If you have been injured in a workplace accident, you may be eligible for workers’ compensation benefits. These benefits can help you recover all of your reasonable medical expenses and a percentage of your lost income if you are unable to return to work. However, when filing a claim there are a number of timeframes you must be aware of. While there may not be a specific ‘waiting period’ under the workers’ compensation system, certain benefits are not paid until a certain amount of time has passed.
Medical Benefits
You have the right to receive medical benefits for all reasonable expenses, including emergency room visits, doctor’s appointments, ambulance transportation, hospitalization, physical therapy, prescription medication, laboratory tests, and more. Generally speaking, any medical expense you incurred as a result of your workplace injury is covered by the workers’ comp system.
Any medical expenses that qualify for benefits are payable as soon as the insurance company covering your employee approves them. Insurance companies have just 21 days to accept or deny payment for a claim, although in many instances, benefits are received before this time. The shortest amount of time you will likely have to wait for medical benefits is four weeks from the date of your workplace accident.
There may be times when you pay medical expenses out of your own pocket and need reimbursement for them. For example, you may have to visit an emergency room immediately after a workplace accident. If you pay for these costs yourself, you have the right to notify the insurance provider and receive compensation for them.
Lost Wages Benefits
Unlike medical benefits, the benefits you receive for lost wages are subject to a certain waiting period. Before receiving any benefits for lost wages, you must miss work, or be assigned to light duty work, for a total of seven days. The doctor who is treating you must confirm that you are unable to return to work at all, or cannot perform your normal duties and require lighter work. This period of delay applies regardless of the severity of your medical condition or the severity of your injury.
After you have waited the seven days, you may qualify for temporary disability payment benefits. If you are able to return to work between 8 and 13 days of the injury, you cannot recover your lost income for the first seven days of your injury. On the other hand, if you miss work or can only perform light duties for a minimum of 14 days, you can recover the lost wages from the first seven days of your injury and any other subsequent days that you could not work.
When Should You Receive Workers’ Compensation Benefits?
After satisfying the seven day waiting period, you will receive workers’ compensation benefits depending on the type of coverage you are receiving. These are as follows:
- Temporary total disability benefits: You will receive benefits for a temporary total disability every 14 days. The insurance company has 21 days to accept or deny the claim after they have received it. You will receive the first payment after the claim is accepted and processed.
- Temporary partial disability benefits: If you have suffered a temporary partial disability, you will receive payments every 30 days.
- Permanent partial disability benefits: If you will never make a full recovery from a work-related medical condition or injury, you can receive permanent partial disability benefits. These benefits are paid monthly.
- Death benefits: When an employee is involved in a fatal workplace accident, immediate surviving family members can receive death benefits under the workers’ compensation system. Death benefits are also paid monthly.
Regardless of the type of injury you sustained, the payment schedule will depend on the type of benefits you are trying to recover and when you file your claim. Generally speaking, the longest an employee will have to wait to receive benefits is about five weeks. This is the total amount of time between the seven-day waiting period before collecting lost wages benefits, and the first benefits for a temporary partial disability that will be paid 30 days after that.
What to Do if Your Benefits are Delayed
In the majority of cases, injured employees will start receiving benefits in the timeframes noted above. Unfortunately, this is not always the case. Those timelines depend on nothing going wrong with your claim, and things do not always go smoothly. There are a number of reasons a workers’ compensation claim may be denied. The most common of these include:
- The paperwork is incorrect or incomplete
- Disputes regarding the injury and whether it was work-related
- Insufficient medical evidence proving the nature and severity of the injury
- Disputes between employers and their insurance carriers
In some cases, the above delays are legitimate. For example, if your claim was not completed, the insurance company may send it back and ask for more information. This is a valid reason for your claim being denied. However, insurance companies and employers are known to delay workers’ compensation claims in bad faith, meaning they do not have a valid reason to delay your benefits.
It is important to know that you do have options if your claim is being wrongfully delayed. A workers’ compensation lawyer can advise on when you should start receiving benefits and provide the representation you need to obtain the benefits you need as quickly as possible.
Our Workers’ Compensation Lawyer in Arizona Can Help You Obtain Benefits Quickly
There are sometimes reasons why you may have to wait a certain period of time before receiving the benefits you need. However, waiting too long can result in paying significant out of pocket expenses, and perhaps not even obtaining the medical care you need if you cannot afford it. At Snow, Carpio & Weekley, PLC, our Arizona workers’ compensation lawyer can help you through the claims process so you obtain the benefits you need as quickly as possible and do not suffer additional harm. Call us or contact us online to schedule a free consultation and to get the legal advice you need.