Workers’ Compensation
Biggam, Fox & Skinner: Home of Vermont’s Most Experienced Workers’ Compensation Attorneys
Vermont and federal law requires employers to maintain a safe work environment in order to reduce the likelihood of tragic on-the-job accidents, injuries, and deaths. If you’ve been injured on the job, your employer is legally responsible to pay all of your medical bills and all prescriptions, with no out-of-pocket expenses and no co-pays. They are also responsible to pay wage replacement for all the time you are forced to miss from work due to your work-related injury.
Even if you think you’re already being taken care of, or that you are already getting what you should be, you should know that your employer’s workers’ compensation insurance company is not looking out for you. Insurance adjusters can play nice (or sometimes not), but they will never explain everything that you’re entitled to.
Maybe the Workers’ Compensation insurance company hired a doctor who has now said that your injuries were not work related? Perhaps the doctor found that your work injury was really a pre-existing condition. Or did they have another explanation; that the injury could not have been caused by your awkward ergonomic setup, or that your injury was instead due to a degenerative condition? How do you know that your employer and employer’s insurance company are telling you the truth? And, what are they not telling you? How much is this costing you?
Biggam, Fox & Skinner has been handling workers’ comp cases in Vermont for more than thirty years and our lawyers carefully double-check all claims rates, and money paid already to make sure that you receive the full disability benefits owed to you. If you have been denied Workers’ Compensation and have not received anything from Workers’ Compensation and you know that you were injured on the job, if you do nothing, you will never get anything. If you want to find out what you’re entitled to, and how we can get it for you, read on and contact our Vermont attorneys through our toll free number or the form below. We’ll evaluate your workers’ comp claim for free—it could mean more money for you. Letting us fight for you and checking to make sure that what you are getting is right, is a lot less painful than dealing with the insurance company on your own and just hoping for the best. How will you ever know for sure that you are getting what you should without checking it out with an attorney who specializes in representing injured workers?
Vermont Workers’ Compensation Rights
The Right to Receive Temporary Disability Payments through Workers’ Comp
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.
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. 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.
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 partial 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 Right to Have Your Medical Bills Paid Through Workers’ Comp
The workers’ compensation insurance company should pay all medical expenses caused by your work injury. You have the right to choose your own doctor. There should be no co-pay to any provider, 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. Insurers often fail to do this. Biggam, Fox & Skinner will fight to get these bills and mileage paid if there is any problem with 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.
The Right to Vocational Assistance
If your work injury makes it impossible for you to return to 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. Biggam, Fox & Skinner’s experienced workers’ compensation lawyers will assist you to make sure that the insurance company pays for a vocational counselor if needed. These 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.
The Right to Compensation for Permanent Injury
After it has been determined that you have reached an “end medical result,” or “medical end point,” 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. 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 if you are not back at work, but can also be paid in a lump sum in many situations.
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.” Many doctors, and most treating doctors in Vermont, do not conduct permanency evaluations in accordance with 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 competent to do your evaluation. If the insurance company does not agree with your doctor’s evaluation, 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.” The insurer has to pay for your examination with a doctor you 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.
Permanent Total Disability
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. This type of claim can take a long time to win. 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 what you’re owed. We know how to successfully fight and win these major claims.
A Few Real Workers’ Comp Cases that Our Lawyers Have Handled
Please note that all names in these examples have been changed to protect our clients’ privacy.
The Story of Joe:
When Joe first hurt his back at work four years ago he had no problems with the workers’ comp insurance company. They took care of his bills; paid for the visit to the emergency room, x-rays, and physical therapy; and his employer paid his wages if he missed work for a few days from pain related to the injury.
Whenever Joe had a flare-up of his back pain, the insurance company paid for Joe’s visits to the doctor. Then, one day, the insurance company said they would not pay for any more medical treatment because they now ruled that Joe’s back problems were related to his age and smoking.
That’s when Joe hired Biggam, Fox & Skinner. Our workers’ comp attorneys successfully proved that the insurance company was still responsible for Joe’s back condition. Not only did we make sure that Joe didn’t lose all of his medical benefits, but our law firm also recovered over $34,000 in permanency benefits for Joe—workers’ compensation payouts that he had no idea he was entitled to. This was money that the workers’ comp insurance company never told him about.
Wendy’s Story:
Wendy was discouraged by the time she called Biggam, Fox & Skinner’s workers’ compensation lawyers. After she hurt her shoulder at work she needed surgery. The insurance company denied her claim because no one witnessed the injury. They also sent Wendy’s medical records to a doctor who said that even if Wendy got hurt at work, the surgery she had wasn’t related to the work injury—it was related to “other shoulder problems.” That’s when Wendy turned to Biggam, Fox & Skinner for a no cost up-front workers’ comp case.
Our lawyers forced the workers’ comp insurer to pay for Wendy’s surgery and other medical care, as well as money for her time out of work and over $13,000 in permanency benefits.
When to call Biggam, Fox & Skinner’s Worker’s Comp Lawyers
As you probably know by now, work injury cases are complicated and your employer’s insurance company’s incentive is to provide just enough benefits for you to stay quiet. Just because you’ve been denied a workers’ comp benefit after a serious or life-changing work injury, doesn’t mean that you’re not entitled to benefits. Examples of applicable workers’ compensation injuries include spine and back, neck, lumbar, cervical, repetitive use injuries, and gradual onset injuries.
Call 1.800.995.4807 to contact our worker’s comp lawyers…
→ If you’ve been injured at work and you want to know your rights.
→ If your workers’ compensation claim has been denied for any reason.
→ If the insurance company is paying for some things, but is refusing to pay for others, or if any workers’ comp benefit or payment has been denied.
→ If you think you’re entitled to benefits that you are not receiving.
→ If your work-related injury was treated, but you never received your workers’ comp permanent impairment benefits.
→ If you just want to check up on the insurer and make sure you are getting everything you are entitled to.
Even if you were paid a lump sum, it doesn’t mean the end of the case or that your workers’ comp claim has been settled or closed. In many cases you are still entitled to additional medical and rehabilitation treatment if needed.
Please fill out and submit the short form below if you’d like one of our experienced workers’ compensation attorneys to review your case for free. We never work for insurance companies, but have worked for New Englanders like you for the past thirty years. Help is only a click or a call away.
Disclaimer: This form is for contact purposes only. Submitting this form does not mean that Biggam, Fox & Skinner is representing you.
