If you have a work injury or illness you may be entitled to one or more of the benefits listed here. Contact Biggam Fox Skinner, LLP if your employer is not providing the benefits you think you are entitled to. Letting our workers’ compensation attorneys in Vermont fight for you is far less painful than dealing with the insurance company on your own.
Call us at 802-445-9141 to schedule your free consultation with a member of our team.
You are entitled to receive Temporary Total Disability Benefits or TTD if you are injured on the job and unable to work due to that injury. Often times the insurance company miscalculates TTD, paying you less than what you are owed, which means that you lose money every week without knowing it. We always double-check TTD figures for our clients to make sure that they are getting paid exactly what they are rightfully owed. This can make a huge difference over the life of a claim because everything you receive (besides medical benefits) is based on your compensation rate, so when we find money here it makes a big difference to our clients.
Temporary Total Disability Benefits continue until you either return to work or until your doctor finds that you have reached an “end medical result.” You are considered to be at an end medical result when you have essentially reached a stable plateau in your recovery and there is no medical treatment or physical therapy which will substantially improve your condition. End medical result does not necessarily mean that you have recovered to your pre-injury health, or that there is nothing else that you can do to feel any better. It also doesn’t mean that you are not due future medical benefits, it just means you are at a point where you are essentially as good as you are likely to get. It is the end of TTD, but not other benefits.
If you are released to work part-time, you can also receive Temporary Partial Disability Benefits or TPD. We will explain to you how these TPD benefits are calculated if you are eligible to receive them. The important thing you need to know is that if you are released to work with limitations or with reduced hours, you must accept work offered to you that allow for your limitations. You must also look for work within your limitations if the insurer advises you of this obligation. Please contact our workers’ comp lawyers if this happens. This part of the process can be tricky so we are happy to discuss specific concerns about part-time or light duty.
As part of our legal representation, Biggam Fox Skinner carefully checks all figures to make certain that you are receiving the full disability benefits owed to you. Generally, your weekly disability benefits should be two-thirds of your average weekly wage (gross plus any tips or “extras”) earned over either the 12 or 26 weeks prior to your work injury. The number of weeks used for the calculation depends on your date of injury. These workers’ compensation benefits are tax-free.
The workers’ compensation insurance company should pay for all medical expenses caused by your work injury. You have the right to choose your own doctor and specialists. You can get second and even third opinions. Insurance companies won’t tell people this. There should be no co-pay to any provider ever, and free prescription drugs as directed by your doctor and required for your treatment.
You should also already be receiving payment of mileage reimbursements from the insurer for your travel to and from your medical appointments. No miles should be subtracted from this calculation. Insurers often fail to do some or all of this. Biggam Fox Skinner will fight to get these bills and mileage paid if there is any problem with any payment.
You should always be prepared to provide a medical provider’s office the address of your workers’ compensation insurer and insist that all bills go directly to that insurer. Even after your case is “closed,” you still have the right to have medical bills paid so long as the treatment is related to your work injury. This is true for your lifetime so long as you do not have a new injury to whatever part of your body that was injured. This lifetime body part medical coverage continues even if you stop working for the employer where you were hurt. This is a huge benefit that insurance companies often do not explain.
If your work injury makes it impossible for you to return to the job and even the type of work you were doing before, the insurer may be obligated to pay for vocational services so that you can return to productive work at your previous wage level or as close to it as possible. Biggam Fox Skinner’s experienced workers’ compensation lawyers will assist you to make sure that the insurance company pays for a vocational counselor. You get to choose your VR provider. If the insurer chose a bad one for you, then you can change. This matters because we know who is good in this industry. VR counselors are the key to getting back to your pre-injury wage. These VR benefits can be huge because they can restore a career or help you start a new one. They can get you back to work and earning wages, and help you to avoid a lifetime of disability. If you misstep here or do not know who to use or what your rights are, you can lose a lot over your career. This can potentially affect your financial health for the rest of your life.
After it has been determined that you have reached an “end medical result,” or “medical endpoint,” you should be evaluated to see if you have suffered any degree of permanent injury or “permanency.” If you have had surgery, you will probably have some permanent impairment or injury. Most back injuries have permanent impairment even without surgery. For instance, if you used to be able to lift sixty pounds, but are now restricted to only thirty pounds, you may be considered to have a permanent injury.
The degree of your permanent injury is determined by a doctor and expressed as a percentage figure for a particular part of the body, such as a 10 percent impairment of the upper extremity (arm). This is converted into a percentage of your “whole person.” That percentage of permanent disability will entitle you to a certain number of weeks of workers’ comp benefits. The number of weeks depends on what part of your body is involved and the rating (percentage figure) assigned. Permanency benefits are sometimes paid on a weekly basis but can also be paid in a lump sum in most situations. Getting you PPD is not the end of the case, your medical benefits stay open in most cases.
Permanency evaluations are fairly complicated and must be done in accordance with the American Medical Association Guides to the Rating of Permanent Impairment, Fifth Edition, known as the “AMA Guides.” Psychological injuries (mental claims) use the Sixth Edition of the AMA Guides to Permanent Impairment. Many doctors, and most treating doctors in Vermont, do not conduct permanency evaluations in accordance with either edition of the AMA Guides. If your doctor does not perform evaluations, you are entitled to have another doctor of your choosing perform your evaluation. Our experienced workers’ comp attorneys will work with you to find a doctor who is the best to do your particular evaluation. If the insurance company does not agree with the doctor we chose and the number they assign, , however, you may be required by Vermont law to see a doctor chosen by the insurer for what they call an Independent Medical Exam or “IME.” Fortunately, the insurer has to pay for both examinations; the one they choose and the one with a doctor that we chose.
It is very important to make sure that you get a fair and proper permanency evaluation, since getting a bad one can cost you thousands or tens of thousands of dollars in permanency benefits. The lawyers at Biggam, Fox & Skinner work very hard to make sure that our clients receive the permanency benefits they are entitled to under Vermont law. We also take the time to carefully explain the permanency evaluation process to our clients and make sure that you understand your rights.
If you can never return to “sustained gainful employment“ you may be entitled to a lifetime’s worth of wage replacement benefits. These benefits are also tax-free. Workers’ compensation insurance companies almost always refuse to pay Permanent Total Disability benefits and they defend these claims vehemently.
In their view, if you are breathing and conscious, you can work. This type of claim can take a long time to win and is an uphill battle. But with Biggam Fox Skinner’s workers’ comp lawyers on your side, you can rest assured that we will work tirelessly on your behalf so that you will eventually win or settle for what you deserve. A settlement means you agree to the amount.
We know how to successfully fight and win these major claims. Most of these claims settle at mediation. Few of these claims go to trial.
We know how to maximize these settlements and if they need to be tried, to give you the best chance possible of winning a lifetime of benefits.