Nebraska Workers Compensation Payments Motion to Continue Payments
Worker Frequently Asked Questions
Worker Frequently Asked Questions
What is workers' compensation?
What is workers' compensation?
If an employee is injured by accident or occupational disease arising out of and in the course of their employment, they may be entitled to workers' compensation benefits. Workers' compensation insurance covers the risk of an employee getting injured on the job. Workers' compensation is different and separate from unemployment compensation, Social Security disability benefits, health and accident insurance, or other disability benefit plans provided by the employer.
The Nebraska Workers' Compensation Act (the Act) is found at Section (§) 48-101 to § 48-1,118 of the Nebraska Revised Statutes (laws, written as "NEB. REV. STAT."). It provides the only avenue for employees to obtain benefits from their employer for their work-related injuries.
Who is covered by Nebraska workers' compensation?
Who is covered by Nebraska workers' compensation?
The Act applies to most employees. It does not apply to independent contractors. Most Nebraska employers are required to have workers' compensation insurance to make sure coverage is in place if employees are injured while working. Exceptions, such as for federal employers, can be found in N EB . R EV . S TAT . § 48-106.
Who May Be Entitled To Benefits?
Who May Be Entitled To Benefits?
An injured employee who is covered by the Act may obtain benefits:
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if the injury was caused by an accident or disease that arose out of and in the course of their employment and the injury occurred in Nebraska,
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the employer was performing work in Nebraska or the employment is in Nebraska, or
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the employee was hired in Nebraska and the employer is doing business or performing work in Nebraska, whether or not the injury occurred in Nebraska.
If an employee dies as a result of a work-related injury, the employee's dependents may be entitled to benefits under the Act.
What Benefits May Be Available?
What Benefits May Be Available?
The employer / insurer is liable to pay for all reasonable medical and hospital services, appliances, prescribed drugs, prosthetic devices, and other supplies along with mileage that are necessary as the result of a work-related injury. Medical benefits may include reasonable travel expenses in some situations. The mileage rates for allowable travel are listed in the Tables of Maximum/Minimum Compensation Benefits, Burial Benefits, and Mileage Reimbursement Rates on the Nebraska Workers' Compensation Court (court) website.
Choice of doctor . The employer must notify the employee that the employee has the right to choose a physician they or their family have seen as their primary treating physician. If the employee does not choose a physician, the employer may select the physician. More information about Choosing a Doctor for a Work-Related Injury can be found on the court's website.
An employer / insurer may also ask an injured employee to be examined by a doctor chosen by the employer / insurer at the company's expense.
The employee should promptly submit expenses for medical care to their employer or to the insurer for payment.
"Indemnity benefits" (also called "disability benefits") may be paid when an employee misses time from work or suffers permanent effects after a work-related injury. Employees may be entitled to temporary and / or permanent disability benefits.
1. Temporary Disability Benefits
Temporary disability benefits may be for either:
(a) total disability, or
(b) partial disability.
Temporary Total Disability Benefits . An employee may be entitled to temporary total disability benefits for as long as they are unable to work as a result of their injury. Temporary total disability entitles the employee to two-thirds of their average weekly wage, subject to the maximum and minimum benefit rate per week. More information can be found in the Tables of Maximum / Minimum Compensation Benefits, Burial Benefits, and Mileage Reimbursement Rates on the court's website.
Temporary Partial Disability Benefits . Benefits are paid when the employee is able to return to work but under limited circumstances such as for a few hours a day or at a job which pays less than the job held at the time of the injury.
Temporary disability benefits usually end when an employee has reached maximum medical improvement or has been released from medical care.
An employee is entitled to temporary disability benefits while participating in an approved vocational rehabilitation plan.
2. Permanent Disability Benefits
Permanent disability benefits may be either:
(a) permanent partial or permanent total disability of certain body parts listed in the Act ("scheduled" injuries) or,
(b) permanent partial or permanent total disability to the body as a whole.
Permanent Partial Disability for Loss of a Scheduled Body Part . Benefits are paid for the loss or loss of use of a body part such as a leg or hand based upon the value the Act assigns to various body parts.
Permanent Total Disability for Loss of Multiple Scheduled Body Parts . The total loss or total loss of use of two scheduled body parts in one accident is considered permanent total disability.
Permanent Partial Disability to the Body as a Whole . Benefits are paid for permanent disability resulting from a body as a whole injury, such as neck, back, or head. Generally, if the injured body part isn't included in the schedule of body parts, the injury is considered to be to the body as a whole. Typically, compensation for permanent partial disability to the body as a whole is compensated on the basis of loss of earning capacity. More information about Loss of Earning Power Evaluations in Nebraska can be found on the court's website.
Permanent Partial Disability for Loss of Scheduled Body Parts . When an employee has an injury to more than one scheduled body part, they may request that compensation be determined based on loss of earning capacity.
Permanent Total Disability Benefits . If an employee is permanently unable to return to the workforce as a result of their injuries, permanent total disability (PTD) benefits may be due.
3. Death Benefits
If the injury results in the death of the employee, the surviving spouse and other actual dependents may be entitled to death benefits. Additionally, burial expenses may be paid.
C. Return-to-Work Services (also known as Vocational Rehabilitation Benefits)
C. Return-to-Work Services (also known as Vocational Rehabilitation Benefits)
An employee may be eligible for return-to-work services (vocational rehabilitation benefits), such as job placement with the same or a new employer or formal training. Temporary disability benefits are paid while an employee is participating in a court-approved job placement or formal training plan.
These services are voluntary and, if not offered by the employer / insurer, the employee can request vocational rehabilitation services. An employee can contact their employer, the claims representative of their employer's insurer, or the court's Vocational Rehabilitation section to request return to work services. If it is determined that the employee will need vocational rehabilitation services, a court-certified vocational rehabilitation counselor can submit a plan of vocational rehabilitation services to the court for approval.
More information about return-to-work services can be found on the court's website.
Indemnity (wage replacement) benefits begin on the eighth calendar day of disability, after a seven-day waiting period. If disability (either temporary or permanent) continues for six weeks or longer, then benefits are payable for the waiting period. See NEB. REV. STAT. § 48-119. In that situation, benefits for the waiting week are paid after six weeks elapse after the accident.
Medical benefits may begin on the date of the work injury.
Return-to-work (vocational rehabilitation) benefits may begin when the employee has permanent impairment or restrictions and is unable to perform suitable work within their training and experience.
What should an employee do when they are injured at work?
What should an employee do when they are injured at work?
An employee should notify their employer of any work-related injury or occupational disease as soon as possible. After a work-related injury, the employee also should seek treatment for urgent medical issues and inform their treating physician that it is a work-related injury.
Can an employee obtain the name and contact information of the employer's workers' compensation insurer?
Can an employee obtain the name and contact information of the employer's workers' compensation insurer?
Yes. This information can be obtained by contacting the employer or the court. Insurance companies are required to report to the court each policy of workers' compensation insurance they issue. A small number of Nebraska employers are self-insured for workers' compensation.
You can find an employer's workers' compensation insurance coverage using the Coverage Lookup app on the court's website. The court's website also has a list of Self-Insured Employers .
How long does it take to receive compensation after the injury is reported?
How long does it take to receive compensation after the injury is reported?
Compensation payments for lost wages (indemnity) and medical expenses are typically paid within 30 days after notice of the injury. However, payment of benefits might be delayed if liability for the claim is disputed.
What happens if benefits are not paid on time?
What happens if benefits are not paid on time?
A 50 percent penalty may be added to indemnity benefits for waiting time if payment is not made within 30 days of the notice of injury or impairment. The 50 percent penalty is due if there is no reasonable dispute regarding the employee's claim for workers' compensation benefits. Waiting-time penalties may also apply when there is a failure to pay compensation after 30 days from the entry of a final order, award or judgment of the court.
When are permanent disability benefits paid?
When are permanent disability benefits paid?
After the employee has been released from medical treatment and has been placed at maximum medical improvement, permanent benefits may be payable. The employer / insurer may offer payment in a one-time lump sum or pay weekly benefits.
What may an employee do if the employer / insurer does not pay benefits?
What may an employee do if the employer / insurer does not pay benefits?
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Contact the Employer / Insurer . The employee or their attorney may contact the employer / insurer to discuss the benefits that may be due. You can find the insurer's phone number by using the Coverage Lookup app on the court's website or by calling the court's information line (800-599-5155 or 402-471-6468).
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Request Informal Dispute Resolution (mediation) . Any person involved in a workers' compensation claim may request informal dispute resolution (mediation) to help settle an issue or an entire case without the need for a formal hearing. This service is free of charge. To request informal dispute resolution, call the court's information line (800-599-5155 or 402-471-6468) and ask to speak with the mediation coordinator or complete the Informal Dispute Resolution Request Form on the court's website. More information about Informal Dispute Resolution and Mediation can be found on the court's website.
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Request an Independent Medical Exam . The court's Independent Medical Examiner process may provide a way to get unbiased answers to questions about an employee's medical condition or related issues when there is a disagreement. More information about Independent Medical Exams can be found on the court's website.
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File a Petition . The employee or their attorney may file a petition (lawsuit) with the court. Petition forms can be found on the court's website or obtained from the Clerk of the Court. Employees representing themselves in court are held to the same standards, laws, and rules as attorneys.
You are not required to have an attorney. It is up to you to decide if you want to hire an attorney. If you decide to hire an attorney, you will have to make those arrangements. The court does not provide or recommend attorneys. If you represent yourself, you will be required to follow all court rules, statutes, and procedures.
What do I need to know before going to court?
What do I need to know before going to court?
Can I choose my own doctor?
Can I choose my own doctor?
There are rules about whether the employee or employer chooses the doctor. The employee has the right to select a physician who has maintained the medical records of the employee (or an immediate family member) when the employer notifies the employee of this right. If the employee does not have or does not choose such a physician, then the employer may select the physician. If the employer does not give proper notice to the employee regarding the right of selection, then the restrictions on choosing and changing physicians do not apply and the employee has the right to select any physician. The employee also may select a physician to perform a major surgical operation or in cases involving dismemberment. "Physician" means any person licensed to practice medicine and surgery, osteopathic medicine, chiropractic, podiatry, or dentistry in the State of Nebraska or in the state in which the physician is practicing. Please refer to the court's pamphlet, Choosing a Doctor for a Work-Related Injury , for more detailed information.
What if I want to change doctors?
What if I want to change doctors?
If the doctor has been chosen by you or your employer after you were notified of your right to choose by your employer, you can't change doctors unless your employer agrees or the court orders a change. If you want to change, talk to your employer about the reasons. If your employer agrees, you may change. If your employer does not tell you about your right to choose a doctor, you may change doctors without your employer's agreement.
What if my employer won't agree to let me change doctors?
What if my employer won't agree to let me change doctors?
You can ask for Informal Dispute Resolution (IDR) from the court. You must first try to get your employer to agree to a change in doctors. If this doesn't work, you or your employer can ask for help through the IDR process. A court staff member will try to help you and your employer agree. If that doesn't work, a motion or petition (lawsuit) can be filed with the court.
What if my employer wants me to change doctors?
What if my employer wants me to change doctors?
You can't be made to change your treating doctor if the doctor was chosen by you or your employer after your employer notified you of your right to choose a doctor, unless you agree or unless the court orders you to change.
Can my employer make me see another doctor?
Can my employer make me see another doctor?
Your employer cannot make you receive treatment from another doctor, but your employer (or its insurer) can ask you to see another doctor for an examination. If you unreasonably refuse to be examined by this doctor you may not receive compensation for the time you refuse to be seen. You may be asked to see more than one doctor for other examinations.
What doctor should I see if it is an emergency?
What doctor should I see if it is an emergency?
If it is an emergency, see any doctor as soon as you can. The rules regarding choice and change of doctor don't apply until after the emergency is over. Then, if you need more treatment, the rules apply.
Which doctor do I see if my employer or the insurer has a managed care plan?
Which doctor do I see if my employer or the insurer has a managed care plan?
You can still choose a doctor. You can choose one who has treated you or a family member before your injury, if that doctor agrees to the rules of the plan . Otherwise, you may choose among the doctors signed up with the plan.
Who can receive return-to-work services (also called vocational rehabilitation)?
Who can receive return-to-work services (also called vocational rehabilitation)?
The goal of return-to-work services is to help you get back to work after your injury. If you are unable to return to the type of work you were doing, you may be entitled to return-to-work services.
What return-to-work services are available?
What return-to-work services are available?
A vocational counselor will be involved in providing return-to-work services. You will be asked to take an active role in meetings, evaluations, and putting together a return-to-work plan (RTW plan). A vocational counselor will talk to you about your prior jobs, schooling, work restrictions, and the type of work you would like to do. Based on this information, the vocational counselor will recommend a RTW plan. This RTW plan may provide help finding a new job, training to do a new type of work, or schooling that would lead to a new job. The vocational counselor will submit the RTW plan to the vocational section of the court for approval.
Who pays for return-to-work services?
Who pays for return-to-work services?
If the RTW plan is approved by the court and employer / insurer, your weekly benefits and medical expenses are paid by the employer / insurer. Expenses for mileage, transportation, tuition, school supplies, housing are paid by the court trust fund. Expenses paid from this fund require prior approval by the court. This fund does not cover things like child care expenses, internet services, or clothing.
What if there is a disagreement with the proposed RTW plan?
What if there is a disagreement with the proposed RTW plan?
If you do not agree with the RTW plan, you do not have to sign it:
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You can talk to the vocational counselor about changing the RTW plan.
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You can request voluntary mediation (also called IDR or Informal Dispute Resolution). A court mediator acts as a neutral third party to assist you and the employer in trying to resolve the dispute. However, the mediator is not a judge and does not issue an order at the end of the mediation.
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You or the employer / insurer can file a petition or motion with the court. If there is a trial, the judge will decide whether to approve the RTW plan.
If the employer / insurer does not agree with the RTW plan : The options are the same as above. The employee and employer / insurer can talk to each other, request mediation, or file documents with the court requesting the judge to decide whether to approve the RTW plan.
If you and the employer / insurer agree with the RTW plan, but it is not approved by the vocational section of the court : The options are the same as above. The employee, employer / insurer, and vocational counselor can talk to the vocational section of the court about why the RTW plan makes sense and is in your best interest, request mediation, or file documents with the court requesting the judge to decide whether to approve the RTW plan.
Source: https://www.wcc.ne.gov/workers/worker-frequently-asked-questions
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