The FAQ's of Alabama Workers' Compensation gives the injured worker information concerning their rights. It provides the busy worker with quick answers of the most frequently asked questions that are asked on a daily basis.
Alabama Workers' Compensation Benefits
There are only four workers' compensation benefits. These benefits are medical treatment, mileage reimbursement, cash money and job retraining.
You are entitled to lifetime medical care for treatment relating to your on-the-job injury. This means that your employer must pay for your medical bills. Medical bills include doctor bills as well as other medical necessities such as medicines, crutches, prostheses, wheelchairs, etc. However, as a general rule, your employer gets to choose your doctor. If you don't like the doctor your company uses, you can ask your company to give you a list of four doctors from which you may choose a new doctor. You only get
one chance to choose a new doctor, unless you need surgery; then, you can choose twice.
Your employer must pay you the cost of mileage for your visits to and from the doctor. Make sure you keep a running tally of how many miles you travel for each doctor or rehabilitation visit. The amount is calculated by multiplying the number of miles you traveled by the official state rate. For example, if the official state rate for Alabama is $.38 per mile and you travel 20 miles round-trip to your doctor, your employer owes you mileage pay of ($.38 x 20) or $7.60 for each trip you make to your doctor.
If you are a "proper candidate," the workers' compensation rules require that your employer pay for you to be retrained. This benefit comes into play when you are unable to return to your regular job because your injury prevents you from doing the same kind of work. The rule recognizes that you will likely lose earning potential due to the fact that you can no longer do the job you were trained to do. The rule requires your employer to pay for you to be retrained to do another job that's equal to your regular job; however, your employer is not required to pay for you to better your station in life through vocational rehabilitation such as obtaining a college degree through vocational rehabilitation when you did not have one prior to your accident.
How Much Will I Get For My Pain and Suffering?
Probably the most often repeated question I hear from injured workers is, "How much will I recover for my pain and suffering?" This is a legitimate question, as on-the-job injuries are almost always painful and equally frustrating. However, unlike most personal injury accidents in Alabama (such as auto accidents or slip-and-falls), the law doesn't allow an injured worker to recover money for pain and suffering in a workers' compensation case. The money to which you may be entitled as an injured worker (temporary and/or permanent cash) is calculated by the use of formulas. The formulas try to pay you for past loss of wages or estimated loss of wages in the future. However, by law, the formulas do not include compensation for pain, suffering, nor punitive damages. I know this sounds unfair to you.
However, when the system was created, the lawmakers tried to balance the competing interests of the business owner and the worker. In exchange for giving up the right to get money for pain and suffering, the worker got other benefits as explained earlier.
My Company Caused My Injury. Can I Sue for Negligence?
I had a client who injured her back when she fell at a loading dock. She fell as she attempted to stand on a beam and use a broom to reach up and lower some bay doors. Sounds hazardous, huh? For months she and other employees had complained to her employer to replace the broken chains on the bay doors so that the employees did not have to put themselves in a dangerous position to lower the doors. The employer promised to fix the doors, but did nothing. My client fell one afternoon and guess what? New chains for all bay doors the next day. Like many others, she asked me, "Can I sue my employer for negligence?" The answer is no. When our legislature created the workers' compensation system in 1919, it passed a rule that said that an employee, injured on the job, cannot sue his employer for negligence. This rule was a part of a trade-off wherein the legislators gave businesses protection from negligence suits but required them to pay workers' compensation benefits to workers even if the employer did nothing wrong to cause the workers' injury.
My Workers' Compensation Checks are Contantly Late. What Can I Do?
Nothing can be more frustrating to an injured worker who is off work recuperating from an on-the-job injury than to go to the mailbox on payday only to find that his temporary cash, workers' compensation check (technically called TTD) did not come. If this happens to you, there are several things you need to know about temporary cash benefits. First, if you are entitled to temporary cash payments, they are due on the same day that you would have received your regular paycheck or close thereto. Second, the check should be equal to 2/3 of your average weekly income for the last year of employment. Third, if your check is over 30 days late, without good cause, you are entitled to a late fee that is equal to 15% of the late check. Finally, insurers (the folks that cut your workers' compensation check) are always monitoring your situation to see if you still qualify for temporary cash payments. This means that they have to review your file every week and authorize payment. If you haven't received payment, it could mean that the insurer has determined that you are no longer entitled to payment or has simply dropped the ball in authorizing payment. If the insurer has dropped the ball on occasion, then I would tell you that, "the squeaky wheel gets the oil." If the insurer drops the ball frequently, then you need to call a lawyer.
My Company Doctor Is Not Helping Me. What Can I Do?
If you are injured on the job, you are entitled to go to a doctor chosen by your employer. Your employer must pay the related medical bills of this doctor. If you are receiving treatment now, you probably call this doctor the "company doctor." Very frequently, clients tell me that the company doctor is not helpful, does not appear concerned, does not listen to them, is not ordering the proper testing, is not documenting their complaints, is a flunky for the insurance company, etc. If you are dissatisfied with your doctor, the law gives you a one-shot opportunity to choose another one. You have to request a "panel of four" from your employer. This is a list of four doctors in your geographic area, who are specialists in the same area of medicine as the company doctor, who are chosen by your employer, from which you may choose a new doctor. If you are dissatisfied with your current doctor, call the most experienced workers' compensation lawyer you can find in your area and seek counsel. Let the lawyer evaluate your situation to determine if it is wise to request a panel. If so, these lawyers generally are familiar with most local company doctors in your area and can give you some aid in choosing a new doctor. If you have exercised your panel option and you still think you are not getting straight answers from the company doctor, you may consider going to a doctor of your own choosing. The law doesn't keep you from going to your own doctor; it only says that under normal circumstances, the company does not have to pay for this unauthorized doctor. I know you're thinking that you can just use your health insurance to go to your own doctor. Be careful in doing so. Most health insurers have exclusions in their insurance policies for on-the-job injuries. If the health insurer discovers that your visit to your own doctor arose out of an on-the-job accident, they may cause you or your doctor problems. It may be worth your while to pay cash for your personal doctor to see you and review the medical records of the company doctor to give you a third opinion. I have used the opinion of a worker's personal doctor to have the company doctor change his mind or to have the court name the personal doctor as the new company doctor.
Who Is This Lady That Shows Up At My Doctor Appointments?
This is a case management nurse. The insurer hires her to help you and to help it. ( I say "she" not to be sexist; I have just never seen a male case management nurse.) In the complex injury case, she helps you by coordinating the various medical treatments you need. She helps the claims adjuster by serving as the adjuster's "eyes, ears and hands" in the field. She goes to your doctor appointments and gives the adjuster written reports regarding the status of your treatment. She obtains opinion letters from the doctor regarding issues of concern to the adjuster. The nurse's dual role has been the cause of great debate in the workers' compensation world. Opponents of case management nurses argue that although the nurse is ethically bound to help you, she is commercially bound to help the insurer that pays her. Opponents argue that the nurse's role, for example, in obtaining written opinions from the doctor that serve the essential function of eliminating your claim or controlling the value of your claim is in conflict with her role of being an advocate of your medical treatment. The nurse will tell you that she is working for you. She is. But what she may not tell you is that she is working for the insurer, too. Since she's working for you, ensure that she gives you good service. If you're having problems obtaining your medicines, call her. If you don't have transportation to the doctor, call her. If you need a doctor's appointment, call her. She's there to help you. Most importantly, be sure to remind her that you would like to obtain a copy of each written report that she sends to the claims adjuster and all letters that she sends to your doctor. If she's working for you, she will have no problem sending you this information.
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