential for your insurance carrier to file an official document known as notice of controversy within 10-18 days. Here, reasons must be given for his/her refusal to pay your claim, to the board. You should also not sit silently and appoint a top workers compensation lawyer Orange County to represent and determine the feasibility of your claim. The final decision is made by judge after conducting hearings.
What to do if you are not content with the decisions made by the judge or the board?
In case of a judge, you should file an application with your board within 30 days right after the judge’s decision has been announced. Make sure to state the reason for which you disagree with that decision. In case of the board, you should make appeals to the judicial department of the court within 30 days after the announcement of the decision.
