Workers' compensation provides various benefits, including medical expenses, temporary total disability, temporary partial disability and permanent disability. Unlike the tort/negligence system which allows recovery for pain, suffering and the very real aggravation associated with injuries, the workers' compensation system provides coverage primarily for economic losses. Because of this limitation injured employees must work carefully through each of the following benefit areas to be sure they are fairly compensated:

•  Medical Expenses. Expenses associated with medical treatment that are reasonable or necessary to effect a cure, give relief, or lessen the disability must be paid by the employer or their workers' compensation insurance company. There is no deductible, no co-pay, and no requirement that you miss work to receive medical benefits. You must show a relationship between the job-related accident and the treatment. Frequently there is a tug-of-war between the insurance company and the employee to control the medical care. Employees have the right to a second opinion to any permanent disability rating and to request a hearing to resolve medical treatment issues.

•  Temporary Partial or Total Disability (TTD or TPD). If a doctor writes you out of work for more than seven days you are entitled to receive TTD. TTD is calculated based on two-thirds of your average weekly wage (AWW). If you are unable to earn the same wages as before the accident you may be entitled to the difference (TPD).

•  Permanent Partial or Total Disability. If a doctor determines that you are permanently partially disabled, you are entitled to benefits determined by a formula which factors in your average weekly wage, the part of your body that is injured and the severity of the injury. You may be entitled to receive benefits for life if you are permanently and totally disabled. In some cases, the better measure of benefits is the difference in wages earned prior to the accident and after the accident.

You have two years after you receive your last payment to request additional medical treatment or other benefits if your condition worsens. Workers are frequently offered an additional amount on top of their entitlement in exchange for their agreement not to pursue additional benefits and not to reopen the case if the condition worsens. This is called a clincher agreement. Carefully consider the effect of such an agreement before executing it.


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