Indiana Workers Compensation Claims: Eligibility, Filing and Appeals
Indiana Worker’s Compensation requires all employers to carry worker’s compensation protection, even if they have only one employee. Executive officers, part time employees, students in on-the-job training, volunteer firefighters and EMTS, and recipients of Workfare are covered. Exempt employees who are not covered include railroad employees, real estate professional who work on commission, domestic employees who work in private residences, farm and agriculture employees, independent contractors, prisoners, scholarship athletes, and volunteers other then EMTs and firefighters.
Common Covered Work Related Injuries
Covered injuries include personal injury or death, by accident, arising out of the employment and in the course of employment. Injury or personal injuries refer only to accidental injuries and not to diseases. Accident means the injury was unexpected. Arising out of employment means there was a causal relationship between the injury and the job services or duties. In other words, there is a connection between the working condition and the injury. In the course of employment means that the injury or accident happened in a place where the employee would reasonably be expected to be in the course of his or her job. Occupational diseases that arise out of employment are also covered.
Intentional injuries by managers, supervisor or foreman are covered. If the injury is caused by assault or horseplay, it is only covered if the victim was innocent in the activity. Carpal tunnel and other repetitive stress injuries are covered if they can be medically proven to arise out of and in the course of employment. Injuries that occur in employee owned parking lots, entrances and exits, and when taking care of personal needs such as bathroom breaks are also covered. Heart attacks, hernias, heatstroke, sunstroke and psychological injures are also covered if the injury occurred out of or in the course of employment. Finally, employees eating lunch on the employer’s premises are usually covered.
If an employee deviates from work activities or from a route while off the premises, the injury may be not found to be in the course of employment. Injury that occurs while intoxicated is not covered. Voluntary attendance at work social functions is not covered unless there was some employment benefit to be gained form attending or attendance was not mandatory.
How to file an Indiana Workers Compensation Claim
You must notify your employer of injuries that occur. Your employer will refer you to a designated physician to receive care for your injuries. Your employer then must file the Employer’s Report of Injury, Form 24401, with the Worker’s Compensation board. Your employer then has 29 days to begin making payments, or notify you of a denial in writing. If you are notified in writing of a denial, you can appeal your claim.
Workers Compensation Claim Denials
Common reasons for denial include questions as to whether the injury occurred in the context of employment. Other potential reasons include failure to support your claim with appropriate documentation and/or failure to provide proper notice to your employer of your injury.
Appealing an Indiana Workers Compensation Denial
Your employer must provide you notice of denial within 29 days of learning of the injury. At this point, you may be able to mediate your dispute with help from the Ombudsman division of the Worker’s Compensation Board. Mediation is voluntary.
If you do not wish to mediate your dispute or are unable to come to an agreement, you can request a formal hearing from the Worker’s Compensation Board. To request a hearing, you must file an Application for Adjustment of Claim with the Worker’s Compensation Board. You must send three copies of the application by regular mail, certified mail, or in person. The appeal must be filed within two years from the date of injury.
When your application is received, a case file will then be opened and a member of the Worker’s Compensation Board will be assigned to your claim. Hearings are informal, but standard rules of evidence generally apply. You may be asked to provide evidence and documentation of your disability. A final decision will be provided in writing.
If you wish to appeal the finding of the worker’s compensation judge, you can appeal to the Full Worker’s Compensation Board by filing an application for review within 30 days of the original hearing. The Full Board reviews cases seven times annually and reviews evidence presented at the original haring only. You may be able to make an argument or file a brief to support your case, but cannot present new evidence.
If you wish to appeal a decision by the Full Board, you can submit an appeal to the Indiana Court of appeals within 30 days of receiving a final decision from the Board.
Collecting Indiana Workers Compensation Benefits
Benefits include medical care, disability payments, and death benefits. Medical care includes payment of medical expenses reasonably related to the injury. The employer can mandate that you obtain medical care from a specific physician, and you must go to that physician as long as the care is reasonable.
Temporary total disability is paid for a maximum of 500 works if you are unable to work. Temporary total disability benefits are calculated at 2/3 of your average weekly wage. Temporary partial disability is paid at 2/3 of the difference between your pre-injury wages and post-injury wages. Temporary benefits begin if you are unable to work for 8 days. If you are still unable to work 22 days after injury, then the first 8 days of lost wages will also be paid.
Permanent total disability is paid if you are permanently unable to work. You are paid or 500 weeks at 2/3 of your average weekly wage. The maximum amount of permanent total disability benefits to be paid are $75,000. If you are permanently impaired but unable to work, you are paid according to a schedule of payments designed to compensate for the loss of a particular body part or bodily function.
Disability payments are paid biweekly. They are not taxed.
Hiring an Indiana Workers Compensation Lawyer
While you are not required to hire an attorney, employers are required to be represented by legal council at dispute hearings. Therefore, it may be advisable for injured workers to also obtain legal council in order to be prepared for the hearing. A worker’s compensation attorney can assist you in filing claims or disputes, and in presenting your case for benefits.
Indiana Workers Compensation Office Locations
Worker's Compensation Board of Indiana
402 West Washington Street Room W-196
Indianapolis, Indiana 46204