Guide to Benefits and Claims Filing
IF YOU ARE HURT OR INJURED AT WORK:
CLAIM FORMS - To be filed by the employer, insurance carrier or third party administrator are:
IN GENERAL - These conditions must exist to entitle
an injured employee to benefits under the Alabama Workers' Compensation
WAITING PERIOD - In cases of temporary total or temporary
partial disability, no compensation shall be allowed for the first three
days after disability, nor in any case, unless the employer has actual
knowledge of the injury or is notified thereof within the period specified.
Compensation shall begin with the fourth day after disability, and in
the event the disability from the injury exists for a period as much
as 21 days, compensation for the first three days after the injury shall
be added to and payable with the first installment due the employee after
the expiration of the 21 days.
EXCEPTIONS - Circumstances which may negate an employee's
claim for benefits:
WEEKLY COMPENSATION BENEFITS - Weekly compensation
benefits for injury and death claims are computed as follows:
For injury claims, multiply the employee's average weekly earnings for
52 weeks prior to injury by 66 2/3%. Benefits cannot exceed maximum benefits
in effect on date of injury. The State's
Average Weekly Wage is determined in accordance with Section 25-5-68.
For death claims, multiply the employee's average weekly earnings prior
to the accident by 50% if the employee has one dependent, or by 66 2/3%
if the employee has two or more dependents. Death benefits are subject
to maximum and minimum in effect on date of injury. If the deceased employee,
at the time of his or her death, has no dependents, then within 60 days
of his or her death, the employer shall pay a one-time lump sum payment
of $7,500 to the deceased worker's estate.
In no case can weekly rate of compensation be less than the minimum
compensation which was in effect at the time of injury, unless the average
weekly earnings of the injured employee were less than that minimum.
In such case, 100% of the injured employee's average weekly earnings
LIMITATIONS - The following types of claims cannot exceed the time period shown:
STATUTE OF LIMITATIONS - All claims for compensation
shall be barred unless within two years from the date of the accident
a verified complaint is filed in the courts. Where payments of compensation
have been made, such complaint must be filed within two years from the
date of the last compensation payment. (The word "compensation" does
not include payments made for hospital, medical, and surgical treatments.)
BURIAL EXPENSES - In the event of the death of the
injured employee, the employer shall be responsible for paying an amount
not exceeding $3,000 toward the burial expenses. This liability is not
reduced by reason of private burial insurance carried by the deceased.
HOSPITAL, MEDICAL, SURGICAL TREATMENT - In addition
to weekly compensation payments to the employee or his dependents, the
employer is responsible for the payment of reasonably necessary medical,
surgical and chiropractic treatment and attention, medicine, medical
and surgical supplies, crutches, artificial members, and other apparatus,
as may be obtained by the injured employee during the disability.
The employer will select the treating physician at the time of the accident.
If the employee is dissatisfied with the initial treating physician selected
by the employer, and if further treatment is required, the employee may
so advise the employer, and be entitled to select a second physician
from a panel or list of four physicians selected by the employer.
NOTE: If the injured employee refuses to comply with any reasonable
request for examination, or refuses to accept the medical service or
physical rehabilitation which the employer elects to furnish, the employee's
right to compensation shall be suspended and no compensation shall be
payable for the period of such refusal.
FILING OF CLAIM BY EMPLOYEE - A claim is filed by properly
notifying the employer of the accident and the injury, and by making
application to the employer for benefits. If the employer declines to
accept liability, the employee may call the Workers' Compensation Division
and ask to speak to an Examiner, or the employee has the right to obtain
the services of an attorney to handle the claim in the courts as provided
by the law. The Judge of the Circuit Court shall fix the fee of the attorney
and its manner of payment upon hearing the case. Fees of attorneys cannot
exceed 15% of the amount of compensation awarded or paid.
THIS IS DISTRIBUTED FOR INFORMATIONAL PURPOSES ONLY. IT IS NOT TO BE CONSTRUED AS, NOR DOES IT HAVE THE EFFECT OF LAW OR REGULATION. ADDITIONAL INFORMATION MAY BE OBTAINED FROM: