Workers’ compensation benefits are helpful, but you have to make a claim properly in order to get what you deserve
If you have a job, workers' compensation insurance will likely cover you if you become injured at work.
Each state has its own system for providing workers' compensation benefits to injured employees. Arkansas requires a business with three or more employees to carry workers' compensation insurance coverage.
The exceptions are:
maritime workers (different types of coverage apply)
- Agricultural farm labor
- Domestic employees
- Non-profit employees
- Employees of religious, charitable or relief organizations
Arkansas workers’ compensation law
Workers' compensation laws benefit both the employee and the employer.
If you're in an accident outside of work like a car accident, slip and fall, or suffer any other type of injury, you might file a personal injury lawsuit to recover costs. The basis for a personal injury lawsuit is that the plaintiff (injured person) must prove that the defendant (the person or entity being sued) was negligent in a way that caused the injury.
Workers’ compensation follows a different standard. You never need to prove fault or negligence to make a workers’ compensation claim.
To be eligible for an Arkansas workers’ compensation claim, you must prove:
- The injury happened while you were at your workplace; or
- The injury happened while you were not at your workplace, but you were engaged in duties for your job; or
- The injury developed over time because of conditions or activities of your job; and
- The injury cost you money.
Let’s break this down further.
You could be injured at work in two ways:
1. You experienced a specific accident or incident that caused your injury. This could be a trip or fall, an equipment-related accident, burn injury, or anything else that happened while you were at work. We know there are some dangerous jobs that have a higher likelihood of injuries, but anyone could be injured at work. If you work in an office and trip over a phone cord or slip on a puddle on your way to the bathroom, your injury would still be covered under workers’ compensation simply because you were in your workplace at the time.
You're also covered if your job requires you to travel to clients’ offices or homes, construction sites or other off-site locations. Wherever you happen to be, if you’re there to do your job, an injury would be covered by workers’ compensation.
What if my boss asks me to pick up lunch for the team and I get into a car accident on the way?
If you’re injured en route to or from work on an errand or task that your job requires or requests, your injuries are covered. Your commute to and from home is not covered.
2. You developed a condition or injury as a result of long-term exposure at work. You might have a job that results in a repetitive strain injury (RSI) like carpal tunnel syndrome or that leads to musculoskeletal disorders or pain in the back, neck, arms, shoulders or elsewhere.If you engage in heavy lifting or other motions that strain your body, you might not have an injury because of a specific accident, but it could develop gradually. Even if you have a sedentary job, you can suffer these kinds of injuries. People who sit at a desk in front of a computer configuration, or who repeatedly answer phones, or who drive long hours can suffer injuries from sitting in positions that don’t work for their bodies.
Other types of injuries develop gradually, too, like hearing loss or other complications from noise exposure or injury or illness from exposure to toxins or chemicals. You could even suffer illness from repeated exposure to allergens in the workplace.
Injuries that develop gradually can be more challenging to claim for workers’ compensation benefits because you’d need to prove that they’re the result of conditions at work. You need to prove that the illness is not caused by conditions outside of work, an underlying condition or even genetics.
That’s one reason why you need a qualified, experienced Arkansas workers’ compensation lawyer. Your lawyer knows how to calculate your exposure based on the number of hours you worked, the level of risk of the exposure as related to your injury, and other evidence to prove how the injury or illness happened.
Regardless of how you were injured, you’ll need to prove the existence of the injury and its financial cost.
You can't receive workers' compensation benefits if you suffer a minor injury that doesn’t require medical treatment or time off from work for recovery.
Types of benefits you can recover from an Arkansas workers’ compensation claim
Your Arkansas workers’ compensation insurance benefits should cover:
1. Medical treatment, including hospital or doctor visits, surgery, prescription medication, chiropractice services, ambulatory devices, prosthetics, diagnostics, and other expenses up to $10,000.
Your treatment can be covered for up to six months following the injury if you didn’t miss any time from work. If you are out of work recovering from your injury, your treatment is covered for six months following your return to work.
Your employer has the right to choose an initial treating physician, but you may petition your employer once to change to a physician of your choice;
2. Rehabilitative therapies like occupational or physical therapy;
3. Lost wages, which are calculated based on your level of disability. You can receive payments for lost wages beginning on the eighth day of your partial or total disability. You can receive compensation for the first seven days if you are disabled for more than 14 days;
4. Disability benefits if you’re unable to work.
If you qualify for total disability benefits, you could receive a weekly benefit of 66 ⅔% of your average weekly wage up to a maximum that is set annually by the state. If you have a temporary total disability, you can receive the benefit until you’re able to return to work. If you are permanently totally disabled, the benefits would continue for your lifetime.
If you are temporarily partially disabled, which means you may return to modified or part-time work at a rate that pays less than your wages prior to the injury, you can receive 66 ⅔% of the difference in your earnings. In other words, if you earned $400 per week before the injury and you earn $300 per week after the injury, the difference is $100. You could receive 66 ⅔% of $100, which is $66.66. Added to your wage of $300, you’d be earning $366.66 per week.
If you’re permanently partially disabled, or suffered a permanent impairment that is not a total disability, you can receive 66 ⅔% of your average weekly wage. The length of time you can collect this payment depends on the percentage of your body that is impaired. If you’re totally impaired, you may receive 450 weeks of benefits, which is a little more than 8.5 years. If you’re partially impaired, the number of weeks is reduced according to the percentage of your body that’s impaired.
Amputation and limb loss would entitle a worker to a higher weekly benefit, usually equaling the total disability rate. Arkansas has a specific schedule of rates for amputations; and
5. Survivor benefits for the dependent family members of a worker who died from a workplace-related accident or illness. If a permanently disabled worker or deceased worker’s survivors are eligible for payments that total more than $50,000, they would draw benefits from the Death and Permanent Total Disability Trust Fund, which was established in 1981. This fund can compensate a disabled worker up to $75,000.
Arkansas Code § 11-9-527 sets forth the benefits families can receive. Usually, workers’ compensation becomes a continuing wage benefit for a deceased worker. The family would continue to receive support as ⅔ of the worker’s original wages and up to $6,000 for funeral costs. You can usually receive support until the end of the benefit period for which the deceased person would have received benefits if they had lived.Family members who are eligible include (in this order of priority):
• A spouse, who can receive 35% of the weekly wage
• Each child can receive 15% if the deceased person had a spouse
• Each child can receive 15% and split an additional 35% among children if there is no surviving spouse
• Parents may receive 25% apiece
• Dependent siblings, grandchildren or grandparents can each receive 15%.
Benefit amounts might be reduced if the survivor was not wholly and actually dependent.
What to know about filing a claim for Arkansas workers’ compensation benefits
You must notify your employer immediately or as soon as you’re able to do so after your injury by completing Form N.
One of the major benefits to workers’ compensation is that you can begin to receive benefits quickly once your claim is accepted. If your employer doesn't file a claim on your behalf, you can use Form AR-C to file a claim to the Arkansas Workers’ Compensation Commission.
When visiting the doctor treating your injury or condition
- Be sure to provide an accurate and clear statement about how your injury or accident happened, and be consistent with previous accident reports and medical examination findings.
- Describe your pain, symptoms or other relevant information.
- Know your medical history. If you have had similar injuries previously, let the doctor know how this situation is different from the past.
- Ask the doctor your questions and voice your concerns.
How to appeal a denial or partial denial of benefits
If you believe that the insurer isn't providing the amount of benefits to which you are entitled, you need to hire an attorney and work with your lawyer to file an appeal.
Once an appeal is filed, the Commission might schedule you for a mediation. This involves the parties trying to reach a settlement with the help of a mediator, or a neutral third party. If you can't reach agreement, you would request a hearing before an Administrative Law Judge.
If you're still unsatisfied (and your lawyer agrees that you're not receiving the correct amount of benefits), you can request a review from the Workers' Compensation Commission. The final process would be to file an appeal with the Arkansas Court of Appeals.
Contact an Arkansas workers’ compensation attorney
Workers' compensation can be a tremendous help to an injured worker—but it can also be a complex process.
If your claim is easily and quickly resolved, you might not need to engage in lengthy negotiations. But if you were seriously injured and require ongoing or future treatment, if you've been left disabled or if the amount of benefits doesn't cover all of your costs, you need an experienced workers' compensation lawyer. A workers' compensation lawyer's fee structure is similar to that of a personal injury lawyer—they will receive a percentage of your benefit amount. However, the benefit of having a lawyer to make sure you’re receiving the correct benefits is generally far greater than the cost of trying to navigate the system on your own.
Once you accept a settlement, you can't go back for more if it's not enough. That's why it's important to have a lawyer review your case and make sure that the amount you're being offered is correct and will cover your expenses today AND in the future.
The basis for personal injury law is fairly straightforward:
If you're injured because of someone's negligence, then you're entitled to recover for your financial losses related to the injury.
The premise for the workers' compensation system is similar:
Your employer is required to have specific insurance that provides benefits if you're injured at work.