Worker's Compensation Law Book

About the Author     xi
Introduction     xv
Overview of Workers' Compensation
In General     1
Historical Background     2
Advent of Workers' Compensation     2
Purpose     3
Federal Workers' Compensation Programs     3
The Federal Employees' Compensation Program     4
The Longshore and Harbor Workers' Compensation Program     5
The Black Lung Benefits Program     5
The Energy Employees' Occupational Illness Compensation Program     6
Additional Federal Disability Programs     6
The Federal Employment Liability Act     6
The Merchant Marine Act     6
Veterans' Disability Programs     7
Social Security Disability Insurance     7
State Workers' Compensation Programs     7
Type of Insurance Coverage Required     7
Compulsory Laws     7
Elective Laws     8
Purchasing Workers' Compensation Insurance     8
State Insurance Funds     8
Private Insurance Carriers     8
Self-Insured Employers     8
Eligibility for Workers' Compensation Benefits     8
Financing     9
ProgramAdministration     9
Reporting Requirements     10
Time Limits     10
Payment of Compensation     10
Employer Immunity     11
Exceptions to Employer Immunity     11
Retaliation     11
Disability Discrimination     11
Disability Benefits for Workers Who Suffer Non-Employment Related Injuries or Illnesses     12
Types of Disability Policies     12
Private Insurance     12
Government Insurance     13
Coverage     13
Short-Term Disability Insurance     13
Long-Term Disability Insurance     13
Employer-Provided Group Disability Insurance     13
Mandatory State Disability Programs     13
Third Party Liability     14
Statute of Limitations     14
Proving Negligence     14
Duty     14
Breach of Duty     15
Foreseeability     15
Proximate Cause     15
Damages     16
Document the Accident     16
Retain an Attorney     17
Maintaining A Safe Workplace     18
Statistics     18
The Occupational Safety and Health Administration     18
Employee Rights Under the Occupational Safety and Health Act     19
Filing a Complaint with OSHA     20
Whistle Blower Protection     21
Safety Initiatives     21
Filing the Workers' Compensation Claim
Types of Workers' Compensation Claims     23
Injury Claims     23
Causal Relationship     24
At the Place of Employment     24
Off-Site Injuries     24
Personal Activities     24
Lunch and Coffee Breaks     25
Travel Time     25
Disfigurement Claims     25
Occupational Disease Claims     25
Causal Relationship     26
Continuous Trauma     26
Schedule of Diseases     26
Medical Documentation     27
Aggravation of Pre-Existing Condition     27
Eligibility Restrictions     28
Occupational Hearing Loss     28
Death Claims     29
Filing the Workers' Compensation Claim     29
Notice to the Employer     30
Filing the Claim Form     30
Denial of Coverage     31
The Workers' Compensation Hearing     31
Legal Representation     31
Findings and Award     32
Settlement     32
Right to Appeal     32
Workers' Compensation Benefits
In General     33
Wage Loss Compensation     33
Percentage Based on Weekly Earnings     33
Length of Time Compensation is Payable     34
Extent of Disability     34
Temporary Total Disability     34
Permanent Total Disability     35
Temporary Partial Disability     35
Permanent Partial Disability     36
Scheduled Disabilities     36
Medical Benefits     36
Rehabilitation Benefits     37
Federal-State Vocational Rehabilitation Program     38
Subsequent Injury Funds     38
Death Benefits     39
Offset Provision Under the Social Security Amendments     39
The Federal Employees' Compensation Program
In General     41
Covered Employees     41
Types of Federal Workers' Compensation Claims     42
Traumatic Injury Claims     42
Occupational Disease or Illness Claims     42
Death Claims     43
Benefits     43
Wage Loss Compensation      43
Temporary Disability     43
Permanent Disability     44
Cost of Living Increases     44
Attachment and Garnishment of Compensation Payments     44
Medical Benefits     44
In General     44
Seek Immediate Medical Attention     45
Choosing a Physician     45
Covered Medical Providers     45
Submit Timely Medical Bills     46
Vocational Rehabilitation     46
Survivor Benefits     46
Termination Provisions     46
Burial Expenses     47
Filing A Claim Under the Feca     47
Legal Representation     47
Written Notice Requirement     47
Written Notice of a Traumatic Injury     48
Written Notice of Occupational Illness or Disease     48
Establish the Necessary Elements of the Claim     49
Required Proof - Causal Relationship     49
Time, Place and Manner     49
Medical Evidence     49
Performance of Duty Requirement     50
Lunch and Break Time     50
Recreational Activities     50
Travel Time     50
Continuation of Pay Claim      51
Time Limits in Adjudicating a Federal Compensation Claim     51
Injured Employees     51
Occupational Disease     51
Appeal Rights     52
Penalties for Filing a False Claim for Compensation     52
Return to Work Provisions     53
Recurrence of a Work-Related Disability     53
OWCP Right to Reimbursement from Third Party Claim Recovery     54
Privacy Rights     54
The Longshore and Harbor Workers' Compensation Program
In General     55
Covered Workers     55
Excluded Workers     56
Filing A Claim     56
Benefits     57
Monetary Benefits     57
Permanent Total and Temporary Total Disability     58
Permanent Partial Disability     58
Temporary Partial and Non-Scheduled Permanent Partial Disability     58
Permanent Partial Disability for Retirees     58
Medical Benefits     58
Vocational Rehabilitation     59
Death Benefits     59
Surviving Spouse     59
Children     59
Other Eligible Survivors     59
Termination Provisions     59
Funeral Expenses      60
Alternative Dispute Resolution     60
The Black Lung Benefits Program
In General     61
The Division of Coal Mine Workers' Compensation     62
Insurance Requirement     62
The Black Lung Disability Trust Fund     62
Filing A Claim Under the Black Lung Act     63
Claims Processing Procedure     63
Development of Evidence     63
Determination of Claim     64
Notice of Claim     64
Submission of Additional Evidence     65
Development of Evidence by the Claimant and the Responsible Operator     66
Evidence Regarding Liability     66
Medical Evidence     66
Claim Review     67
Informal Conference     67
Proposed Decision and Order     68
Administrative Hearing     69
Reconsideration and Appeal     69
Final Decision     69
Benefits Under the Black Lung Act     70
Monetary Benefits     70
The Black Lung Monthly Benefits Rate for 2007     70
Part-B Black Lung Monthly Benefit Rates     70
Part-C Black Lung Monthly Benefit Rates     70
Medical Benefits     71
Diagnostic Testing     71
Medical Coverage     71
Death Benefits     71
The Energy Employees' Occupational Illness Compensation Program
In General     73
Eligibility     73
Survivorship Rules     74
Part B Benefits     75
Lump Sum of {dollar}150,000 and Medical Expenses     75
Lump Sum of {dollar}50,000 and Medical Expenses     75
Part E Benefits     76
Variable Compensation     76
Wage Loss     76
Impairment     76
Survivorship     77
Filing A Claim     77
The Claims Process     78
Lump Sum Payment     79
Obtaining Medical Benefits     79
Additional Federal Disability Programs
The Federal Employment Liability Act     81
Damages     81
Filing a Claim     82
Settlement     83
The Merchant Marine Act     84
Covered Employees     84
Requirements for U.S. Flagged Vessels     84
Workers' Compensation Provisions     84
Veterans' Disability Programs     85
Disability Compensation     85
Eligibility     85
Amount of Benefits     85
Applying for Disability Compensation Benefits     86
Related Benefits     86
Disability Compensation for Sexual or Personal Trauma     86
Eligibility     87
Amount of Benefits     87
Applying for Disability Compensation Benefits     87
Disability Pension     87
Eligibility     87
Amount of Benefits     88
Applying for Disability Pension Benefits     88
Related Benefits     88
Vocational Rehabilitation     88
Eligibility     89
Amount of Benefits     89
Applying for Vocational Rehabilitation Benefits     89
Related Benefits     89
Housing Assistance for Disabled Veterans and Military Personnel     90
Burial Benefits     90
Dependents and Survivors Benefits     90
Health Care Services     90
Service-Disabled Veterans Insurance     91
Benefits for Selected Reserve and National Guard Members     91
Active Duty Service     91
Non-Active Duty Service     91
Compensation     91
Medical Care     91
Vocational Rehabilitation      92
Social Security Disability Insurance     92
Appendices
Directory of Office of Workers' Compensation Programs (OWCP) District Offices     93
The Federal Employees' Compensation Act-Selected Provisions     97
The Longshore and Harbor Workers' Compensation Act-Selected Provisions     119
The Black Lung Benefits Act-Selected Provisions     143
Directory of State Workers' Compensation Boards     155
Type of Insurance Required Under State Workers' Compensation Laws     161
Workers' Compensation Coverage Requirements for Agricultural and Domestic Workers     165
Directory of Occupational Safety and Health Administration (OSHA) Offices     169
Jurisdictions Providing Disfigurement Benefits     173
Availability of Benefits for Occupational Hearing Loss     177
Death Benefits for Surviving Spouses and Children     181
Maximum Burial Allowances     185
Employee's Statement of Rights Under the New York State Workers' Compensation Program     189
Employee's Claim for Compensation Under New York State Workers' Compensation Program     191
Allowable Attorney Fees Under State Workers' Compensation Laws     193
Waiting Period for Benefits Under State Workers' Compensation Laws     197
Retroactivity of Benefits Under State Workers' Compensation Laws     201
Percentage of Wages Payable for Temporary Total Disability Under State Workers' Compensation Laws     205
Percentage of Wages Payable for Permanent Total Disability Under State Workers' Compensation Laws     209
Percentage of Wages Payable for Permanent Partial Disability Under State Workers' Compensation Laws     213
Choice of Physician Rules Under State Workers' Compensation Laws     217
Workers' Compensation/Public Disability Benefit Questionnaire (Form SSA-546)     221
Federal Employee's Notice of Injury and Claim for Compensation (Form CA-1)     225
Federal Employee's Notice of Occupational Disease and Claim for Compensation (Form CA-2)     231
Claim for Continuance of Compensation Under the Federal Employees' Compensation Act (Form CA-12)     237
Notice of Employee's Injury or Death Under the Longshore and Harbor Workers' Compensation Act (Form LS-201)     241
Directory of Black Lung District Offices and Jurisdictions Served     245
Directory of Energy Employees Occupational Illness Compensation Program District Offices     247
Directory of Energy Employees Occupational Illness Compensation Program Resource Centers     249
Claim for Benefits Under the Energy Employees' Occupational Illness Compensation Act (Form EE-1)     251
Glossary     255
Bibliography and Additional Reading     269