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Frequently Asked Alabama Workers’ Compensation Questions Answered

Frequently Asked Alabama Workers’ Compensation Questions Answered

The workers’ compensation system provides benefits to workers who are injured while on the job. Obtaining the benefits you earned is not always easy, though. The help of an experienced workers’ compensation lawyer can often make the difference in these cases.

Powell & Denny, P.C., has successfully handled many workers’ compensation cases, and we may be able to help you.

Answers to some of the more commonly asked workers’ compensation questions appear below. You probably have additional questions about your situation. An attorney at Powell & Denny can answer these and provide a free case evaluation. You can also learn more by reading through our frequently asked questions below or contacting our office.

Call 800-227-0882 to schedule your appointment. We have offices in Birmingham and Huntsville, Alabama, to serve you.


WHAT SHOULD I DO IF I’VE BEEN INJURED ON THE JOB?

  • Get medical care as soon as possible.
  • Notify your employer promptly.
  • Do not speak with the insurance company, provide them with a recorded statement, or sign any insurance company documents.
  • Keep track of your expenses and collect documents that prove your annual earnings.
  • Contact Powell & Denny for a free consultation.

WHAT CAN I GET BENEFITS FOR?

You can get workers’ compensation benefits for medical expenses, lost wages, rehabilitation services, vocational training, and related expenses. People often fail to ask for everything they are entitled to. For example, you can get mileage reimbursement for travel to and from medical appointments and physical therapy sessions. You can also get reimbursed for prescriptions and other types of medical expenses related to your work injury.

Powell & Denny will work to help you obtain all the benefits you deserve.


I CAUSED OR CONTRIBUTED TO MY OWN INJURY. AM I ENTITLED TO BENEFITS?

Yes. Workers’ compensation is a no-fault insurance program. You are entitled to benefits for any injury you suffered while on the job.


A THIRD PARTY (NOT MY EMPLOYER) CAUSED MY INJURY. CAN I GET BENEFITS?

Yes, you can. In addition to workers’ compensation benefits, you may be entitled to compensation from the party that caused your injury. These “third party claims” can include losses for pain and emotional suffering as well as financial losses, so the total compensation can be far higher than that for just a workers’ compensation claim.

Powell & Denny has successfully handled many cases involving on-the-job injuries caused by third parties, and will aggressively pursue your claim.


MY EMPLOYER TOLD ME I WAITED TOO LONG TO INFORM THEM OF MY INJURY. IS THERE ANYTHING I CAN DO?

You can have up to 90 days to report the injury to your employer. But the clock starts ticking when you become aware of your injury, so you should report it as soon as possible. This point is important. You may not become aware of an illness or chronic ailment such as a repetitive stress injury until sometime after the condition began.

An attorney at Powell & Denny can evaluate your situation and discuss your chances of obtaining compensation.


IS IT POSSIBLE TO OBTAIN BOTH WORKERS’ COMPENSATION BENEFITS AND SOCIAL SECURITY DISABILITY (SSD) BENEFITS?

Yes. But these dual claims can be complicated and there are complex interactions between SSD and workers’ compensation claims. If your workers’ comp claim is not handled properly, it can reduce your SSD benefits. Powell & Denny works in both areas, so we can coordinate both claims with the aim of maximizing your total stream of benefits.


I’VE BEEN TOLD THAT I AM NOT ELIGIBLE FOR ALABAMA WORKERS’ COMPENSATION BENEFITS BECAUSE THE JOB INJURY I SUFFERED WAS MY FAULT. AM I OUT OF LUCK?

NO. Alabama’s workers’ compensation statute states that an injured worker cannot be denied workers’ compensation benefits because the job accident was caused by (i) his or her own negligence; (ii) the negligence of a fellow employee or because (iii) the employee had assumed the risks of injury by working at the job site.


IS MY EMPLOYER RESPONSIBLE FOR PAYING MY MEDICAL EXPENSES?

YES, the Alabama Workers’ Compensation statute states that the employer shall pay for the reasonably necessary medical and surgical treatment and attention, physical rehabilitation, medicine, medical and surgical supplies, crutches, artificial members and other apparatus as the result of an accident arising out of and in the course of an injured worker’s job duties.


IS IT TRUE THAT WORKERS’ COMPENSATION HAS TO PAY ME MILEAGE REIMBURSEMENT FOR DRIVING BACK AND FORTH TO MY AUTHORIZED TREATING PHYSICIAN OR ELSEWHERE FOR MEDICAL TREATMENT?

YES, it is; you will be reimbursed.


WHAT IS THE STATUTE OF LIMITATIONS FOR FILING A CLAIM FOR WORKERS’ COMPENSATION BENEFITS?

An injured worker has two years from the date of their injury, or date they were last paid temporary total disability benefits, in which to have either settled their claim or filed a law suit. Claims not made within this time period are forever waived. Don’t take a chance with your workers’ compensation claim — call Powell & Denny today.


CAN I RECEIVE WORKERS’ COMPENSATION BENEFITS AND SOCIAL SECURITY DISABILITY BENEFITS AT THE SAME TIME?

Yes, although workers’ compensation benefits may cause a reduction in your Social Security Disability benefits.


DO I HAVE A RIGHT TO A JURY TRIAL?

We have been asked this question for years. Most injured workers know that they have a right to a trial on their workers’ compensation case, and most of them believe that this includes a right to a jury trial. This is simply not the case. In Alabama, workers’ compensation trials are bench trials, which means that the judge hears all the evidence and issues the decision. Bench trials are the only means of trying a case in Alabama unless the defendant argues that your job injury was the result of some form of willful misconduct on your part.


DO I HAVE A WORKERS’ COMPENSATION CLAIM IF MY INJURY OCCURRED WHILE I WAS IN THE PARKING LOT?

Alabama Workman’s Comp benefits are not limited solely to workers who were hurt at work while they on the clock. Under Alabama’s Workers’ Compensation law, “’employment is not limited by the actual time when the workman reaches the scene of his labor and begins it nor when he ceases, but includes a reasonable time, space, and opportunity before and after while he is at or near his place of employment. One of the tests is whether the workman is still on the premises of his employer. It was further stated that an employee’s completing his actual service for the workday and preparing to leave the employer’s premises at a suitable interval of time thereafter are acts naturally related and incidental to the course of employment.’” Cook v. AFC Enterprises, Inc., 826 So.2d 174, 177-178 (Ala.Civ.App.2002)(quoting from Thompson v. Anserall, Inc., 522 So.2d 284, 286 (Ala.Civ.App.1988).

One important question is whether the parking lot is provided by your employer for employee use; is it “their” parking lot. Injuries in public parking lots would not be covered, and a personal injury action might be appropriate, but if you suffered your injury while going to, or leaving, work, then you will most likely be held to covered by your employer’s workers’ compensation insurance carrier.

So, if were hurt at work while not being “on the clock,” but you were in the parking lot engaged in activity related to your job, including getting ready to begin work or preparing to leave work, then you may be entitled to workman’s compensation benefits.


WHAT CAN I DO IF MY PAY IS CUT AFTER MY JOB INJURY?

Unfortunately, unless you have a contract which sets forth your rate of pay, the answer is generally yes, but there are remedies available.

If, due to injuries you sustained while performing your job duties, you are not able-or your employer is not willing-to earn the same wages you did prior to being hurt at work, and you are still recuperating from said injury, you are entitled to temporary partial disability (tpd) benefits. TPD benefits are 2/3rs of the difference between what you were making prior to your job injury and what you are now earning. If, during your recovery period, you are making $100.00 less a week at work, then you are entitled to $66.67 in ttd benefits per week until (a) your employer increases your pay/hours or (b) you reach maximum medical improvement.

Just like with temporary total disability (ttd) benefits, your right to tpd benefits ends once you reach maximum medical improvement (mmi). At that time, if you have sustained a permanent physical impairment which prevents you from being able to earn the same money you did prior to your injury, you may be entitled to compensation for your vocational loss-depending on whether your injury is to a scheduled member (as defined by Ala.Code §25-5-57(a)(3)).


CAN MY EMPLOYER FORCE ME TO WORK OUTSIDE MY WORK RESTRICTIONS?

No. If you have been hurt at work and given work restrictions by the workers’ compensation doctor, your employer has two choices: (i) they can either make sure that they accommodate your work restrictions or (ii) they can tell you that they do not have any work available given your restrictions and you will then be entitled to temporary total disability (ttd) benefits. But what do you do when your boss insists that you come to work and do more than the workers comp doctor said you can perform?

As always, be polite and respectful to your employer. Chances are good that they simply did not understand the full breadth of your work restrictions. We always tell our client to make sure that when they receive a copy of any work restrictions the company doctor has given them, make two copies, one is delivered to us and one is taken to their employer. If your employer has any questions about your job restrictions, they can always call the doctor and ask for clarification.

If reason doesn’t work, then don’t hesitate to call and speak with one of the experienced Alabama Workers’ Compensation lawyers at Powell and Denny.


WHAT IF MY INJURY OCCURRED DUE TO A FALL IN THE BATHROOM?

Through the years, the attorneys at Powell and Denny have spoken to hundreds of workers who were hurt at work, and many of these injured workers were hurt when they slipped and fell in the bathroom. Sometimes the worker seems slightly embarrassed at how their injury occurred, but they really shouldn’t. A fall in the bathroom is no different than a slip and fall in the middle of the warehouse.

Some workers have been led to believe that a fall which occurred in the bathroom is not considered a job injury; this simply is not the truth. Alabama law recognizes that certain activities performed by workers may not be solely for the benefit of their employer, but that the actions are incidental to employment, and injuries sustained while performing these incidental activities are also covered by workers’ compensation. This includes injuries which occur in the restroom (assuming no misconduct was taking place).


AM I ENTITLED TO WORKERS’ COMP BENEFITS IF MY WORK INJURY AGGRAVATED AN OLD INJURY?

I could not tell you the number of times we have received a call from a worker who was hurt at work who called us because the workers’ compensation adjuster told them that their job injury was not the result of the job accident they were recently involved in, but rather was due to some old injury.

I wish I could tell you that the majority of adjusters just did not understand Alabama law, but I can’t. They are trying to convince you that you do not have a compensable claim and hoping that you will not speak with an experienced workers comp attorney so they can save money. Workers’ compensation is not solely available to workers in perfect health, it is there for all workers, including those with pre-existing medical problems.

In Alabama, if you have an old injury, or some other form of pre-existing condition, which has not prevented you from performing your job duties, then any job accident which aggravates your old injury (or preexisting condition) is a valid workers’ compensation claim and the workers comp insurance carrier is responsible for your worsened condition.


DO I HAVE A WORKERS’ COMP CLAIM IF I WAS INJURED DURING LUNCH BREAK?

It depends. Alabama law holds that injuries which are suffered while an employee is conducting activities incidental to their employment-acts necessary to the life, comfort or convenience of the employee-may be compensable injuries. Injuries suffered during lunch break have been held to be one type of said injuries when the injury occurs at an appropriate time and place. If you are in the lunch room and slip and fall in some liquid on the floor, any injury you sustained would be covered under workers’ compensation; however, if you were goofing off, any injury would not be covered.

A more difficult question is what if you are driving somewhere off site for lunch and are injured. If you job calls for you to drive and you are often off site and free to eat lunch at an appropriate location, then your injury should be covered. If you just choose to run out to grab a burger and had a wreck, you may have a personal injury claim but most likely you would not be entitled to workers’ compensation benefits.


DO I HAVE A WORKMAN’S COMPENSATION CLAIM IF I WAS INJURED WHILE LEAVING WORK?

Injured workers are usually surprised when we tell them that an injury suffered while leaving work can still be a compensable workers’ compensation claim. It is understandable that the injured worker might think otherwise; they were off the clock and not working when they fell, and their boss may have even indicated that such an injury would not be covered under workers comp, but this is usually wrong.

In Alabama, an injured employee’s “’employment is not limited by the actual time when the workman reaches the scene of his labor and begins it nor when he ceases, but includes a reasonable time, space, and opportunity before and after while he is at or near his place of employment. One of the tests is whether the workman is still on the premises of his employer. It was further stated that an employee’s completing his actual service for the workday and preparing to leave the employer’s premises at a suitable interval of time thereafter are acts naturally related and incidental to the course of employment.’” Cook v. AFC Enterprises, Inc., 826 So.2d 174, 177-178 (Ala.Civ.App.2002)(quoting from Thompson v. Anserall, Inc., 522 So.2d 284, 286 (Ala.Civ.App.1988).

What this means is that if you tripped and fell or were struck by something while you were trying to leave your place of business, or in the company provided parking lot, the law considers you still acting in the normal course of your employment and therefore any injuries sustained would be covered by workmans’ compensation.


WHAT HAPPENS IF I QUIT MY JOB?

Rest assured that the fact that you quit your job does not mean that your injuries are no longer covered by your former employers’ workmans’ compensation coverage. The workmans’ comp carrier is still responsible for your medical treatment and compensation whether you still work for the same employer or not.

However, quitting your job could affect your right to temporary total disability benefits (ttd) you are entitled to receive if the treating physician gives you work restrictions. When a worker is given work restrictions, the employer has the right to accommodate said restrictions and allow you back to work, or if no such accommodation is made, the injured worker is entitled to ttd benefits during the time of their recovery or until such time as their employer can accommodate any restrictions. By quitting your job before your reach maximum medical improvement (mmi), you have basically waived any obligation for your employer to try to accommodate your work restrictions, and if they would have been able to accommodate said restrictions, then you would not be entitled to any ttd benefits.

So, quitting your job will not act to waive your overall rights under Alabama’s workers’ compensation system, but it may affect some rights temporarily.


CAN MY BOSS FORCE ME TO SEE THE DOCTOR ON MY OWN TIME?

Yes, if it is possible for you to do so. If you can still perform your job duties given your injuries, or if your employer has made accommodations for your injuries and you are working for pay, then your employer can ask that any doctor appointments or physical therapy appointments be made during your off hours. Having stated this, the doctor or therapist must also be available to see you during these hours. If you work from 8:00 am. – 5:00 p.m. and the doctor’s office closes at 5:00, then you obviously cannot make it in to see the doctor and your employer must allow you to schedule your appointments at a time in which you can be seen, even if it is during “office hours.” However, just because seeing the doctor during work hours is more convenient for you is not a sufficient reason to try and force your employer to let you leave early.


WHAT DO I DO IF MY BOSS REFUSES TO FILE INJURY REPORT?

Every now and then we receive a call for a worker who was hurt at work who is complaining that their employer refuses to file an injury report. The reason most often given is that the injured workers boss simply does not believe that they are injured, but the reason behind why an accident report is not being completed is immaterial.

By law, if a workers claims to have suffered a work injury (not just having a job accident, but suffering an injury), then the employer is supposed to file a First Report of Injury with the Alabama Department of Labor. If your employer simply refuses to do this, what do you do?

The first thing we tell the injured worker to do is to contact the Alabama Department of Labor at (334) 353-0690 and report your employer’s refusal to comply with the law. They will then contact your employer and an injury report should be filed in a timely manner thereafter.

The next thing we bring up is whether they need to speak with an attorney to see if they believe they should hire an attorney to represent them in their claim for workmans’ compensation benefits. If your employer is already saying that they don’t believe you or is refusing to file an Accident report for whatever reason, chances are that you will need a lawyer somewhere down the line.


WHAT CAN I DO IF I WAS FIRED AFTER SUFFERING A JOB INJURY?

Unfortunately, it is not unusual for our attorneys to receive a phone call from a worker who, after suffering a job injury, was fired. A lot of the times, the termination (or layoff) was for legitimate reasons–things are tough all over in the modern economy. However, many times there is a practice at a particular place of business where anyone who pursues workers’ compensation benefits soon finds themselves without a job. In this situation, you do have legal recourse available.

Ala.Code §25-5-11.1 states that “[n]o employee shall be terminated by and employer solely because the employee has instituted or maintained any action against the employer to recover workers’ compensation benefits under this chapter or solely because the employee has filed a written notice of violation of a safety rule pursuant to subdivision (c)(4).”

In Alabama, your employer cannot fire you solely because you have reported and sought workers’ compensation benefits related to a job accident.


WHAT DO I DO IF I WORK THROUGH A TEMP AGENCY AND SUFFERED A JOB INJURY?

Many people believe that they would be able to pursue workers’ compensation benefits through their employer-the Temp Agency-and sue the company where they are actually working under a general tort theory such as negligence; however, this is not how workers’ compensation works in Alabama.

In Alabama, the courts have repeatedly held that a person who works through a temporary agency (such as Kelly Services, Manpower, Mighty Men, Labor Ready, etc.) and are working at and for another business, then the Temp Agency is considered your general employer and the company where you are actually working is called a special employer. What this means is that, for workers’ compensation purposes, you will be considered an employee of both companies and therefore-generally-your sole means of recovery is though workers’ compensation. Moreover, most times the temporary agency covers any job injury claims through their workers’ compensation insurance coverage.


CAN I BE FORCED TO SEE A NEW DOCTOR?

If you have suffered a serious injury and are receiving costly treatment from your treating physician, chances are that at some point you will be contacted by workers comp and told that you have to see another doctor (called an independent medical examination or IME). It is not because the doctor caring for you has done anything wrong, but because workers comp doesn’t like paying the medical bills associated with your treatment. So, what are your rights when workers comp tries to force you to see another doctor?

If you are satisfied with the treatment you are receiving from your authorized treating physician, I do not personally believe that you have to, or should, submit to being examined to another doctor chosen by the workers’ compensation insurance carrier. The comp carrier is most likely only trying to create some uncertainty in your case so they can use it to their advantage. Make no mistake, the workers’ compensation insurance carrier is not wanting you to see another doctor because they believe it is in your best interest.


CAN I FILE FOR WORKERS’ COMPENSATION BENEFITS IF I WAS ONLY A PART-TIME EMPLOYEE?

Through the years the Alabama job injury attorneys at Powell & Denny have spoken to numerous injured workers who thought that their work injury would not be covered under Alabama’s workers’ compensation laws because they were a part time employee. This is simply not the case.

Alabama’s Workers’ compensation Statute defines an employee/worker as “every person in the service of another under any contract of hire, express or implied, oral or written….” The number of hours you work each work is only relevant in determining your average weekly wage. As long as the injured worker can show that (i) they were hurt at work, (ii) that their employer has 5 or more regular employees, (iii) that they were hurt at work while performing their job duties and (iv) that they provided timely notice of being hurt at work to their employer, then they have a valid workers comp claim and are entitled to all right provided by the Alabama Workers’ compensation laws.


WORKERS’ COMP DENIED MY CLAIM. WHAT DO I DO?

If your claim for workers’ compensation benefits was denied, don’t give up.

Often the reason for the denial is because the workers’ compensation adjuster says the job accident was not the cause for the injury; rather, it was caused by an old injury. As we have stated in blogs on pre-existing conditions, this defense rarely works. If you were able to work as a normal employee and a job injury aggravates an underlying preexisting condition, then the claim is considered a compensable workers’ compensation claim. As our courts have stated, workers’ compensation benefits are not solely for those in perfect health.

We have also had cases where the employer and/or their comp carrier deny liability simply because they don’t want to be liable for the injury. In these cases, we hear things like “I don’t believe them,” or “there were no witnesses.” These are not valid reasons to deny liability.

Having stated this, establishing liability was possible because our clients did not give up, and they did not attempt to prove their cases on their own. They did what anyone who has had a claim for workers’ compensation benefits wrongfully denied should do; they hired an experienced workers’ compensation attorney.


CAN I TAKE A NEW JOB?

Yes. If a better job becomes available, you should do what is best for you and your family. Having stated this, you should be aware of how changing jobs could affect your workers’ compensation claim.

First, if you are off work due to a job injury and are drawing temporary total disability benefits (ttd), you have must inform the employer with whom you have your workers’ compensation claim or their insurance provider that you have a new job and are receiving wages. You are not entitled to draw temporary total disability benefits or temporary partial disability benefits while working for a new employer.

Secondly, it you take a new job making similar or more money than you were at your previous position, you may be waiving your right to vocational compensation. Having stated this, in my opinion you should never let a possible monetary recovery cause you to make a decision which would hurt you and your family in the long run.

Lastly, if you are thinking of taking a new job, be sure to inform you potential new employer of your job injury and any physical limitations you have as the result of said job injury. If you mislead your new employer and somehow make your injury worse at your new job, you may be found to have waived your rights under the Alabama Workers’ compensation system for any new injury and to have cut off your right to further benefits in your current claim.


CAN I STILL BRING A CLAIM FOR WORKERS’ COMPENSATION BENEFITS IF I DID NOT IMMEDIATELY FILE AN INJURY REPORT?

First off, it is not an accident report that is to be filed, it is an INJURY report. This is not just a matter of semantics. Per Alabama law, employers are to file an injury report once they have been informed that one of their employees believes that they have suffered a job injury; there is not such obligation to file an accident report. If you believe that you were hurt at work, you have to tell your boss that you believe you were injured; simply saying that you were involved in an accident is not sufficient–your employer must know that you are claiming to have been hurt in said accident. If you tell your employer that you had a job accident, but never tell them that you believe that you were hurt, you have not properly reported a job injury, and time could later become an issue.

Secondly, speaking of time, according to Alabama law, an injured employee has up to 90 days after suffering a job injury to report said injury to their employer. The extended time is allowed because many times a worker thinks that they have merely suffered another pulled muscle and that it is no big deal–it will work itself out over time. Only after days (or weeks) of continued pain does the worker realize that they have really been hurt. The 90 days allotted is there to protect the injured worker, but also to protect the employer. If someone were allowed to wait 6 months before reporting a job injury, the employer’s ability to properly investigate any injury would be severely compromised, and this would not be fair to employers.

Having stated this, it is always best to report a potential job injury as soon as possible. If after 90 days no INJURY has been reported, then you will have waived any right to workers’ compensation benefits (however, actual knowledge on the employer’s part that you have suffered a job injury is sufficient knowledge-but again, report any injury as soon as possible).


CAN I STILL BRING A WORKERS’ COMPENSATION CLAIM IF I TESTED POSITIVE FOR DRUGS?

Taking illegal drugs, or misusing prescription drugs, is against the law–we all know this. If you suffered a job injury because you were under the effects of an illegal drug, or because you were abusing a legally prescribed drug or alcohol, then you are not entitled to workers’ compensation benefits. No one argues that this is not just.

However, just because you may have tested positive for drugs does not mean that you are automatically disqualified from receiving workers’ compensation benefits in Alabama. Failing a drug screen is not what would prevent you from receiving benefits; suffering a job injury because you were under the influence of said drugs is what estops you from receiving benefits. Several years ago, the defendant in one of our cases argued that since my client failed a post-accident drug test, my client was not entitled to any benefits. My argument was to give the court the following example: “Hypothetically, say my client had recently smoked marijuana, and later at work the steel beam he was standing on broke, causing him to fall and be injured. It was not the marijuana that caused my client’s injury, it was the fact he steel beam he was standing on broke.” Using this analogy, the court was able to easily understand that the defendant had the burden of proving that the presence of any illegal substance caused the job injury; if the defendant is not able to prove this, then the injured worker is still entitled to workers’ compensation benefits.

Additionally, any drug screen must be taken after the job injury was suffered and the test must comply with legal standards. Having a drug test taken 2 days after a job injury will most likely not be sufficient to deny benefits.


CAN I USE MY OWN INSURANCE TO RECEIVE MEDICAL TREATMENT?

Generally, NO.

Alabama law dictates that your employer has to report a job injury. This is not open for interpretation; at this point your claim should be turned over to your employers’ workers’ compensation insurance carrier. In order to use your personal health insurance, you would have to lie about how the accident occurred in order for your health insurance to pay for your treatment, and you would be committing fraud. Your actions would be forcing your insurance carrier to bear a cost they are not legally obligated to pay.

If your insurance provider later finds out that your injury was really the result of a job accident, they will withdraw all the monies they have already paid for your treatment, and you will be personally responsible for paying these medical bills. Most of us simply do not have the money to pay for a surgery out of pocket.

Lastly, despite any promise from your employer to “take care of you,” if you fib about how your injury occurred, once you lie to several doctors about how your injury occurred, it is extremely tempting (and easy) for your employer to “forget” that you were hurt at work. At this point, all they have to say is that you never told them that you were hurt at work, and it can be extremely hard (but not impossible) for you to prove otherwise.

If workers’ compensation has refused to accept liability for your injury, then you are free to see whom you wish and try to have your insurance carrier cover the expenses.


WHAT DO I DO IF THE RECOMMENDED MEDICAL TREATMENT WAS DENIED?

In Alabama, the law is clear: the employer (their workers’ compensation carrier actually) shall pay for any and all reasonably necessary medical treatment. What happens these days is that the workers’ compensation insurance carrier will send some of your records to another doctor (generally in another State), pay for their services and ask them to opine whether the treatment that was recommended is really needed. The carrier will not explain Alabama law to their paid doctor, and not surprisingly this doctor will often say that the expensive treatment is not needed, leaving the injured worker high and dry.

At this point, we file suit and take the question straight to the court, and while no one knows what tomorrow may bring, thus far no court has ruled against us when we ask that they order the insurance carrier to pay for the recommended treatment, because our judges know the law-we make sure of it.

If the doctor the workers’ compensation insurance carrier has told you to see has recommended some treatment, but he insurance company writes to tell you that you really don’t need the treatment-don’t accept it. Call an experienced Alabama Workers’ compensation attorney at Powell and Denny.


WHAT ARE THE ATTORNEY FEES?

In Alabama, attorneys are limited to a fee of no more than 15% of any settlement or recovery, plus reimbursement of reasonable expenses. Unlike automobile accidents or other torts, workers’ compensation lawyers in Alabama cannot use a sliding fee scale, and they cannot collect more than 15% plus reasonable case expenses.

At this point, we often are asked “what are case expenses.” Clients are worried that in order to make up for the low fee we are entitled to in a comp case, we will try to make up the money by padding our expenses. While I cannot speak for other attorneys, at Powell and Denny, we try to keep our expenses to a minimum. Case expenses generally consists of the costs we have to pay for necessary items, like medical records (doctors don’t send them to us for free), filing fees if a suit is filed, deposition costs and the like. Moreover, in the vast majority of cases, the court has to approve our fee and expenses; if the court believes that our expenses are unreasonable, the court will not allow us to charge you for them.

This is something to keep in mind; unlike other personal injury type actions, most workers’ compensation case go before the court-even if the case settles, and the court oversees our fees and expenses to ensure that the injured worker is being protected.


CAN I RECEIVE WORKERS’ COMP BENEFITS IF I WAS OFF THE CLOCK AT THE TIME OF MY INJURY?

Alabama Workman’s Comp benefits are not limited solely to workers who were hurt at work while they on the clock. Under Alabama’s Workers’ Compensation law, “’employment is not limited by the actual time when the workman reaches the scene of his labor and begins it nor when he ceases, but includes a reasonable time, space, and opportunity before and after while he is at or near his place of employment. One of the tests is whether the workman is still on the premises of his employer. It was further stated that an employee’s completing his actual service for the workday and preparing to leave the employer’s premises at a suitable interval of time thereafter are acts naturally related and incidental to the course of employment.’” Cook v. AFC Enterprises, Inc., 826 So.2d 174, 177-178 (Ala.Civ.App.2002)(quoting from Thompson v. Anserall, Inc., 522 So.2d 284, 286 (Ala.Civ.App.1988).

Don’t give up. If were hurt at work while not being “on the clock,” but you were engaged in activity related to your job, including getting ready to begin work or preparing to leave work, then you may be entitled to workman’s compensation benefits.


DO I HAVE TO SEE THE COMPANY DOCTOR?

While you are free to see whomever you wish to see, you should realize that your personnel health insurance will not pay for treatment related to a work injury. This means that any treatment you receive by seeing who you want to see-instead of who comp tells you to see-will have to be paid for out of your pocket. Most of us simply cannot afford much medical care on a cash basis-which means that for most practicable purposes, yes, you do have to see the doctor workers’ compensation tells you to see. Having stated this, if workers’ compensation denies liability or otherwise refuses to provide you with the reasonably necessary medical treatment needed, then you may go to whomever you wish and if later your injuries are shown to be related to a job injury, then workers comp will be responsible for ensuring your medical bills are paid and the doctor you picked will be your treating doctor.

As for who the doctor works for, rest assured that the majority of physicians who handle workers’ compensation cases are reputable and their primary concern is helping you heal so you can return to work; however, just as with all professions-there are some doctors who have a reputation for putting the desires of the insurance carrier over the needs of the injured worker. Both of the attorneys at Powell and Denny have over 22 years of personal experience handling workers’ compensation cases in Alabama and we know most of the bad ones and we can try to help get you to another doctor whose concern is centered on you.


WHAT IS AN IMPAIRMENT RATING?

After suffering a work injury and receiving medical treatment, you will eventually come to the point where your treating physician states that you are as good as you are going to get; this is known as your date of reaching “maximum medical improvement.” At this juncture, the physician will give an opinion as to whether you have suffered a permanent injury; if you have, then an impairment rating will be calculated.

What exactly is the impairment rating and what does it mean? Impairment ratings are generally calculated in accordance with procedures listed in the A.M.A. Guides to the Evaluation of Permanent Impairment. Specific impairment ratings are provided according to the type of injury you have suffered and what permanent restrictions you now have to the affected body part (arm, hand, leg, feet, eye) and/or to the body as a whole. While the A.M.A. Guides specifically state that their ratings are not purposed to say what an injured worker can do post-accident, in practice these ratings are viewed by most courts as evidence of your permanent physical impairment, but the court is not bound by these ratings.

If you have suffered a permanent injury to a non-scheduled body part (neck, back, shoulder or hip), or if you injury is such that it effects to proper functioning of the body as a whole and you are no longer able to perform your job duties or earn the same type of money, then the impairment rating really is not as important as your physical limitations, as your permanent restrictions are what will be relied upon in determining what compensation you are entitled to receive


WHAT DOES MMI MEAN?

The way I generally explain this is to explain “maximum medical improvement” is just a fancy was of saying “you’re as good as you’re going to get.”

Legally, an injured worker is found to have reached MMI status once “‘there is no further medical care or treatment that could be reasonably anticipated to lessen the claimant’s disability. G. UB. MK. Constructors v. Traffanstedt, 726 So.2d 704, 709 (Ala.Civ.App.1998). ” When MMI is reached depends on the circumstances of the particular case, and in many cases just because one doctor has opined that an injured worker has reached maximum medical improvement does not mean that another physician (maybe one chosen from a Panel of Four) will agree with this assessment, and ttd benefits can be reinstated if the new treating physician states that you have not yet reached MMI.

Once you have been found to have reached maximum medical improvement, any physical restriction you have is deemed to be permanent, and your right to any temporary total disability (ttd) or temporary partial disability benefits (tpd) ends, and it makes since. You are no longer considered to have any “temporary” problem; now any limitations are considered permanent and any monetary compensation you may be entitled to receive would be either permanent partial disability (ppd) benefits or permanent total disability (ptd) benefits-with a right to lifetime medical treatment.


THE DOCTOR SAID THAT I HAVE REACHED MMI, NOW WHAT?

The first thing you should know is that your right to temporary total disability (ttd) benefits or temporary partial disability (tpd) benefits stops once you have reached maximum medical improvement.

Next, if you have suffered permanent physical restrictions, you will be given an impairment rating given your permanent limitations. If you permanent injury is to your neck, back, shoulders, hips or some physical/pain disorder which effects the effective functioning of your body as a whole, we look to see if you can return to your previous job given your permanent restrictions. If you cannot, then it is time to see a vocational expert to have a vocational evaluation performed so it can be determined if a settlement can be reached or if suit has to be filed.

You also need to know that for the rest of your life, as long as you require medical treatment for your work related injuries, workers’ compensation will be responsible for ensuring that you receive any and all reasonably necessary medical treatment. If you are involved in another accident and make your condition worse-then workers’ compensations’ liability stops.


CAN WORKERS’ COMPENSATION CUT OFF MY CHECK?

Just the other day a worker who had reached maximum medical improvement (mmi) called to ask if workers comp could cut off his check because his boss was saying that they did not have a job available for him given his permanent work restrictions. If you are not able to return to work, it just doesn’t seem fair that workers comp can cut off your check.

You may be right, and it may not be fair, but once you reach maximum medical improvement, you are no longer entitled to any “temporary” benefits as any physical limitations you have are now considered permanent. So it does make sense that once you reach mmi status, your right to temporary total (tpd) or temporary partial disability (tpd) benefits would stop as there is nothing temporary about your permanent work restrictions.

Of course workers’ compensation could begin issuing temporary partial disability (tpd) or temporary total disability benefits (ttd) to you every week/bi weekly, but they cannot be compelled to do so absent a court order. Knowing this, in my experience it is very rare that the comp insurance carrier will begin making payments as-honestly-it is in their interest to try to squeeze you so you will hopefully take less in a settlement.

If your check has been stopped and you are wondering what your next step should be, contact an experienced Alabama Workers’ compensation Lawyer at Powell and Denny.


AM I ENTITLED TO COMPENSATION FOR PAIN AND SUFFERING?

No. Workers who have experienced job injuries are entitled to those benefits set forth in Alabama’s Workers’ compensation Statue and only those benefits prescribed by the Legislature; pain and suffering is not one such benefit. In Alabama, if a worker has suffered a permanent injury, then their employer must pay for (a) all of the workers’ reasonably necessary medical treatment, (b) reimburse the worker for mileage in driving back and forth for medical treatment or to receive medications; (c) pay the worker 2/3rds of their average weekly wage when off work pursuant to the advice of a physician treating them for their job injuries (until the date they reach maximum medical improvement), (d) pay compensation to the injured worker for any permanent physical impairment sustained as a result of an on-the-job injury and (e) they are entitled to lifetime medical care directly attributed to their job injury. Depending on the type of injury they have suffered, the injured worker may also be entitled to vocational considerations.

Workers’ compensation claims are not like other personal injury type claims, that is why you need to speak with an attorney who has experience handling Alabama Workers’ compensation claims, not at attorney who may handle one every now and then.


CAN I SEE MY OWN DOCTOR?

If you have suffered a job injury, technically you are free to see whomever you wish to treat you for your injury-including your own personnel physician; however, your personnel health insurance will likely not pay for said treatment if it was work related (most health insurance policies have language which specifically states that they do not pay for medical expenses covered under workers’ compensation), meaning that for all practical purposes you have to see the physician chosen by your employer’s workers’ compensation insurance carrier.

We have had cases where the injured workers’ employer has told the injured worker to see whomever they want to see. In this situation, the doctor you choose to use is the authorized treating physician. Additionally, if your claim is denied, then you are free to use whomever you wish and, if liability is later established, then workers’ compensation will be responsible for ensuring all of your medical bills are paid and the doctor you have chosen will be deemed to be the authorized treating physician.


WHAT SHOULD I DO IF MY BOSS TOLD ME TO USE MY OWN INSURANCE?

We have heard this a lot through the years; a worker suffers a job injury and informs their boss of this fact as they are supposed to do; then, the injured workers’ boss asks them to put any medical treatment they receive on their personal health insurance. The injured worker is not sure what to do. In order to have their own insurance cover their medical treatment, they will have to lie about how they suffered their injury (your personal health insurance will not cover treatment for a compensable job injury)-but in Alabama we have all been taught that lying is wrong.

Don’t lie and don’t use your health insurance for treatment of your job injury. If you do and your insurance carrier later learns the truth, they will most likely pull the money they have paid, leaving you personally responsible for payment of all the bills you have thus far incurred. I know I can’t afford to pay a doctor and hospital for a MRI or surgery, and you probably can’t either. In addition, even if your employer promises to “take care of you” if you lie about your job injury-these promises seem to have a short shelf live when the workers’ injuries end up being serious. Lying at the outset of your case will cause severe problems if later you attempted to obtain workers’ compensation benefits. Lastly, doctors don’t like being lied to, and if the doctor later finds out that you have lied to them, it can effect whether they believe you and therefore the type of treatment you receive and their deposition testimony if they should later be called on to give a deposition on your case.

Don’t lie at any time during your workers’ compensation claim–it just isn’t worth it.


AM I ENTITLED TO A SETTLEMENT?

At the outset, when we are just meeting with a potential client, we go ahead and discuss settlement. No, we have no idea what type of figures we will be dealing with or how long it may take to reach a potential settlement–there are just too many variables to deal with for any credible attorney to be able to give you any figures at the outset of your case.

Why then do we broach the subject out the outset if we can’t give any figures or time frame? Because we want our clients to know from the start that they are not entitled to a lump sum settlement; no one is. A settlement is an agreement, a meeting of the minds, between two parties-both of whom agree to a certain set of terms. Since you cannot control what the other side is willing to do, you can’t claim to be entitled to a settlement, and any attorney worth their salt will tell you the same thing. This is not to say that most cases don’t settle, because the fact of the matter is that most cases do settle.

One of the main reasons cases settle is because in a settlement, you can demand a lump sum payment. If you try your case, the court does not have the power to force the defendant to make you a lump sum payment; all the court can do it determine and rule on the percentage of disability you have suffered as the result of your job injury. At this point, the defendant will generally choose to pay you in weekly checks. Most clients would rather have the money up front, for various reasons, but again-they cannot demand the same.


WHAT IS A PANEL OF FOUR?

The Alabama workers’ compensation law understands that there will be instances in which an injured worker is not pleased with the treatment (or lack thereof) that they are receiving from their authorized treating physician and that they may wish to make a change. Given this simple fact, the law allows an injured worker to request a Panel of Four physicians, and from this panel of physicians, the injured worker is allowed to choose a new treating doctor. However, you are only allowed to request a Panel of Four once (twice if surgery is recommended and you wish to have a second opinion). With this in mind, it is important not to burn your Panel choice on a spur of the moment fit of frustration. Additionally, most injured workers do not know much about the doctors provided in their panel. Having the advice of an experienced Alabama workers’ compensation lawyer can be invaluable at this juncture, as some of the panel doctors have a definite bent in favor of the workers’ compensation provider.


DO I HAVE TO TAKE THE JOB OFFERED ME FOLLOWING MY JOB INJURY?

No, you do not have to accept any position. Being hurt at work does not remove your ability to choose what you want to do for a living, but failure to attempt to return to a position your employer believes you can perform given your restrictions-or to a position they have created for you-will cause you to forfeit any right to ttd benefits while you are not working. The law allows for your employer to attempt to find a position for you. We have had situations where an employer has offered to pay an injured work their full pay for sitting in an office doing not much of anything; the worker may feel like they are being harassed by such a job, but as I always inform them, it is better to make 100% of you pay as opposed to the 2/3rds you receive with ttd benefits. If the amount you make in another position is less than your average weekly wage made prior to your job injury, then you would be entitled to temporary partial disability (tpd) benefits-2/3rd of the difference. You would still be better off financially.

If you try the offered position, but are unable to do it given your restrictions, then inform your physician of the same and you may then be entitled to ttd benefits until you can return to work.


WHAT DO I DO IF I HAVE TO MOVE?

It is not uncommon for one of our workers’ compensation lawyers to speak with an injured worker who is concerned about their workers comp case because they have to move. Maybe their spouse has to move for their job; unfortunately many times the injured worker has to move in with a relative given the financial strain trying to live on 2/3rds of your average weekly wage imposes.

Regardless of the reason, the injured work is understandably concerned about how they will continue to receive their medical treatment if they have to move out of the area. We are quick to let them know that it does not matter where you move to in the United States (I haven’t had a client move to another country, so I haven’t dealt with that issue, but something should be able to be worked out in this situation as well). If you end up moving, then after being informed of where you are now residing, workers’ comp will find you a new authorized treating physician in your area.

Furthermore, regardless of where you move to, your worker compensation case will continue to be governed under the Alabama workers’ compensation system. Our firm has handled numerous cases where the injured worker lives in another State, or where the injured worker had moved to another State. We continue to pursue your case here, while you work on getting better and starting your new life. With telephones, faxes and the internet, it is easy to keep in contact.


CAN I TAKE A NEW JOB WHILE PURSUING A WORKERS’ COMP CLAIM?

Of course you can, and if the new job is one you can perform and is better for you and your family, I believe you have an obligation to do what is best for you and yours. Suffering a job injury does not mean that you cannot continue to strive for something better. Having stated this, you do have some obligations if you are going to accept a new job.

First, be sure to be honest with your new employer. Let them know what your injuries are, what your medical regime is and what your current physical limitations are-failure to be upfront and honest could cause irreparable harm to your claim and your new employment status.

Secondly, if you are drawing temporary total disability (ttd) benefits, you have to inform the workers’ compensation carrier of the fact you are working so your ttd check can be stopped or the amount lessened. Working and earning an income while drawing ttd benefits can be found to be a fraudulent and criminal act, so it is vital to be sure all the appropriate parties are aware of your new job.

Additionally, a new job may have an effect on any settlement are verdict you are entitled to receive. While you should bear this in mind, it alone should not stop you from doing what is best for you and your family.


IS THE COMPANY NURSE ALLOWED TO BE PRESENT DURING MY DOCTOR VISIT?

No, they are not. You have the right to ask them (politely) to wait outside while you are evaluated and discussing your injury with the doctor. The law allows the insurance company to have a nurse speak with the doctor about your treatment, but this can be done before or after you visit is over. While you are with the doctor, they should be listening to you and your concerns, not those of the insurance carrier.

By no means do I mean to infer that all Case Nurse Managers are predisposed to try to hurt your case. Just as with all other professions, there are some excellent Case Nurse Managers who work hard to help the injured worker, and there are others who care more about their client-which you are not.


DO I HAVE TO HAVE SURGERY IF I DON’T WANT IT?

If you have suffered a compensable job injury in Alabama, you have to see the company doctor. You are also obliged to cooperate with the treatment recommended by the treating physician, be it by attending physical therapy, properly taking certain medication or other reasonably forms of medical treatment. But what if the doctor says you need surgery and you don’t want surgery? Do you have to go under the knife just because you were hurt at work?

Generally, no. Surgery can be a serious thing, and not something to run into. If a back surgery has been recommended, but you are doubtful about the results-you don’t have to have surgery. If the surgery could lead to worse problems, then the decision whether to move forward with surgery belongs to you. You cannot be forced to have surgery as long as your reasons are reasonable.

You’ll notice that I said “generally,” this is because certain surgical procedures are deemed relatively low in a risk vs. benefit analysis (like a knee surgery or surgery to correct carpel tunnel syndrome) that refusing to have them to correct your injury would not be deemed reasonable. In those situations, refusing to undergo surgery could lead to a suspension of your workers’ compensation benefits.


DO I NEED A LAWYER?

No one has to have an attorney to represent them, but I would like to let you know what the Court of Appeals of North Carolina had to say on the subject; “…in contested workers’ compensation cases today, access to competent legal counsel is a virtual necessity.” Church v. Baxter Travenol Laboratories, Inc., 409 S.E.2d 715, 718 (1991).

Alabama’s workers’ compensation laws have very specific rules, and if you do not know what to do, or what time period you have in which to act, you could be waiving valuable rights.

Not everyone who calls our offices ends up hiring us to represent them. In certain situations we are able to answer the injured workers’ questions and give some free advice (for instance, we have a book which explains workers’ compensation cases available for fee if you request it). In other cases, the worker realizes that they need help; the choice is yours, but it is smart to at least call a knowledgeable workers’ compensation lawyer with the questions you have.


HOW MUCH MONEY AM I ENTITLED TO?

This is one question we receive which we are not able to readily answer because every case is unique. For instance, I have a B.A. and a Juris Doctorate and the job I perform, while mentally trying at times, is not especially physical in nature. If I were to suffer a serious injury, after surgery I would still most likely be able to return to my job and probably would be able to do so shortly after surgery. However, for a client who is 47 years old, who only has a limited education and has only used their body to provide for their family in the jobs they perform, the same injury may be disabling. One client may recover and do fine, while another may have chronic pain or suffer from depression or anxiety following their injury. We were all created uniquely, and how an injury affects us all is also unique.

If you have suffered a serious job injury and the insurance company is pushing you to settle, it is worth the time for you to at least call an experienced Alabama workers’ compensation attorney and let them take a look at your case. Additionally, the language contained in any settlement petition is extremely important, as certain terms and phrases could waive your right to future vocational benefits and/or the right to pursue a wrongful termination claim if you are wrongfully terminated after seeking worker compensation benefits.


AM I ENTITLED TO WORKERS’ COMPENSATION?

If you work in Alabama and suffered a job injury, you will generally be entitled to Alabama workers’ compensation benefits if you can show:

(i) That you are employed by your employer,
(ii) that your employer has 5 or more employees,
(iii) that your job injury occurred while you were performing your job duties (you were doing your job, not goofing off or under the influence of any drugs or alcohol), (iv) that the injury being claimed was the result of your job accident, and
(v) that you provided notice of your job injury (an actual injury, not just that you were involved in an accident–this is an important distinction) within 90 days of said injury (the sooner the better),

then you should be entitled to Alabama Workers’ Compensation benefits. In Alabama, if a worker can show this, then their employer must pay for:

(a) all of the workers’ reasonably necessary medical treatment,
(b) reimburse the worker for mileage in driving back and forth for medical treatment or to receive medications;
(c) pay the worker 2/3rds of their average weekly wage when off work pursuant to the advice of a physician treating them for their job injuries (until the date they reach maximum medical improvement) and
(d) pay compensation to the injured worker for any permanent physical impairment sustained as a result of an on-the-job injury.

You may also be entitled to vocational benefits depending on the facts in your case.


HOW DO I GET MEDICAL TREATMENT?

If you were hurt at work in Alabama, your employer has 5 or more employees and you reported your job injury (not just that you were involved in a job accident, but that you suffered an injury), chances are that you are entitled to Alabama Workers’ compensation benefits, and in my opinion, the most important workers’ compensation benefit you would be entitled to receive is your medical benefits.

Once you have informed your employer that you have suffered a job injury and desire medical treatment, your employer has an obligation to inform the Alabama Department of Labor of the fact one of their employees has suffered a job injury and they are to file a First Report of Injury with the State and file a claim with their workers comp insurance provider. Then your employer and their workers’ compensation insurance carrier have the legal obligation to pay for any and all “reasonably necessary” medical treatment needed to treat your job injury; but, remember that you have to request medical treatment for the injury you suffered at work.

Alabama’s workers’ compensation laws were was set up so that lawyers would only be needed to help a worker who suffered a catastrophic injury and might not be able to return to their old job, or to any other type of employment. Medical care was assumed to be something that really did not require the use of an attorney; unfortunately, in the last few years the workers’ compensation insurance carriers have been trying to avoid there liability to pay for your medical treatment. In today’s climate, Alabama workers have to fight just to have a MRI performed. This is not hyperbole. We have filed suit for clients several times where the doctor the workers’ compensation insurance carrier told our client to see ordered a MRI, but the insurance carrier refused to comply with the doctor’s request. We filed suit to ensure that the worker receives the treatment the law states they are entitled to receive so they can recover and get back to work as soon as possible.


WHO CONTROLS MY MEDICAL TREATMENT?

For some reason, there appears to be some disagreement over this question. If you go to the Alabama Department of Labor’s website and look under their frequently asked questions, there response to this question is that your employer (actually their workers’ compensation insurance carrier) controls your medical treatment, but this is not the case.

Yes, the workers’ compensation laws in Alabama allow the employer/insurance carrier to pick the initial treating physician, but their control basically ends here. As long as the treatment recommended by the authorized treating physician is reasonably necessary, the employer is legally responsible to pay for said treatment, whether or not the employer likes what the proposed treatment is, who performs said treatment or where it is carried out. The authorized treating physician is also free to refer you to any specialist they deem reasonably necessary as well; they do not need the approval of the workers’ compensation insurance carrier as long as their decision is reasonably necessary given your situation.

It is true that if the workers’ compensation insurance carrier does not like what the authorized treating physician recommended in terms of medical treatment, then they have the right to use the utilization review process and hire another physician to review the findings of the authorized physician and opine if they agree with the doctor’s findings. Utilization review (UR) typically works like this. Your treating physician informs you that surgery is needed. At this time the workers’ comp insurance provider hires a physician in another State to review some of your medical records and state whether the suggested treatment meets the insurance provider’s definition of medical necessity. Not surprisingly, the doctor hired by workers comp generally states that the requested treatment does not met this contrived standard, surgery is then denied and you are informed that the surgery is not needed.

If this has happened to you, do not let the insurance carrier get away with it; to date, I do not know of a single instance where a judge in Alabama has upheld a UR denial of treatment. The judges know what the definition of “reasonably necessary” is and give little credence to the findings of a doctor in another State who has never seen you and who is not aware of what the standards are in Alabama.


DO I HAVE TO SEE THE IME DOCTOR?

If you have suffered a serious injury and are receiving costly treatment from your treating physician, chances are that at some point you will be contacted by workers comp and told that you have to see another doctor (called an independent medical examination or IME). It is not because the doctor caring for you has done anything wrong, but because comp doesn’t like paying the medical bills associated with your treatment. So, do you have to see this new IME physician?

Generally, NO. The law in Alabama is clear, the workers’ compensation insurance carrier “shall pay” for any and all reasonably necessary medical treatment. They don’t have to like it, but they do have to pay for it.

Having stated this, there is a situation in which you may have to submit to an independent medical examination if it is ordered by the Court. Alabama law allows either party to request an IME of the court-or the court may order one on its own initiative-if a dispute arises as to the injury itself of the extent of disability you have suffered as a result of said job injury. While I have requested such an examination several times for my clients, I have only had such a Motion filed by the defendant once in the last 22 years, so it is not something which occurs often; and, it can only be done after suit has been filed. This means that the workers’ compensation insurance carrier cannot force you to see an IME doctor.


HOW MUCH AM I PAID UNDER WORKERS’ COMPENSATION?

If you suffered a job injury and have a valid Alabama Workers’ compensation claim, you may be entitled to different types of monetary compensation. The most common type of compensation is temporary total disability (ttd) benefits. This is money you receive when you are unable to return to work as the result of your job injury, and your rate of pay is 2/3rs of your average weekly wage (calculated over the 52 weeks immediately preceding your job injury.

Another form of compensation you might be entitled to receive is called temporary partial disability (tpd) benefits. This is paid when you are able to return to work following a job injury, but you are not being paid the same amount of money that you were making prior to your job injury. TPD benefits are 2/3rd of the difference between what your average weekly wage was prior to your injury and what you are making now while you are still receiving medical treatment and have not yet been released by your treating physician. For instance, if your average weekly wage was $500 prior to your injury, your treating doctor gives you light duty work restrictions which your employer accommodates, but your are only receiving $400 a week now, then your tpd benefit would be 2/3rds of $100, or $66.67.

If, once you have been released by your treating physician, it has been determined that you have suffered a permanent physical impairment, then there are two different types of compensation you might be entitled to receive. The most common is called permanent partial disability (ppd) benefits. Your PPD benefit is based on your permanent physical impairment. The other type of benefits an injured worker with a permanent physical impairment might be entitled to is called permanent total disability (ptd) benefits. These benefits are payable to a worker (with a non-scheduled member injury) who is no longer able to return to their past relevant work or similarly types of work given their job skills, age, education, physical/mental impairments and similar in pay.


HOW IS MY AVERAGE WEEKLY WAGE CALCULATED?

In Alabama, an injured worker’s average weekly wage (AWW) is determined by taking the injured workers’ earnings for the 52-weeks immediately preceding their job injury and dividing this number by 52. This is to include any bonus paid. In addition, if the worker missed a week of work during the 52 week period and did not receive any compensation, then that week should be subtracted from the calculation.

The value of any fringe benefits (e.g., Health insurance) received by the worker is NOT included in the calculations UNLESS their employer stop paying their portion of said benefits. If this occurs, then the value of said fringe benefits is included in the calculation of the injured workers’ average weekly wage.

If the injured worker has not been working for 52 weeks prior to their job injury, then the average of the earning they received while so employed is used and divided by the number of weeks worked, unless this amount is not just. In this situation, the average weekly wage of a similarly situated employee is used.

Ensuring that your average weekly wage is properly calculated is vital to your receiving the compensation you need while you are recovering from your job injury, and often the workers’ compensation insurance carrier will forget to add bonus or subtract weeks in their calculations, so you need to be sure to review these figures yourself.


WHAT IS THE 3-DAY WAITING PERIOD?

According to Alabama law, if an worker suffers a job injury and is taken off work (or given restrictions which their employer cannot/will not accommodate), then the injured worker will be entitled to temporary total disability (ttd) benefits, BUT these benefits do not begin until the 4th day the worker has been out of work.

Why? I don’t know. Going 3 days without pay is difficult in today’s economic climate, but it is the law. After the 3-day waiting period, your right to ttd benefits begins, and if you miss 21 days of work, then you are entitled to be reimbursed for the initial 3 days.


WHAT IF THERE WERE NO WITNESSES TO MY JOB INJURY?

While many job injuries happen in the middle of the warehouse with plenty of witnesses present, many do not. If you suffer a job injury, but there were no witnesses to the event, can your employer refuse to file a Workers’ compensation claim?

NO. There is no requirement in Alabama that a job injury be witnessed in order to be compensable, and as such, your employer is under the same obligation to file a First Report of Injury for a non-witnessed injury as they are when the entire warehouse saw the injury occur.

We have had to file suit several times through the years when the defendant simply refused to believe that our client was injured because there were no witnesses, and we are quick to point out to the court that just because the injury wasn’t witnessed does not mean that it did not occur.


DO I HAVE TO TAKE A DRUG SCREEN AFTER A JOB INJURY?

If you want to receive the Alabama workers’ compensation benefits that you are entitled to receive following a job injury, YES, you do have to submit to a drug or alcohol screen post injury. Failure to do so will stop you from receiving any monetary compensation for the job injury you suffered.

What does a positive drug or alcohol post injury screen mean to your claim for workers’ compensation benefits? Well, it doesn’t help matters. Taking illegal drugs, or misusing prescription drugs, is against the law–we all know this. If you suffered a job injury because you were under the effects of an illegal drug, or because you were abusing a legally prescribed drug or alcohol, then you are not entitled to workers’ compensation benefits. No one argues that this is not just.

However, just because you may have tested positive for drugs does not mean that you are automatically disqualified from receiving workers’ compensation benefits in Alabama. Failing a drug screen is not what would prevent you from receiving benefits; suffering a job injury because you were under the influence of said drugs is what stops you from receiving benefits. Several years ago, the defendant in one of our cases argued that since my client failed a post-accident drug test, my client was not entitled to any benefits. My argument was to give the court the following example: “Hypothetically, say my client had recently smoked marijuana, and later at work the steel beam he was standing on broke, causing him to fall and be injured. It was not the marijuana that caused my client’s injury, it was the fact he steel beam he was standing on broke.” Using this analogy, the court was able to easily understand that the defendant had the burden of proving that the presence of any illegal substance caused the job injury; if the defendant is not able to prove this, then the injured worker is still entitled to workers’ compensation benefits.

Additionally, any drug screen must be taken after the job injury was suffered and the test must comply with legal standards. Having a drug test taken 2 days after a job injury will most likely not be sufficient to deny benefits


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