George Allen Moore Moore. Johnston, Moore & Thompson & Thompson. Huntsville, AL AL (256)

Transcription

1 Medical Vocational and Disability and Disability Benefits Benefits What Rights To Medical, To Medical, Vocational, Vocational, And Disability And Benefits Disability Benefits Does an an Injured Injured Employee Employee Have under Have the Alabama under Workers the Alabama Workers Compensation Act Act George Allen Moore Moore Johnston, Moore & Thompson & Thompson 400 Meridian Street Street Suite Suite Huntsville, AL AL (256) A: Medical Benefits: Benefits: The employer is liable is liable to the to Employee the Employee for reasonable for reasonable and and necessary medical medical treatment treatment resulting resulting from a job-related from a injury. job-related This injury. This liability for for medical medical treatment treatment is limited is only limited by the only requirement by the that requirement it that it be necessary and and reasonable. The employer The employer is also liable is also for the liable cost for the cost of medical supplies, such such as crutches, as crutches, hearing aides hearing or prescriptions, aides or prescriptions, and other expenses incident incident to reasonable to reasonable and necessary and medical necessary medical care. This includes mileage mileage to and to from and medical from and medical rehabilitation and rehabilitation providers at at the the rate rate paid by paid the by State the for State official for travel. official travel. If the Employee needs needs medical medical treatment treatment because of because a work-related of a work-related injury, the the Employee must must go to the go physician to the physician or hospital chosen or hospital by chosen by the employer. If at If some at some point this point physician this physician is unsatisfactory unsatisfactory to the to the Employee, the the Employee has the has right the to select right another to select doctor another from adoctor from a panel of of four four physicians provided provided by the employer. by the employer. B: Vocational Rehabilitation Rehabilitation Services: Services: In some circumstances, the employer the employer is also liable is also for vocational liable for vocational rehabilitation of the of injured the injured Employee, Employee, including the including costs and the costs and expenses of of such such rehabilitation. If an employer If an employer offers vocational offers vocational rehabilitation and and the Employee the Employee refuses, refuses, the Employee the risks Employee losing risks losing

2 future disability benefits. benefits. C: Disability Benefits: Benefits: Besides medical benefits, benefits, the employer the employer is liable for is disability liable for benefits disability benefits to compensate an Employee an Employee for wages for lost wages due to lost a job-related due to a injury. job-related injury. Unless the the injured Employee Employee is permanently is permanently and totally and disabled, totally the disabled, the period he he can can receive receive benefits benefits is limited is by limited the Act, by and the the Act, amount and ofthe amount of benefits is is limited limited for all for injured all injured Employees. Employees. An injured worker An injured is alsoworker is also entitled to to vocational disability disability benefits benefits if the worker if the suffers worker a loss suffers a loss earning capacity from from a job-related a job-related injury. injury. D: Types of Disability of Disability and Amount and of Amount Benefits of Benefits 1. Temporary Total Total disability disability occurs when occurs an injury when causes an total injury causes total disability - that that is, the is, Employee the Employee cannot perform cannot gainful perform employment gainful - employment for a limited period. period. The amount of compensation of available available is two-thirds is two-thirds of the injuredof the injured Employee s average weekly weekly earnings earnings at the time at of the the time injury, of subject the injury, subject to maximum and and minimum minimum amounts amounts set by the set Act. by They the are Act. payable They are payable until the the Employee recovers recovers completely completely or reaches or maximum reaches medical maximum medical improvement, which which is the is full the extent full that extent the Employee that the can Employee recover can recover given the the injury. injury. Example: John John works works in a warehouse in a warehouse and makes and $ makes per $ week. per week. He hurts his his back back on the on job, the and job, his and doctor his says doctor he cannot says work he cannot at all work at all while he he recovers. John John is entitled is entitled to $ to per $ week in per temporary week in temporary total benefits until until the doctor the doctor releases releases him to go him back to work: go back twothirds of of his his salary salary at the at time the he time got hurt. he got hurt. 2. Temporary Partial Partial disability disability occurs when occurs an injury when causes an ainjury causes a partial disability (i.e. (i.e. a partial a partial loss of ability loss to of earn ability wages) to earn for a wages) for a limited period. To determine the the benefits benefits owes to owes the Employee, to the Employee, the amount the by which amount by which the Employee s earning earning capacity capacity is reduced is reduced must be established must be first. established first. This is is accomplished simply simply by comparing by comparing the amount the earned amount beforearned before injury with with the the amount amount earned earned after injury. after The injury. amount of The amount of compensation available available is two-thirds is two-thirds of the difference of the between difference what between to work: two- what

3 the Employee earned earned before before the injury, the for injury, up to 300 for weeks, up to subject 300 weeks, to subject to maximum and and minimum minimum amounts amounts set by the set Act. by the Act. Example: Jane Jane works works in the in same the warehouse same warehouse as John and as makes John and makes $ per per week. week. She also She hurts also her hurts back her on the back job. on While the she job. While she recovers, however, she can she do can some do of some her duties. of her Her duties. employer Her employer agrees that that until until Jane Jane completely completely recovers, recovers, she only has she to only answer has theto answer the warehouse phone, and and pays pays her $ her $ per week. per Jane week. is also Jane is also entitled to to $ $ per week per in week temporary in temporary partial benefits partial until benefits her until her back improves: two-thirds two-thirds of the difference of the difference between the between $ she the $ she was making at the at the time time she got she hurt got and hurt the $ and the she $ will earn she will earn until she she recovers. 3. Permanent Partial Partial disability disability occurs when occurs an injury when causes an aninjury causes an irreparable injury injury to part to of part an Employee s of an Employee s body. body. To determine the the amount amount of benefits of benefits payable, the payable, degree the to which degree the to which the injury decreases the Employee s the Employee s ability to ability earn wages to earn must wages be must be established first. first. This This degree degree of disability of disability expressed is expressed as a as a percentage of disability. of disability. The amount The amount of compensation of compensation available is available is that percentage of two-thirds of two-thirds of the Employee s of the Employee s average earnings average earnings before injury for up for to up 300 to weeks, 300 weeks, subject to subject maximum to and maximum minimum and minimum amounts set set by the by Act. the Act. The percentage of permanent of permanent disability disability based on is limitations based on caused limitations caused by the Employee s injury. injury. Employees Employees who return who to work return making to work the making the same wage as as when when they they were injured were injured can only recover can only permanent recover permanent disability benefits based based on their on degree their of degree medical of impairment. medical impairment. Employees who who cannot cannot return return to work to making work the making same wages the same are wages are entitled to to permanent disability disability benefits benefits based on their based loss on of ability their loss of ability to earn income, or vocational or vocational disability. disability. If within 300 If weeks within from 300 theweeks from the date of of injury a returning a returning Employee Employee is unable to to continue performing performing the job, the or job, she may he or then she pursue may then pursue benefits based on vocational on vocational disability. disability. Examples: Once Once Jane Jane recovers recovers from her from back her injury, back she injury, returns to she herreturns to her job in in the the warehouse and to and her to $ her $ per week salary. per week She still salary. has She still has some continued pain pain and a and slight a loss slight of motion loss of at motion her waist, at however, her waist, however, Jane s doctor places places some some restrictions restrictions the amount on the of amount lifting, of lifting,

4 bending and and stooping, she can she do. can She do. has She a 10% has permanent a 10% physical permanent physical impairment. Jane Jane is entitled is entitled to draw to $40.00 draw a $40.00 week in permanent a week in permanent partial disability benefits: benefits: 10% of 10% two-thirds of two-thirds of her wage of ($400.00) her wage at ($400.00) at the time she she got got hurt. hurt. After six six months and and two surgeries, two surgeries, John recovers John to recovers the extentto the extent possible, but but has has lost lost motion motion in his back in his and back has two and fused has disks two in fused his disks in his back. The The doctor doctor releases releases John from John his from care, his but care, restricts but John restricts from John from any bending or stooping or stooping at all, at sitting all, or sitting standing or for standing more than for 30more than 30 minutes at at a time, a time, and from and all from lifting all more lifting than more five pounds. than John five pounds. John cannot ever ever return return to work to in work the warehouse, in the warehouse, but he does but find another does find another job that pays pays him him less than less $ than $ per week. per Based week. on the Based doctor s on the doctor s testimony about about John s John s restrictions, restrictions, and vocational and vocational testimony about testimony about John s ability to find to find and hold and a hold job, John a job, has John a 50% has permanent a 50% permanent disability. John John is entitled is entitled to $ to $ a week in a permanent week in partial permanent partial disability benefits: 50% 50% of two-thirds of two-thirds of his wage of ($400.00) his wage at the ($400.00) at the time he he got got hurt. hurt. 4. Permanent Total Total disability disability occurs when occurs a worker when can no a worker longer can no longer perform his his former former job and job is and unable is to unable perform to reasonably perform gainful reasonably gainful employment. Reasonably gainful gainful employment employment is work that is is work suited that to is suited to the worker s skills, skills, education education and age, and and age, is comparable and is comparable to the to the worker s previous work work in the in areas the of areas compensation of compensation and job duties. and job duties. Permanent Total Total disability disability does not does require not that require the Employee that the beemployee be completely helpless. The amount of compensation of available available is two-thirds is two-thirds of the average of the average weekly earnings received received before before injury, subject injury, to subject maximum to and maximum and minimum amounts set by set the by Act. the The Act. benefits The are benefits payable are for life, payable or for life, or until the the disability ends. ends. Examples: Rita, Rita, who who also works also works in the warehouse in the warehouse and makes $ and makes $ per week, is run is run over over by a forklift by a and forklift seriously and injured. seriously After injured. a year ofafter a year of surgery and and treatment she recovers she recovers somewhat, somewhat, but has stringent but has stringent permanent restricts on her on physical her physical abilities. In abilities. addition to In restrictions addition to restrictions on bending, lifting lifting and the and like, the she like, can she no longer can no drive, longer has blurry drive, has blurry vision, and and can can only only walk walk with a with cane. a Her cane. injuries Her have injuries caused have her tocaused her to be depressed, as well. as well. In her In doctor s her doctor s opinion, Rita opinion, cannot Rita return cannot to return to

5 any gainful employment. Rita is Rita entitled is to entitled $ to a week $ (two-thirds a week (two-thirds of her wage at the at the time time of her of accident) her accident) in permanent in permanent total disabilitytotal disability benefits for for the the rest rest of her of life her or until life she or until recovers she enough recovers to be enough able to be able to work again. again.