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What is workers’ compensation?

In short, workers compensation provides (1) some wage loss replacement, (2) full medical benefits that are reasonable and necessary for a work injury, (3) some vocational rehabilitation, (4) some impairment compensation and (5) full attorney fees.

1. Medical benefits include surgery, therapy, medicine, physical therapy, transportation, prosthetic devices and rehabilitation services. Medical providers include doctors of medicine, surgeons, osteopaths, chiropractors, dentists, optometrists, psychologists, licensed physicians assistant and advanced nurse practitioner. An injured worker cannot be required to pay for medical treatment for a work related injury. A special plan must be filed by the provider with the Board if continuing and multiple treatments are to be provided.

2. While you are not medically stable and not released for work, the insurance company is required to pay you temporary total disability (TTD). Depending on your past earnings and the number of dependents, this amounts to about 80% of your lost wages. TTD is tax-free. It seldom happens, but if an injured worker cannot return to any gainful employment permanent total disability (PTD) is paid. When death results, benefits are paid to the dependent widow or widower and children.

3. Vocational rehabilitation benefits are available when return to the customary employment is not possible. But legal limits imposed by the legislature often prevent the actual benefits from being very valuable. However, signing the job dislocation benefit form is seldom a good idea.

4. If your injury results in a permanent impairment, you will receive $1,770 for each 1% of impairment rating.

5. If you have to hire an attorney, the insurance company has to pay all fees if the attorney is successful.

6. There is no compensation for pain and suffering.


How Does It Work?

It is supposed to work this way. If a work injury results in time off work or the need for medical treatment, the worker gives the employer a written notice of injury. The employer notifies the work comp carrier. The carrier assigns the case to an adjuster. The adjuster and the worker get together. The adjuster is furnished the treating doctor’s report and earnings documentation. Usually the adjuster then must do one of two things, (1) pay compensation and medicals with 14 days or (2) give the worker a written controversion notice stating what specific benefits the adjuster is not paying and the reasons why. The worker can attempt to work things out with the adjuster.


I have been hurt on the job. What do I do?

You should notify your employer as soon as possible. The notice may be given to the foreman, supervisor, personnel office, or anyone in authority at the employer's place of business. Complete the Report of Injury or Illness form immediately.


My boss won’t fill out the injury paperwork or give me the form, what can I do?

Go to the Alaska Workers’ Compensation Board and ask for the Report of Injury form. Complete it there and give it to a workers’ compensation technician. You might also call the Alaska Workers' Compensation Board in Anchorage at 907-269-4980, Fairbanks at 907-451-2889 or Juneau at 907-465-2790.

It is the duty of the Board to advise every injured worker of all the factors bearing on his or her right to compensation and how to pursue that right under the law.


What if my employer doesn’t have workers’ compensation insurance?

If your employer does not have workers’ compensation insurance, notify the Division’s Special Investigations Unit at 1-888-372-8330. There is a Workers’ Compensation Benefits Guaranty Fund established to pay benefits to injured workers whose employers were uninsured at the time of injury.


How long must I be out of work before I am eligible to receive benefits?

The first installment of compensation becomes due on the 14th day after an employer had knowledge of the injury or death. On this date all compensation then due should be paid. Subsequent compensation should be paid in installments, every 14 days after that. No compensation is payable for the first 3 days of disability. However, if the disability lasts more than 28 days, compensation is paid for it all, including the first 3 days.


How is my compensation rate determined?

Currently the compensation rate for most injuries is based on the highest year earnings for the two calendar years prior to the year you were injured. Your first compensation report should show how your compensation was calculated. If you think your compensation rate is incorrect ask your adjuster to explain to you how your rate was determined. For current injuries, there are several different possibilities which might apply. The rules are different for injuries before July 1, 2005. Several recent Supreme Court and workers compensation Board decisions apply different rules for determining the permanent total disability compensation rate in comparison to the temporary total disability compensation rate.


Medical treatment?

Under the Alaska Workers Compensation Act you can choose your own treating doctor. Interference by the employer or carrier with your selection of a doctor to treat you is a misdemeanor. You can only make one change of doctor without the employer’s consent. Getting another doctor after your doctor refuses to treat you is not a change that requires the employer’s consent.

The employer/carrier is entitled to have you seen by its doctor at reasonable times while you are disabled. You must attend, and your refusal can result in a termination of your benefits. The insurer must give you 10 days notice. With good reason, the insurer will often reschedule for you, but don’t wait until the last minute to ask.


What do I do if I cannot return to the same job I had when I was injured?

You or the insurer may ask the re-employment benefits administrator for an evaluation for re-employment benefits. The Alaska Workers’ Compensation Board has a whole section of their site (http://www.labor.state.ak.us/wc/home.htm) devoted to vocational rehabilitation benefits. AS 23.30.041 specifically addresses retraining.


What is a Controversion Notice?

A controversion is a denial of either a specific portion of your claim or it can be a denial of the entire claim. It lets the injured worker know what the adjuster is doing and why.


Why was my claim controverted (denied)?

The controversion notice will specifically state what is being denied and the basis for the denial. There are a variety of reasons. It could be that the insurer has obtained contrary medical evidence. Whatever the reason, a controversion by the adjuster doesn’t mean the claim is over. You can file a claim with the Alaska Workers Compensation Board. It is the Board’s duty to impartially resolve disputes between the injured worker and the adjuster.


What is a deposition?

Depositions are formal, legal proceedings under oath in front of a court reporter. Everything you say is transcribed and will become part of your workers’ compensation case. Keep your answers short. Do not get angry.

A deposition is your testimony concerning the injury the adjuster from the insurance company may be present as well as a certified court reporter.

Be honest.


What happens if I am not honest?

DO NOT GO THERE! If you are dishonest at a deposition or any time else I will not represent you and I do not know of a claimant’s attorney in Alaska who will.

A deposition is your testimony concerning the injury the adjuster from the insurance company may be present as well as a certified court reporter.

The Alaska Act provides for civil and criminal penalties for anyone – claimants, employers or insurance companies – who engages in fraudulent or misleading acts involving workers compensation.

By the way, employers engage in a lot more illegal acts - such as failing to obtain compensation insurance or trying to treat employees as independent contractors – than employees ever do.


Do I need an attorney?

Many workers' compensation claims go smoothly, and if your claim is on track you hopefully can continue to handle it on your own. Often there are disputes about the cause of your injury, the validity of your claim or your entitlement to benefits. Our clients come to us when they have been denied benefits, either by a claim denial (controversion) and/or the termination of time loss or medical benefits.


How much is my case worth?

Every case is different and there is no way to determine the settlement value without a complete review of the file. Settlement is not an absolute. You can’t be forced to settle your claim just as the insurer can’t be forced to settle.


While I was out of work, as a result of a work-related injury, my employer terminated me. Is such termination permissible?

No. However, your employer may end your employment if it needs to fill your position. Your employer is not obligated to hold your position open.


Can I sue my employer for my injury?

Not for your work injury unless your employer intentionally injured you. However, you may have a suit for wrongful termination, discrimination of something like that. But you would need to see someone besides the Crofts Law Office for that type of case.


I just received a check that is for my permanent partial impairment (PPI). Can I cash it?

Cashing the check does not waive your right to any additional benefits under the Act.


I don’t agree with their doctors rating. Can I get my own?

Yes, you do have the right to have your doctor rate your impairment. Additionally if there is a dispute between your doctor and the doctor hired by the comp carrier you can ask the Board to order an independent medical evaluation (called an SIME) by a doctor selected from a panel of specialists. Usually the doctor selected by the Board issues a thorough and impartial report.


Who decides my entitlement to receive workers’ compensation benefits?

Your employer’s workers’ compensation insurance carrier or your employer, if they are self-insured, will investigate your claim and make a determination as to your eligibility to receive workers’ compensation benefits. If you disagree with their determination, you have a right to file a claim with the Division of Workers’ Compensation.


The workers’ compensation doctor has released me for light duty work, but my employer advises that there is no such work available. What can I do?

In this situation, if you haven't returned to work and continue to receive medical care for your injuries, you should continue to receive temporary disability benefits for the period of time up to and including the date the authorized health care provider indicates as the date of maximum medical improvement.


Are workers’ compensation benefits taxable?

Time loss and impairment benefits are not taxable.


What if I recover money from a third party as a result of my injury?

Make sure that your attorney in the suit gets your employers permission to settle or you may/will lost your right to workers compensation benefits.


I have a disability that is preventing me from working. Are there any services offered through the Department of Labor and Workforce Development, such as retraining services that can help me in this situation?

If the employee is totally unable to return to the employee’s employment at the time of injury for 90 consecutive days as a result of the injury the workers compensation reemployment benefits administrator shall order an eligibility evaluation for reemployment benefits. Also look at the links section where we have listed a few job resources.


Does the Workers’ Compensation Law give special consideration to the compensation rate of apprentice workers?

Yes, if the earnings of the apprentice would increase under normal conditions.


How much are the benefits for loss of wages?

It depends on the history of past earnings and the number of dependents but generally about 80% of the worker’s after tax net earnings.


Are cost of living increases provided for under workers’ compensation?

Not currently. But in one recent case we obtained an increase in permanent total disability (PTD) compensation to reflect the workers likely increased earnings if he had not been injured.


What are the time limits for filing a claim with the Division?

You should bear in mind that any claim with rare exceptions must be filed within two years of your injury or last payment of benefits. This is just a general guideline and may not specifically apply to you. The Alaska Workers' Compensation Board can advise you regarding your rights pursuant to the Alaska Workers' Compensation Act.


I am receiving social security. Is there a reduction in my workers’ compensation benefits because of this?

There may be, depending on whether you are receiving retirement or disability payments and how your compensation rate was determined. Each case requires a special calculation.


I think I am being followed. Can the insurance company do that?

Yes they can. When you file a claim you lose your rights to privacy. The insurance industry is increasingly using video surveillance to attempt to discredit injured workers. You should therefore assume you either have or will be subject to video surveillance.

It is also possible that your Facebook or MySpace page or that of your spouse, significant other or children will be reviewed.


DISCLAIMER

THE INFORMATION ON THIS WEBSITE IS GENERAL INFORMATION AND DOES NOT APPLY TO EVERY SINGLE INJURED WORKER. THIS IS NOT INTENDED TO ANSWER EVERY QUESTION, BUT HOPEFULLY WILL HELP YOU. THERE IS SPECIFIC STATUTE OF LIMITATIONS AND YOU SHOULD CONTACT THE BOARD AT 907-269-4980 FOR MORE SPECIFIC INFORMATION REGARDING THE DETAILS OF YOUR CLAIM.

THIS IS NOT LEGAL ADVICE AND SHOULD NOT BE USED TO MAKE ANY DECISIONS ABOUT YOUR CASE OR ANY ACTUAL CASE

Please be aware that at this time the Crofts Law Office does not represent you and will take no action on your behalf. THE CROFTS LAW OFFICE DOES NOT REPRESENT YOU UNTIL WE HAVE FILED AN ENTRY OF APPEARANCE.