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indiana occupational diseases

Don’t Let The Insurance Company DENY YOU Medical Care!

Workers’ comp carriers, more than ever, look for ways to avoid paying expensive treatment.  Whether you’ve been ordered to have an MRI, surgery, a spinal cord stimulator or pain treatment, be aware that the workers’ comp carrier may seek to avoid paying for these necessary treatments.  Tactics used by these carriers may include utilization review, a second medical opinion, a psychological evaluation or simply denying the treatment.

Don’t let the insurance company get away with denying you needed medical care!  Under the law in Indiana, the workers’ comp carrier MUST provide you with all necessary care as deemed medically needed by the attending physician.  If you need assistance, please contact our office.

If you would benefit from legal counsel, our office does not charge for a consultation.  We’re here to offer our experience to make sure you receive what you’re legally entitled.

Did you know that all Indiana Worker’s Compensation attorneys charge the same fees? The fees are set by Indiana law.  Under the Indiana Workers’ Compensation Act, attorney fees are limited to 20% of the first $50,000.00, and 15% of any remaining balance.

Klezmer Maudlin can only charge a percentage of any recovery received and never charge you an up-front fee for our services.  With limited exceptions, we also will collect our out-of-pocket expenses from the recovery and not from you. If you hire us with an offer already given to you, we will typically agree not to charge an attorney fee unless we recover additional money.  For example, if you hire us with an offer already of $5,000.00 and 3 months later we tell you we can only get you $5,000.00, we will typically not charge you.

We will discuss this in more detail at the initial meeting and put our agreement in writing. If you have any questions regarding our attorney’s fee, please contact us at 1-800-809-3776.

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Vocational Rehabilitation for Injured Workers

 

Vocational rehabilitation may be available to you as an injured worker if you are not able to return to the job you were doing before the work accident. However, the Workers’ Compensation Act does not require the employer to pay for this additional treatment. The Office of Vocational Rehabilitation [(317) 232-1319] can assist you with questions regarding this process.

Can I reopen my settled workers’ compensation claim?

 

According to Indiana law, as stated in the Guide to Indiana Workers’ Compensation, one may reopen a claim for the following reasons:

  • The light duty assigned by the employer is no longer available.
  • The injured worker becomes temporarily totally disabled (unable to work).
  • The injured worker suffers a condition change or the condition worsens due to the injury.
  • Impairment from the original injury is now evident.
  • Permanent partial impairment increased from what it was at the time of the original PPI settlement.

To reopen a claim due to any change in condition, directly related to the original injury, an Application for Adjustment of Claim (Form 29109) must be filed with the Workers’ Compensation Board within 2 years from the last date for which you were paid compensation. Compensation includes temporary disability income, a permanent partial impairment award, and permanent total disability income. It does not include the last date a medical expense was paid. Determining the precise date that compensation was last paid can be confusing, and an attorney should be consulted to assist in reopening a case.

Please note that there are time when a case cannot be reopened because of the type of settlement that was agreed upon. For instance, if you signed a Section 15 Settlement Agreement– a full and final settlement agreement– when you originally settled your claim, then you may not be able to reopen your case.

Asbestos Exposure and the Residual Asbestos Injury Fund

 

According to the Guide to Indiana Worker’s Compensation Benefits, the following must apply in order for a worker exposed to asbestos on the job to be eligible for benefits through the Residual Asbestos Injury Fund:

  1. The employee is permanently and totally disabled by the work-related asbestos injury:
  • On or after July 1, 1985, from an exposure to asbestos in employment before July 1, 1988

OR

  • Before July 1, 1985, from an exposure to asbestos in employment and files a claim for benefits from the Residual Asbestos Injury Fund before July 1, 1990
2. Is not gainfully employed because of the disability left by this work exposure injury
AND

3. Is not eligible for benefits under the Indiana Occupational Diseases Act

The worker must also be ineligible for benefits from Social Security Disability, disability retirement, third party settlements or other retirement benefits that are equal to or greater than 66 2/3% of his or her average weekly wage at the time of disablement*.

If, however, the other benefits that the injured worker is entitled to are less than 66 2/3% of his or her average weekly wage at the time of disablement, the worker may be eligible to receive from this fund that difference for up to 52 weeks.

Dependents are eligible to receive either the remainder of the asbestos fund benefits or $4,000, depending on which is greater, should the injured worker die before the benefits from this fund run out.

Similar to the Second Injury Fund, and in accordance with Indiana Code §22-3-11-4, at the end of the 52 weeks, the Worker’s Compensation Board may decide to give the exposed employee additional benefits in 52 week increments as long as the employee still meets the eligibility guidelines cited above.

*Please note that the time of disablement, or in this case when it was determined that the injured worker is disabled due to the asbestos injury, and time of accident, which is used to calculate disability pay for other injuries, are very different terms.

Time Limits for Filing a Claim under the Indiana Occupational Diseases Act

 

The Indiana Occupational Diseases Act defines disablement by an occupational disease as:

…becoming disabled from earning full wages at the work in which the employee was engaged when last exposed to the hazards of the occupational disease by the employer from whom he claims compensation or equal wages in other suitable employment…Indiana Code §223-7-9(e).

In short, disablement means a worker is unable to earn full wages due to an occupational disease.

Understanding the Law

The Indiana Occupational Diseases Act provides that a worker with an occupational disease may not receive benefits unless the occupational disease causes disablement within 2 years from the last date of exposure to the harmful chemical or substance. Thereafter, an injured worker has 2 years from the date of disablement to file an Application for Adjustment of Claim (Form 29109) with the Worker’s Compensation Board of Indiana.

Death Benefits

For occupational diseases that result in death, the worker’s dependents may be eligible for benefits if the death occurs no more than 2 years after disablement and if the dependents file an AAC (Form 29109) with the Board within 2 years after the date of death.

Radiation Exposure

With regard to radiation exposure, a worker must file an AAC with the Board within 2 years from the date the worker had knowledge or by the exercise of reasonable diligence should have known of the existence of the injury and its causal link to his or her place of employment.

Asbestos Exposure

As for asbestos inhalation injuries, the law sets the following time limits based on the date of last exposure:

  1. If the last date of exposure is before July 1, 1985, the employee has 3 years from this fate to file a claim.
  2. If the last date of exposure is on or after July , 1985 but before July 1, 1988, the employee has 20 years from this date to file a claim.
  3. If the last date of exposure is on or after July 1, 1988, the employee has 35 years from this date to file a claim.
Need More Help?

As you can see, all of these time limitations regarding Indiana occupational diseases can be very tricky. If there is a question as to whether you can still file an Application for Adjustment of Claim, you may want to consult with an Ombudsman or a qualified Indiana worker’s compensation attorney.

Worker’s Compensation and the Indiana Occupational Diseases Act

 

Similar to the Indiana Worker’s Compensation Act, the Indiana Occupational Diseases Act provides benefits to workers who suffer disablement by occupational disease arising out of and in the course of employment. The Worker’s Compensation Board of Indiana presides over these cases as well.

Burden of Proof on the Injured Worker

Like worker’s compensation claims, the burden of proof is on the injured worker to prove that exposure to harmful substances at work led to the occupational disease that caused disablement.

In other words, a clear connection needs to be made to show that the disease arose directly out of and in the course of the injured worker’s employment rather than through some other means. This connection is sometimes more difficult to establish in occupational disease cases because of the possibility that the employee was exposed to similar disease-causing agents outside of his or her work environment.

Example

Tom began having some breathing problems and went to see his family doctor. The doctor discovered that Tom had cancerous lumps on his lungs. Tom has worked around a lot of different chemicals during his 30 years in the factory, some of which are known to be cancer-causing agents. However, he has also bowled in a league every week for the last 20 years, and when at the bowling alley, he is around a lot of secondhand smoke.

Although many other details are needed in order to determine the direct cause of Tom’s cancer, this example shows how questions can easily arise concerning the direct cause of an illness due to exposure.

Proving Causation in Your Claim

The following points must be proven in any claim dealing with the causation of an occupational disease:

  • Exposure occured
  • The injured worker does indeed suffer from the alleged disease
  • An appropriate time period has passed between the exposure and the beginning of the disease
  • Scientific evidence exists to connect the chemical exposed to and the alleged disease
  • The amount of exposure was sufficient to cause the disease
  • The exposure occurred in a way that was capable of producing the disease
  • The injured worker was not equally exposed to other causes of the disease outside of the work environment

Doctors specialized in the areas will likely be called upon to answer these questions.