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Mississippi Workers Compensation Claims: Eligibility, Filing and Appeals
In Mississippi, employers with five or more employees are required to have Workers' Compensation Insurance. Exceptions exist for independent subcontractors, certain farm and domestic employment, and certain federal workers. Insurance is paid for by employers, and the rules and regulations regarding state Workers' Compensation laws are supervised by the Mississippi Workers' Compensation Commission. In 2008, there were 11,720 claims filed in Mississippi where employees missed work for 5 or more days.
Common Covered Work Related Injuries
In Mississippi, injuries are covered by Workers' Compensation if they arise “out of the course and scope of employment.” Accidental injuries and disfigurements which happen on the job are covered, as are injuries which develop slowly over time. Work related fatalities are also covered, as are occupational illnesses and diseases that are deemed work related, such as respiratory illnesses due to exposure to toxic chemicals. The course and scope of employment may also cover injuries sustained when traveling as part of a job, though not while traveling to and from work.
How to File a Mississippi Workers Compensation Claim
When a worker is injured, they should report the injury to their employer as soon as possible. The employer should then fill out an Employer's First Report of Injury or Occupational Disease form and submit it to their insurance carrier and also to the Workers' Compensation Commission if the injury results in lost time over five days. An employee is entitled to seek out a medical professional of their choice to receive treatment, though insurance carriers may also request an exam by their own selected doctor.
Workers Compensation Claim Denials
Most claims are accepted and paid, however denials do occur. Claims may be denied if certain paperwork is not correctly filed. Claims may also be denied if the injury or illness is found to not be related to workplace activity, or if the disability is not as severe as claimed. Claims may also be denied if a worker refuses to see a doctor.
How to Appeal a Mississippi Workers Compensation Denial
An employee should first contact the insurance company and discuss the denial. If a resolution cannot be reached, they may then contact the Mississippi Workers' Compensation Commission and speak to a Claims Representative. The matter may then be scheduled for mediation. Mediation may often resolve the matter. If not, a hearing may be requested by filing a Petition to Controvert form with the commission. Appeals of court decisions must be filed with the Commission within 20 days.
Workers Compensation Benefits
Wage loss benefits are not paid until an employee has missed more than five days of work. Payments will then be made at least once every two weeks. Payments may depend on the type of disability, but are generally about two thirds of an employee's average weekly wage. As of 2007, payments may not exceed $387.68 per week, and the maximum overall limit is $174,456. Death and permanent and totally disabled benefit payments may not exceed 450 weeks.
Consulting with an Attorney
The specific rules and regulations regarding Mississippi Workers' Compensation law are complex and confusing, and an attorney should be consulted if there is any question about the benefit claims process. Attorneys may be able to negotiate a settlement in the event of a disputed claim, and will also file all necessary paperwork.
Mississippi Workers Compensation Office Locations
Mississippi
Workers Compensation Commission
Street
Address:
1428
Lakeland Drive
Jackson,
Mississippi 39216
Mailing
Address:
Post
Office Box 5300
Jackson,
Mississippi 39296-5300
(601)
987-4200
