The amount of compensation is generally determined by a state mandated schedule based upon loss of earning power together with payment for a specific loss of use of limbs or a percentage of loss for the entire body. The laws also provide for payment of casually related, reasonable, and necessary medical expenses, including surgical and hospital services, medicine, physical therapy, psychological therapy, and prosthetic devices. An employer must be creative and thorough when analyzing workers compensation cases. In general, the employer must make sure that the claimant is credible and that his or her medical expert has a sound basis for an opinion of causation. In addition, the employer must always make sure that the claim was filed in a timely manner, that notice was given, and that all statutory requirements have been complied with.
Most states also require that an employer file a timely answer.
Thus, if an answer is not filed timely, the employer cannot contest issues such as causality or whether an actual workers compensation injury occurred. In light of the social intent of the legislation, it is imperative that an employer remain creative and vigorous in the defense of these claims. Because of the diversity in workers compensation laws, the following general framework of considerations can be applied. However, these general rules may be modified depending on the state in which the claim is filed. The first consideration should always be jurisdiction.