Posts From August, 2022

How much of your workers comp settlement can be kept by you

When you have a claim filed for workers´ compensation, the entire process can be very involved. The process can involve a lengthy negotiation and an appeal may take place when an agreement has failed to be reached. Right after you reach a workers´ compensation settlement amount, those involved in your case will all be paid by it. Below, we list who gets what and the amount you get to keep.

Contingency Fees For Your Attorney

When your attorney reaches an agreement for you, you will need to pay their contingency fee that you agreed to. The contingency fee refers to you only paying them in the event that a settlement is awarded to you. An attorney representing you is able to obtain a fee that is as much as 40% of the entire award amount.

You will also need to reimburse your attorney if any payment was made for you by them. These reimbursements would be considered service fees. Prior to signing your contingency agreement, make sure to review its contents closely.

Medical Treatment

Paying for your medical treatment will be the next deduction from your settlement amount. Depending on your case and whether you win, your settlement will be used to pay your medical treatment.

If you were able to pay for your own medical bills, then the amount awarded can be kept by you. However, when your doctor allows postponement of your medical bills, then payment will need to be made. Make sure to talk to your attorney to see about having certain expenses covered. Your attorney may also obtain lower health costs. When this happens, the amount of settlement you keep will increase.

Conditional Medicare Payments

Under Medicare, the agency does not provide medical coverage if workers´ compensation covers an injury. However, when a dispute exists, there may be conditional Medicare payments made. So if the worker is Medicare eligible and they win their appeal, then Medicare will obtain its share from the settlement.

Advance Payments for Permanent Disability

If your work injury results in a permanent disability, then you may obtain an advance through a permanent disability award. In instances where you request the advance, then a fee may need to be paid. The advance will also decrease your settlement amount. It is a good idea to consult with your attorney prior to applying for your advance.

Child Support Judgements

When you have child support payments that need to be caught up on, then you could have a lien placed against your workers´ compensation award if you win. In most cases, child support could receive as much as 25% of a settlement award. Plus, workers´ compensation is calculated as income, so a parent is able to collect a certain amount from a weekly payment.

Amount You Can Keep

With the above circumstances pointed out, the amount you get to keep after everything is considered will vary and depend on different amounts. By consulting with your workers´ compensation attorney, they will be able to calculate a close estimate of how much you will take home. When you contact our office today, we will help get your settlement case started and provide you with an estimate of your settlement before you leave.

  • Posted on: Aug 29 2022
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Workers comp fraud warning signs

When an injury occurs in the workplace, the way it is handled may differ between employers. However, when the injury occurs due to a common cause such as a fall, slip, or trip, and repetitive stress, then there may be a potential for fraud.

In fact, fraud involving workers´ compensation is a crime that is always investigated. The type of fraud most common among workers´ compensation is known as claim-related fraud. This type of fraud occurs when a claim is falsely made in order to gain benefits through a false injury that takes place while working. When this fraud is committed, the premiums that the employer pays will become higher, which may cause problems for employers who are truly hurt.

Warning Signs Surrounding Workers´ Compensation Fraud

Although it may be difficult to identify true fraud involving workers´ compensation, a few warning signs exist that an employer needs to recognize.

Beginning of the week Injury

An injury takes place at the beginning or end of the work week on Monday or Friday. Usually, an injury occurring on Friday will be reported on the following Monday morning.

The Injury is Reported Late

An injury is reported several days after the fact with no explanation.

A Change in Employment

If the employee experienced a change in employment, such as being laid off or terminated, then you may see a fraudulent claim come up.

Witnesses are Nonexistent

The employee is unable to present witnesses to the injury and the description does not match up with what caused the injury.

Cannot Reach the Claimant

When trying to contact the claimant, they are difficult to reach.

Providers Seem Suspicious

The medical doctor the employee sees has a suspicious history relating to fraud claims.

General Changes

A claimant has made several changes in the past regarding job, address, or doctor.

Refusing Treatment

When a claimant refuses treatment or a procedure to confirm an injury, then it will likely be fraud involved.

Descriptions are Conflicting

When the report of the injury is different from the employee´s description, then there may be fraud involved.

A Claims History

Several claims have been submitted by the employee that seem suspicious.

Past history has shown that if more than one warning sign exists within a workers´ compensation claim, then fraud may be attempted. It is important to remember that these warnings do not mean true fraud is being committed, they are only indications to be aware of.

If fraud is suspected, then it should be reported to the insurance carrier. That way the claim can be investigated by the authorities. Make sure that there is a sufficient amount of evidence that can back the investigation such as witnesses and being able to recognize when misstatements are made.

Conclusion

Having fraud occur within the workplace can become a nightmare for the employer. It can also impact the way legitimate injuries get handled, which can cause delays. This is why you should get a hold of our office today when you suspect workers’ compensation fraud. We´ll get the fraud investigated and the problem resolved so that you can get back to business as normal.

  • Posted on: Aug 15 2022
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