Who Is Entitled To Workers' Compensation Benefits?
What Is An Injury Arising Out Of And In The Course Of Your Employment?
If I Have Such An Injury, What Benefits Am I Entitled To?
What Is Temporary Total Disability Compensation?
What is Considered Reasonable And Necessary Medical Treatment?
Do I Have A Right To Select A Doctor Of My Choice?
What Is Permanent Partial Disability? Permanent Total Disability?
What Do You Mean By "Rehabilitation"?
What Periods Of Time Do I Need To Be Aware Of?
Can I Be Fired For Filing A Workers' Compensation Claim?
What Is The Multiple Injury Trust Fund? (Formerly Special Indemnity Fund)
What Attorney Fees Can I Expect To Pay And When Can I Expect To Pay Them?
Who Is Entitled To Workers' Compensation Benefits?
Most workers in Oklahoma are covered by the Workers' Compensation Act. Some agricultural workers, domestic workers, real estate brokers, and others are not covered. Generally, if you suffer an injury arising out of and in the course of your employment, you are entitled to workers' compensation. Fault is not relevant. Top
What Is An Injury Arising Out Of And In The Course Of Your Employment?
The Oklahoma Supreme Court has defined it to be many things, in addition to the obvious. Some of the more obvious include such things as:1. Injuries to your neck or back from straining or lifting heavy objects
2. Broken bones
3. Cuts or lacerations
Some of the less obvious include such things as:
1. Cumulative trauma and repetitive motion. Some examples would be:
a) Data Entry Clerks
b) Typists
c) Assembly Line Workers
d) Long Haul Truck Drivers' backs from riding many miles
2. Hearing Loss from being exposed to loud noise
3. Certain stress and/or strain causing a heart attack or stroke (in some instances, the heart attack or stroke itself does not even have to actually take place at work). Top
If I Have Such An Injury, What Benefits Am I Entitled To?
There are four general categories of benefits
1. Temporary Total Disability Compensation
2. Reasonable and Necessary Medical Treatment (NOTE: Be careful when "selecting" or "changing" doctors. If you do not do it properly, you could be responsible for some or all of the doctor's charges);
3. Permanent Partial Disability Compensation -or- Permanent Total Disability Compensation. (Disfigurement is included in this category); and
4. Vocational &/or Physical Rehabilitation
A brief explanation of each of these categories of benefits follows: Top
What Is Temporary Total Disability Compensation?
You are entitled to receive 70% of your "average weekly wage", not to exceed 75% of the State's average weekly wage as determined by the Oklahoma Employment Security Commission.
Your "average weekly wage" can have different meanings. For the majority of workers, it is defined to be your average daily wage multiplied by 260, divided by 52. (This figure applies to your gross wages, before deductions, and includes overtime and some other benefits).
Monies you receive for Temporary Total Disability should be paid to you based on your "average weekly wage" if you are work pursuant to a doctor's orders for more than three calendar days (for injuries occurring after November 1, 2005). You are not entitled to be compensated for the first three days missed.Rule 14 of the Worker's Compensation Court provides, in part:
Upon receipt of notice that an employee has been injured, the employer has an obligation under the Workers' Compensation Act to provide that employee with reasonable and necessary medical treatment, and to commence temporary compensation in the event that the employee is disabled and unable to return to work for more than three (3) calendar days.The "disabled and unable to return to work" must be per a doctor. It is not uncommon for a doctor to give you "light duty" or "restricted duty". These can be tricky. We recommend you obtain competent legal advice if you are put into one of these categories.
The first trigger to the obligation to pay weekly compensation is filing a Form 3 with the Workers' Compensation Court. Filing a Form 3 can be important even if you are already receiving Temporary Total Disability compensation.
If you do not have a Form 3 on file with the Workers' Compensation Court, your weekly checks can be terminated at any time without cause and without notice to you.
However, if you do have a Form 3 on file with the Court, Rule 15 of the Workers' Compensation Court provides that your checks may not be stopped unless:
1. Claimant returns to full-time employment;
2. Claimant fails to:
a) object to termination as required by Section 14(A)(2) within
fifteen (15) days of receipt of written
termination notice from employer, or
b) object to
termination as provided by Section 17 (D)(10) within twenty (20) days
of receipt of written notice of termination
from employer;
3. Claimant is determined by a court-appointed
Independent Medical Examiner to be capable
of returning to work and the Claimant elects not to do so;
4. Claimant requests a trial to determine permanent disability; or
5. Agree in writing
6. Claimant dies;
7. Any other event that lawfully justifies termination under 85 O.S. Section 22. Top
What is Considered Reasonable And Necessary Medical Treatment?
A
Medical Fee Schedule, which is part of the Workers' Compensation Act,
determines what is a reasonable charge for each medical service. You
are entitled to have all reasonable and necessary medical bills paid.
Your physician normally decides what treatment is necessary If there is a dispute, the Worker's Compensation Court will decide. Top
Do I Have A Right To Select A Doctor Of My Choice?
The
answer used to be a simple yes. The answer is no longer simple. Your
Oklahoma Legislature, effective July 1, 2005, in general, gave your
employer the right to select your treating physician.
There
are ways (like failure to provide you with medical treatment) they can
lose that right. Additionally, you have the right to change physicians
upon written request to the Workers' Compensation Court on a Form A.
There is a different set of rules which apply to you if your are enrolled in a Certified Workplace Medical Plan.
We encourage you to seek competent counsel from someone up-to-date on this issue. Top
What Is Permanent Partial Disability? Permanent Total Disability?
PERMANENT PARTIAL DISABILITY basically refers to physical problems you have from your injury after the doctors say you have achieved maximum medical improvement. You can receive money for this, and continue to work. This may be true even if the doctor who has been treating you states, in his opinion, you have little or no disability.
Do not assume the disability your treating physician says you have is in fact the amount you actually have. You have the right to have a doctor of your choice address the issue of how much disability you have. (Doctors' opinions differ and the ultimate judge of whether you have any disability, and if so, how much, is the Workers' Compensation Court).
Further, if you choose to let the Worker's Compensation Court determine your disability, your case stays open. This is obviously a very important right: particularly if your condition should later change for the worse and you need additional medical treatment.
If you are offered a sum of money to settle a claim, be certain you understand whether it is being offered on a basis that will close your claim, or on a basis that will leave it open.
PERMANENT TOTAL DISABILITY generally means the inability to earn any wages in any employment. Top
What Do You Mean By "Rehabilitation"
Section 16 of the Workers' Compensation Act provides in part:
An employee who has suffered an accidental injury or occupational disease covered by the Workers' Compensation Act shall be entitled to prompt and reasonable physical rehabilitation services. When, as a result of the injury, the employee is unable to perform the same occupational duties he was performing prior to the injury, the employee shall be entitled to such vocational rehabilitation services....as to restore the employee to gainful employment...
Vocational rehabilitation normally takes one of two general courses:
1. Assistance in job placement; or,
2. Actual schooling or retraining so you can learn a new trade or profession. Top
What Periods Of Time Do I Need To Be Aware Of?
For single event injuries, unless you give your employer notice of the injury within thirty (30) days of the date the injury occurs or receive medical attention from a licensed physician during the thirty (30) day period, there is a rebuttable presumption the injury was not work-related. The rebuttable presumption may be overcome by a preponderance of the evidence.
Occupational disease and cumulative trauma injuries are subject to different rules and times too complex to include here. It should be noted, however, there is a rebuttable presumption that injury from occupational disease and cumulative trauma does not arise out of and in the course of employment unless notice is given within ninety (90) days of the employee's separation from employment. This presumption likewise, may be overcome with the appropriate evidence.
It is important to know that there is a difference between how long you have to give your employer notice of an injury and how long you have to file your claim with the Workers' Compensation Court.
The statute of limitations for filing your original claim is two (2) years from the date of injury, or, tow (2) years from the last medical treatment which was authorized by the employer or insurance carrier, or, two (2) years from payment of any compensation or renumeration paid in lieu of compensation; whichever is later.
Once your claim is timely filed, you have three (3) years to prosecute it. Top
Can I Be Fired For Filing A Workers' Compensation Claim?
Oklahoma law prohibits firing an employee for filing a workers' compensation claim, or for retaining a lawyer to represent him in a claim. It also prohibits discharge of an employee during a period of temporary total disability solely on the basis of absence from work. The law does not protect you from being fired for many "other reasons".
If you have an employer who would fire you for the "other reasons", there is a possibility he will fire you whether you file your claim or not. If you do not timely file your claim, and still get fired, you will still have lost your job and your workers' compensation.
A relatively new (July 1992) Federal law will provide additional protection from losing your job, as well as prohibiting potential future employers from using certain information for not hiring you. Wrongful termination claims are not part of your workers' compensation claim and must be filed in a different court. Top
What Is The Multiple Injury Trust Fund?
Generally speaking, the Multiple Injury Trust Fund provides additional monetary benefits to certain people who meet the definition of having been a "previously injured person" at the time of their last injury. Certain types of "previous impairment" are included in that definition and certain types are not. The date of your last injury determines how much disability you must have as a result of the combination of your "previously impairment" and your last injury in order to be able to receive additional monies from the Multiple Injury Trust Fund.
If the last injury occurred on or after June 1, 2000, your "combined disability" must constitute permanent total disability in order to receive an award. Top
What Attorney Fees Can I Expect To Pay And When Can I Expect To Pay Them?
Our attorney fee agreement provides for us to receive ten percent (10%) of any contested temporary total disability benefits. If you are already receiving temporary total disability, there is no fee on that amount as long as it remains uncontested.
Our attorney fee agreement further provides that we receive twenty percent (20%) of any other sums we may recover for you. The attorney fee is based on gross (before expenses) recovery.
If we do not recover any money for you, you do not owe us an attorney fee. None of the fee is payable until we have received the money from a settlement or court order.