what to do when workers comp insurance co wont pay your bi weekly wages

I go calls from people wondering about the benefits and downfalls of settling their workers' compensation claim versus keeping their lifetime medical benefits . And then, I wanted to share this data and, hopefully, aid some of you out in that location past making you aware of the differences between keeping your lifetime medical benefits or settling your workers' bounty claim .

Either way, at that place are good and bad things near both options when you've had to file a claim over a chore injury. It really depends on the risks and benefits unique in each state of affairs. Be informed then yous tin can have a clear understanding of the peaks and pitfalls of each option. Existence informed is the best way for you to make a determination nigh what is right for y'all. Every workers' comp claim is different, and the aforementioned option is not going to be the right 1 for anybody.

Main Takeaways:

• A lump sum settlement is a payout that comes in ane large payment.
• Lifetime medical benefits is when the insurance company pays for your medical care. You do non have to worry nigh co-pays or deductibles.
• There are pros and cons of accepting a lump sum settlement or lifetime medical benefits.
• For a lump sum settlement, you no longer have to wait for approval from the workers' bounty insurance company because they no longer involved, but you may take to resign from your job and you lot will lose your right to any future benefits if complications occur later.
• For lifetime medical benefits, the insurance company handles all of your medical bills, but you will have to show that your required treatment is reasonable, necessary, and related to your piece of work injury.

Lump-Sum Settlement of a Workers' Compensation Claim

Pros of a Lump Sum Settlement:

• No more than waiting for approval – Once you settle the claim, you are in the driver's seat; no more waiting for approving from the workers' bounty insurance company because they are no longer involved! You decide what treatment you exercise or practise not want.
• You get to come across whatsoever doctor you want – After the claim is settled, you are in accuse of your medical care. Don't similar your doc? No problem, find a new one who you lot are comfortable with. Get a 2nd opinion. Y'all are the sole decision-maker in your medical care afterwards you settle the claim.
• You go a lump sum of money- Instead of the workers' compensation insurance company paying the dr. for medical care, they pay you that money. Use it for medical care or any other thing you desire. You have total liberty of choice.
• In some cases, you can work out a structured settlement understanding that will provide you lot with a certain amount of coin paid out during regular periods of time rather than taking everything at once. This tin make it easier to manage the coin and what you lot will utilise it for.

Cons of a Lump Sum Settlement:

• Giving up Lifetime Medical benefits – When yous settle your workers' compensation claim for a lump sum, you lot surrender your lifetime medical benefits in render for a lump sum of money. From that point forward, the cost of medical care becomes your own responsibility.
• Liens on settlement – Medicare, Social Security, child back up and Medicaid can have liens on the settlement money. Medicare goes and then far every bit to say it has an interest in the workers' compensation settlement if at that place is a reasonable expectation of you receiving Medicare benefits within 30 months after settling your workers' bounty merits. This tin can brand the settlement process long and drawn out considering approval from 1 or more entities may be required. Yous well-nigh definitely need to talk to an attorney if you are in this situation and are interested in taking a settlement. The paperwork needs to be carefully worded to protect your interests.
• Resignation – Resignation of your employment is typically required as part of the settlement terms. However, if you lot dislike your job or if you are injured to the point that y'all tin can never return to your pre-injury employment, this may not exist an issue for you. This is an insurance effect, not an employment issue . The insurance visitor doesn't want to pay you a lump sum of coin for your hurt back and then yous injure your back at work the very next day and they are stuck with a new workers' compensation injury claim.
• Settlements are final – Once you settle a claim, in that location is no going back to add this or that. You need to make sure y'all go it right on the first try! All workers' compensation benefits volition end and the amount of coin you receive will be final. Future medical care, and, more importantly, hereafter medical expenses will get your responsibility.
• If you've been left with a permanent partial disability or a permanent disability,  almost law firms and medical professionals will recommend that you don't consider a lump sum payment until you lot have reached what is known as maximum medical improvement. This means that your status volition not improve whatsoever farther with more treatment. This way you accept the everyman chance that something like a surprise surgery volition come up in the future after y'all've given upwards coverage.

Lifetime Medical Benefits

Pros of Lifetime Medical Benefits:

• The insurance visitor pays for your medical care- you lot don't take co-pays and deductibles to worry most. Yous don't take to stay employed with the original employer. The insurance basically covers all of your future medical treatment and future medical costs.

Cons of Lifetime Medical Benefits:

• The burden of proof is on yous forever – Merely because the doctor says yous need a specific treatment or diagnostic test does not mean that the insurance company will corroborate it. This ways that even though you lot have the "lifetime" medical benefit, even if y'all have an Award Order stating so, you nonetheless take to show that the current treatment requested is reasonable , necessary, and related t o the workplace injury at every turn. The insurance company does not assume anything.
• Medical providers generally require the insurance company to pre-approve your treatment – Medical providers have been burned past workers' compensation insurance companies too many times. Having lifetime medical benefits does not mean that you lot tin can but get to the physician whenever you desire. The insurance carrier still has to pre-approve everything and they tin (and will) deny annihilation that they believe does non meet the standard of reasonable, necessary, and related t o the workplace injury. This process slows downwards medical treatment.
• Yous may not go lost wages when you are out of work for surgery – Lifetime medical benefits does not always mean that you are entitled to lost wages. If the doctor takes yous out of work for a medical procedure, you may be off of piece of work without pay. You may even lose your chore if you lot are out of work likewise long. This is a instance by case situation depending on your Honor Orders for lost wages. Sadly, this happens more frequently than you might retrieve. I get calls from people who have surgery five years after their injury and are not eligible for lost wages considering as well much time has lapsed since they last collected lost wages pursuant to an Award Order.
• Litigation – If the insurance carrier denies treatment, you volition likely be going to a hearing so the Virginia Workers' Compensation Commission tin can decide whether the requested treatment should or should non be covered under your claim. This is expensive, time-consuming, and delays handling for injured workers. However, it is inside the insurance carrier's right to take a treatment issue before the Committee for a ruling . It is very common to go to a hearing 3 or four or more times with disputed medical treatment and tests. Similar I said earlier, the burden of proof is on you!

Protecting Your Merits

If you've been injured in an accident at your place of employment, you may already know to file a work-related injury merits , merely complications often arise in the pocket-sized impress and details of dealing with Workers Bounty in Virginia.

1. File an accident written report with your supervisor immediately . After you've received medical attending, the very first priority in your heed should exist to notify your employer that at that place was an blow and an injury. Although you legally have up to 90 days to file the accident report, the sooner the amend, and if you miss the deadline, you have no claim to Workers' Bounty in Virginia.
2. Your employer should file a Offset Written report of Injury within vii days later the accident . If your employer fails to file this paperwork, contact a Workers' Bounty attorney.
3. Follow all of your doctor's instructions to the letter . Failure to do and so will be used confronting you by your employer and/or the workers' compensation insurance adjuster.
4. You're entitled to treatment, medication, and travel expenses to and from your medical appointments . If your employer doesn't encompass these expenses or refuses to practise and then, contact a Workers' Compensation attorney immediately.

Remember, if yous've been injured, you have rights through a work-related injury claim under the law. Contact an attorney who has handled Workers' Comp in Virginia to learn more nigh that you can do to fortify your Workers' Compensation instance.

If you are dealing with a work injury or if you would like more information on the Virginia workers' compensation system , order my book, "The Ultimate Guide to Workers' Bounty in Virginia ," or phone call our office today at (804) 755-7755 for a confidential costless consultation.

The Injured Workers Police Firm is a Richmond, Virginia based firm solely focused on serving clients with workers' compensation claims in Virginia. If you take questions well-nigh your benefits or if y'all would like more information on the Virginia workers' bounty arrangement, lodge our book, "The Ultimate Guide to Workers' Compensation in Virginia" , or call our office today (804) 755-7755.

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Source: https://www.injuredworkerslawfirm.com/blogs/settlement-versus-lifetime-medical-benefits/

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