This page provides answers to the following questions:
- I had an accident at work. How do I file a workers compensation claim in my state?
- Should my employer have workers compensation insurance? How do I know I am covered?
- What are the conditions that enable me or prevent me from claiming benefits under my state's law?
- What benefits might I be eligible to receive?
- How much time do I have to file my claim? What are the stages of the claim process? What should I expect?
- If I'm not happy with the determination, how do I appeal?
1. I had an accident at work. How do I file a workers compensation claim in my state?
If you are injured at work or receive a diagnosis that you are suffering from an occupational disease, notify your employer as soon as possible. If the situation requires, seek the appropriate medical attention necessary, especially in an emergency situation and be sure to notify the medical professional that you have suffered from a work-related accident.
2. Should my employer have workers compensation insurance? How do I know if I am covered?
In Nebraska, most employers working in the state are expected to obtain a private insurance coverage program to handle potential workers' compensation claims by their employees. This is expected of non-resident employers as well.
3. What are the conditions that enable me or prevent me from claiming benefits under my state's law?
Workers' compensation is a benefits system for employees who have been injured by an accident or occupational disease arising out of or in the course of their employment. The injury must not be the result of willful negligence and must have occurred in Nebraska or while doing work related to his employment in Nebraska. Workers' compensation applies to employers in the state who employ one of more employees in a regular trade, business, profession, or vocation. Virtually, all employees in the state are covered, with only a few minor exceptions (i.e. certain federal workers, household servants, independent contractors, certain individuals employed in the management of business organizations).
The workers' compensation system in Nebraska is designed to allow the employee to receive benefits from the employer so long as the employer has satisfied its legal obligation to secure potential compensation. This is usually facilitated by the employer purchasing an insurance policy. By accepting workers' compensation benefits, the employee waives his or her right to file a civil action against the employer for a claim relating to the injury or illness.
4. What benefits might I be eligible to receive?
You may be entitled to one or more of the following benefits, depending on the circumstances and extent of your injuries:
- Medical: You employer, upon accepting liability, is responsible for all reasonable medical expenses related to the care and treatment of your injury or condition. Expenses for travel may be included in certain circumstances. Your employer is given the initial right of selection in deciding which physician will provide you with medical treatment unless the employer authorizes you to make the selection yourself.
- Wage-Loss: Benefits paid to you if your injury or illness prevents you from working or receiving wages. They are paid to you on the same interval as you would have received your
- Total Disability Benefits: These are payments for lost wages calculated as roughly 2/3 of your average weekly wage. You are entitled to receive payments for as long as your physician provides you are unable to return to work due to your injury.
- Partial Disability Benefits may fall into one of the three categories:
- Temporary Partial Benefits: You are able to return to work after your injury, but not to the same extent or at the same capacity as you did previous to the accident. These are benefits calculated as 2/3 of the difference between your former wages and your current wages. You are entitled to these payments for a period of up to 300 weeks.
- Permanent Partial Loss of a Member Benefits: This is a payment made as compensation for the loss or loss of use of a body part. These are payments calculated as two-thirds (66.67%) of your wages multiplied by a statutory schedule giving value to the lost body part. A total loss or loss of use of two body parts in one accident is classified as total and permanent disability.
- Permanent Partial to the Body as a Whole: These are payments made for the degree of permanent loss or impairment caused to you as a result of your injury. The amount you are entitled to is calculated as two-thirds (66.67%) of your former weekly wages multiplied by the percentage of disability you suffer from. You are entitled to receive these benefits for a period of 300 weeks, less the number of weeks you receive or have received temporary and permanent disability.
- Death: If your injury results in your ultimate death, your surviving spouse is entitled to receive benefits calculated as roughly two-thirds (66.67%) of you average weekly wages for the period of your life, until the spouse gets remarried. If you leave behind children, your spouse will be entitled to receive seventy-five percent (75%) of your average weekly wages. Surviving children will be entitled to a percentage of the death benefit until they have reached the age of nineteen (19), or twenty-five (25) if they are enrolled in a full time accredited educational institution. Your surviving family may be entitled to receive approximately $6,000.00 to compensate for funeral expenses.
- Vocational Rehabilitation: These are services and opportunities you may elect to use to help you get job re-training in the event that you are unable to return to the kind of employment you engaged in prior to your injury. You are not required to engage in vocational rehabilitation in all circumstances; however, a vocational rehabilitation counselor may be appointed to your case and may submit to the court a vocational rehabilitation plan to help you move toward sustainable employment.
5. How much time do I have to file my claim? What are the stages of the claims process? What should I expect?
In the event that you are unsatisfied with your employer's or your employer's insurance provider's determination regarding your claim, you may contact the Nebraska Workers' Compensation Court to discuss possible avenues to resolve a dispute. Any party, you or your employer, may request an informal dispute resolution to settle issues of your claim. This resembles a mediation, where a neutral third party (a mediator) helps to steer both sides towards a mutually agreeable solution.
If an informal proceeding is unlikely to solve to issues involved, you may file a petition, essentially filing a claim for a lawsuit, with the Nebraska Workers' Compensation Court. You are not required to seek the assistance of an attorney, however it may be to your advantage to consult with one at the very least.
You have two (2) years from the time of your accident or the last date of received benefits payments to file a petition with the court. Failing to file your petition within this two year time period will preclude you from bringing a law suit.
After receiving your petition the Court will issues a summons to the opposing party. The opposing party has fourteen (14) days to provide an answer. After the answer has been made, a hearing will be scheduled and a judge will be asked to listen to the case. The judge will make a written determination about the merits of the case.
6. If I am not happy with the determination, how do I appeal?
If you are not happy with the judge's determination you may appeal the decision by submitting an Application for Review within fourteen (14) days of the date of the decision. The appeal is administered by a three-judge panel which will review the case and issue a decision.
If either party remains unsettled with the determination at this stage of the appeal, either party may appeal the case to the state court system- starting first with the state court of appeals.