Frequently Asked Questions | Workers Compensation

Personal Injury FAQ’S About Your Workers Compensation Case

(Please take a few minutes to read)

NOTE: If you need legal consultation, due to our busy schedule please make an appointment to personally meet Mr. Gagné or one of his associate attorneys, otherwise a legal assistant will be happy to help you over the telephone with routine matters.

The very last thing I want to have happened is a lack of communication between you and my office.  This applies to any issue.  If you feel we are not adequately communicating with you please schedule an appointment to see me.  My door will always be open.  But do it sooner rather than later so we can address the problem before it becomes a larger one.  Make an appointment to see me.  Thank you.

1. What is worker’s compensation and what are my rights when I get hurt at work?Worker’s Compensation is a law enacted decades ago that basically states that if you are injured at work in an accident, the employer and his insurance carriers are responsible for paying your damages. You have a right to receive payment for your medical bills, partial or permanent disability and temporary compensation while you are unable to work as well as permanent disability compensation once you have been released by your doctor. As your attorney, we are now a team: you must communicate with me regarding the status of all your benefits and medical progress. Please call us on these issues so we can timely manage your case.

2. What must I do to collect temporary compensation?

Go to either the company doctor or your assigned doctor and tell him if you are unable to fulfill your work duties. He will probably write you an excuse. Make sure you keep these excuses as they are necessary to collect any unpaid temporary compensation. Also, it is imperative that you keep your doctor’s appointments.

3.   What must I do when I am first injured?

After you are injured, you must tell your immediate supervisor that you have been hurt. He, in turn, must notify the worker’s compensation coordinator for your employer. The employer should schedule you to see a company doctor for a variety of reasons: diagnosis, referral, excuse from work, etc.; however, many employers are reluctant to do this. That’s where a lawyer comes in. As your attorney, I will demand that you see an authorized physician. In most cases, the employer will comply once it knows that you have retained an attorney.

4.  Do I have to see the company, doctor?

Yes. The law requires you to see the “authorized physician”.  It is my experience, however, that these physicians are biased toward the employer and often do not provide the optimum of care. You do, however, have the right to get a second opinion. As your attorney, I will refer you to a physician willing to take your case and provide that opinion.

5.  If I am unable to work, how will I get paid?

The law states that you are entitled to temporary compensation while you are out of work equal to two-thirds of your average weekly wage.  This will continue until you are able to return to work. If you are not receiving temporary compensation, you must tell me immediately. You will only get temporary compensation if a doctor, usually only the company doctor who is “authorized”, gives you a work release. Be sure to keep a copy of these work releases after you have given them to your employer and give them to me. I will forward them to the company’s adjuster to prove that you are unable to work and therefore get your temporary compensation started.

 IF YOU ARE NOT RECEIVING YOUR TEMPORARY COMPENSATION, YOU MUST CONTACT US IMMEDIATELY SO WE CAN BEGIN WORKING ON IT.

6. Can I get fired for filing a claim?

Absolutely not. The law strictly forbids an employer firing or otherwise retaliating against an injured worker because he has filed a workers’ compensation claim. If a claimant is fired, we may file a lawsuit called a “retaliatory discharge claim”.

7. How long will I have to see the doctor?

You must see your doctor as she requires. You cannot miss an appointment without a good excuse you risk losing your benefits. After a period of time, the body will heal to the point of “maximum medical improvement” — MMI.  This either means that you have totally recovered or that you have recovered to the point that you cannot get any better. Once you reach MMI, we will draft an offer based on your disability rating. See question #7.

8.  What happens if I reach a point where I am not completely cured but I cannot get any better?

Unfortunately, this is a common occurrence. In that case, you are “disabled”.  In most instances, you will be disabled to a certain degree. For instance, in most cases, if you have hurt your back, you will not be disabled 100%, but perhaps 40%, 30%, 20% even 5%. It is your degree of disability that will determine the amount of your final compensation award. Your degree of disability is often disputed between your attorney and the opposing attorney that will sometimes require a hearing to resolve. Many cases settle just before the hearing.

9. Will you represent me at the hearing?

Yes. I will represent you at the hearing and through the appeals process if necessary.  If we go to a hearing and win, it may take up to 180 days to receive your check.  Also, you have 14 days (from the date the order is signed) to appeal the order if you are not satisfied with it.

10. What if I am injured while working through someone else’s negligence who is not a co- employee?

In that case, you will be able to recover from both the person who was negligent and your employer. However, to avoid “double dipping”, if you recover from the negligent person, the employer’s insurance may have what is called “subrogation rights”, which means that the employer’s insurer has the right to reclaim money paid to you out of your settlement.

11. If and when I do settle my case with the employer, may I make a claim again if I am reinjured?

That depends on whether you “agree to settle”, “clinch” the settlement, or go to a hearing and receive an award.  If you settle on a Clincher, you are forever barred from claiming for the same injury.  Also, you may not claim a worsening of the condition within one year of the date after award, and your future medical case is terminated.  On the other hand, if you sign an Agreement to Settle, or receive an “award”, you have a right to continued medical care as well as a right to claim a worsening of the condition.

12.  If I am fired from my job, may I collect unemployment?

You may always apply for unemployment, and I encourage you to do so regardless of the circumstances of your termination. If you are unable to seek employment because you are injured, you will most likely be rejected for unemployment benefits.

13. Who should I talk to about my case?

Talk only to me, your attorney, or a member of my staff. I cannot stress this enough. Do not talk about your case to co-workers, supervisors and especially to any adjusters. If the worker’s comp. coordinator at your office has a question, please direct him/her to me in a polite yet firm manner.

14.  How long will this process take?

It is the policy of this office to file a request for a hearing immediately upon signing a client. It takes between 6 and 8 months to get a hearing before a commissioner. As noted most cases settle before a hearing.

15. Should I borrow money elsewhere before my insurance check arrives?

No, this is a bad idea.  You are never 100% certain that a case will settle for an exact amount.  Better to sit tight and wait for the process to run its course before spending money before you have it.  Remember; don’t count your chickens before they hatch.

We understand that you have been drained financially by your accident but let me know your creditors, and I will let them know you are expecting an insurance check.  You might want to turn to a family member to help you over the hump.

16. How often will you or your office contact me?

Now, you may not hear from us for a while.  Don’t let this bother you.  Just keep going to the doctor and call us if there are any problems with your benefits or medical care.  We cannot settle your case until you have reached MMI.  Notify us immediately upon your reaching MMI (released from your MD) of if there is a problem with your benefits.  If you are unsatisfied in any way with the attorney or staff handling your case, simply call my office and schedule an appointment to see me, Thomas Gagné.  I am always available to you for an appointment.

17. How long do I have to file a claim?

In general, you have 2 years from the date of injury to file a claim in SC.

18. Should I listen to advise from outside sources?

Absolutely not!  Do not let anyone else manage your case except Mr. Gagné and his staff.  Outside sources do not have the training or expertise to adequately evaluate or advise you on your case.

***Important Notes:

If you need legal consultation, due to our busy schedule please make an appointment to personally meet Mr. Gagné or one of his associate attorneys, otherwise, a legal assistant will be happy to help you over the telephone with routine matters.

If you move or change your phone number, it is crucial that you tell me.  Many issues are time sensitive, and I may need to get in touch with you at a moment’s notice.  It is also very helpful if you have an answering machine and/or email.

Lastly, the very last thing I want to have happen is a lack of communication between you and my office.  This applies to any issue.  If you feel we are not adequately communicating with you please schedule an appointment to see me.  My door will always be open.  But do it sooner rather than later so we can address the problem before it becomes a larger one.  Make an appointment to see me. Thank you.