The period after a serious injury can be confusing with many questions about how to get medical care and how to pay your bills, among other questions. We can help. We can answer your questions and explain your rights. Below, we answer many of the questions frequently asked by injured truckers.
The trucking company denied my workers’ compensation claim, but I still have injuries that prevent me from returning to truck driving. How can I get further medical treatment?
The first option is to submit medical bills to your personal health insurance or employee group plan, if applicable. While workers’ compensation is the primary payer, once a formal denial is received from workers’ compensation, health insurance should pick up coverage. If you are married, contact your spouses’ health insurance carrier to see if they will cover your treatment. If you are a veteran, contact your local VA to determine whether you have medical benefits. If none of these options work, contact your state department of Health and Human Services to determine if there is any state aid available to assist you in your situation. It will also likely be necessary to file a workers’ compensation petition to determine your entitlement to medical and/or indemnity benefits.
If the trucking company denies my workers’ compensation claim, will Medicare or Medicaid pay my medical bills?
If you are Medicare or Medicaid eligible, Medicare and Medicaid will pay your medical expenses in most instances. However, there are a number of complications. If your injuries were caused by the negligence of someone with insurance, Medicare and Medicaid may refuse to pay your medical bills until you have tried to collect the medical bills from the negligent person or his or her insurance company. Sometimes, this results in a long delay where the medical bills are not paid. If Medicare or Medicaid does pay the medical bills, they usually require you to sign an agreement that you will reimburse them if your medical bills are later paid by the negligent person or his or her insurance company. Under some circumstances, it is possible to pay Medicare and Medicaid less than the full amount.
I am currently not trucking due to a work injury, and workers’ compensation is covering all of my medical bills. My employer has offered me COBRA, should I take it?
If you are off of work for a work injury for an extended period of time, many employers, after a certain date, will deem you a voluntary quit status (or other similar wording), so that they are not obligated to continue your employment benefits. COBRA allows you to continue you health insurance coverage, even after your employer has discontinued paying for it. While the COBRA premiums can be very expensive, we typically advise clients to continue to pay for health insurance through COBRA, if at all possible, so that they and their families are protected.
If I am injured in a highway accident by a negligent driver, and my trucking company denies my workers’ compensation claim, will the negligent driver’s car insurance pay my medical bills?
If the driver of the other vehicle was at fault or partially at fault in causing your injury you may be able to recover damages from the insurance company of the other driver. Most states require that every owner of an automobile have a minimum amount of insurance (usually around $25,000.00) to cover each person injured in an accident.
Sometimes the insurance company of the other driver will voluntarily pay your medical bills and your lost wages in installments and delay the final settlement until the amount of your total damage is known. However, most insurance companies will delay making any payment until the final settlement at which time they will require that you release them and the other driver from any further liability. If the insurance company delays any payment, this can cause a great hardship to the injured trucker. It may even interfere with your medical care if you do not have other insurance to pay your medical bills.
If I am injured in a highway accident, are my medical bills covered under my own car insurance policy.
If the truck you are in has insurance and if that policy has medical payments coverage, then the insurance company insuring the truck that you are in may have to pay your medical bills. You have to pay an extra premium for medical payments coverage, and not every policy includes this benefit. Also, the amount of medical bills that must be paid is limited. Look at the policy to see whether medical payments coverage is included and the limit on payment of medical bills.
Also, you may have medical payments coverage under your own insurance policy. You are entitled to recover medical payments coverage under your own policy even if you are not in your car at the time you are injured. For example, if the truck in which you were injured has medical payments coverage and you also have medical payments coverage on your own vehicle, you may be able to recover under both policies if your medical bills are more than the limit of one of the policies.
If I am injured in a highway accident by a negligent driver, and the negligent driver is uninsured, will my car insurance policy cover my medical bills.
Most states require every owner of a vehicle to carry some insurance on his vehicle, including uninsured motorist coverage. In uninsured motorist coverage, your insurer agrees to pay you certain benefits if you are injured because of carelessness of another driver who does not have insurance. The uninsured motorist coverage must pay your medical bills and lost wages. In addition, it may be responsible for pain and suffering and other intangible human damages.
Also, you can purchase additional insurance coverage at an additional premium, called underinsured motorist coverage. If the other driver has insurance but it is not enough to cover your medical bills and other damages, you may be able to recover additional damages from your own insurance company under the underinsured motorist coverage. There are a number of legal issues involved, and you should contact an attorney for further advice.
What weekly disability payments will I receive?
Your weekly disability payment is called a temporary total disability (TTD) payment. The TTD payment is usually some percentage (usually around 66%) of your average weekly wage, subject to a cap setting the maximum payment required. There are many alternate rules for calculating the average weekly wage if this simple formula does not apply. Generally, you have a right to continue to receive the weekly benefit as long as you are disabled from working at your old employment and still receiving medical care.
What benefits will I receive for my permanent injury?
If you have an injury with a permanent impairment, you are entitled to benefits for the impairment even if you can continue working. For example, you may have a back injury that allows you to continue to work but causes restrictions such as lifting, bending, or twisting. The amount of the disability award is determined by a combination of an impairment rating (given to you by a doctor), your average weekly wage and the part of your body that is injured. For example, if you have an injury to the right arm and a disability rating of 25%, your permanent disability payment can be calculated using that rating plus your average weekly wage.
The treating doctor, selected by your employer, may give you an impairment rating, when your medical care is completed. You are not bound by that rating and you have a right to a second opinion, but you must pay for the second opinion. Most doctors do not perform Workers’ Compensation disability evaluations, and it is usually necessary to retain an attorney who will send you to a doctor that regularly does Workers’ Compensation ratings. Also, the attorney will usually advance the cost of the examination and be reimbursed when your case settles.
The amount of the permanent disability payment can usually be settled by reaching a compromise. If a compromise cannot be reached, then a hearing will be held so the Judge can decide on the amount of your disability.
Can I file a personal injury lawsuit against my employer instead of collecting Workers’ Compensation benefits?
Generally the answer is no, but there are limited circumstances in which a negligence action can be brought against the employer or fellow employees. The most common circumstance is when the employer is not covered by the Workers’ Compensation statute (which is sometimes the case with small companies). The other exceptions that allow a negligence suit against an employer or fellow employees are limited and complex. To be safe, you should always ask an experienced attorney if there is a possible negligence claim.