Documenting wage loss
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Most people understand that they can submit a claim to an insurance company for medical expenses and damage to a vehicle.
Did you know, though, that you can also submit a claim to the insurance company for the at-fault party to recover earnings and benefits that you lost as a result of an accident?
What is included in wage loss claims?
Whether you are an employee or self-employed, you can claim lost wages or income, overtime, bonuses, commissions, and any benefits you used.
Benefits might include vacation or sick time, contributions to a 401K or pension plan, and so on.
Benefits of Personal Injury Protection Coverage
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Recovering lost wages at the end of the case from the insurer for the at-fault party does not help when you have bills to pay today.
Understanding PIP benefits
When you are buying a new automobile insurance policy, insurance agents may not fully explain PIP coverage. Even when you are renewing and checking coverage, you might start questioning provisions of the policy. For those who are trying to save money, PIP coverage might seem like an expense that might not be necessary since you may already have health insurance through your employer.
That’s why it’s important to understand the benefits of Personal Injury Protection (PIP) coverage, particularly the benefits for medical expenses.
This article focuses on the differences between PIP coverage in the state of Washington versus the state of Oregon.
What does PIP cover?
The Personal Injury Protection (PIP) coverage in an automobile insurance policy includes provisions for:
- Medical expenses
- Wage loss
- Essential services
PIP availability in Washington vs. Oregon
In Washington, PIP coverage must be offered with any auto insurance policy. If you choose not to buy PIP coverage, though, you must sign a form to specifically decline that coverage. Read on to better understand the benefits you might receive before you reject that coverage.
In Oregon, PIP coverage is mandatory in all auto insurance policies.
Temporarily covering lost income
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You were injured in an accident. You had to take off time work, so you lost income or benefits. Now you need to find a way to cover that lost income so you can pay your bills and take care of your family.
Eventually, when you settle the case with the at fault party, you can recover your lost income and benefits as well as medical and auto repair expenses. However, that might be months down the road.
In the meantime, what can you do to cover lost wages?
Making up for lost income
The reality is that most people live from paycheck to paycheck. When that paycheck stops, panic can easily set in.
The good news is that, if you have been working, you can generally cover at least some lost income by using benefits through your employer, such as:
- Sick time or vacation time
- Short-term or long-term disability
Using sick time or vacation time
With a doctor’s note, you can use a sick time or vacation time benefit for any time lost at work. Don’t make the mistake of simply staying home from work because you don’t feel well after an accident. Review the blog article “Losing work after an accident” for details about what you must do. Without this required documentation from your doctor, you cannot make any claims or recover lost earnings.
When you settle case, you are entitled to recover earnings the time that you missed—and that includes sick time or vacation time that you took, plus any other benefits that may have accrued. After all, those are benefits you otherwise would not have used if you had not been involved in a collision.
Short- or long-term disability
If injuries require you to be off work for more than a week or so, you may be able to access short- or long-term disability benefits from your employer. Any rules for such disability apply outside of any automobile insurance coverage.
Immediately use Personal Injury Protection insurance
Whether or not you have any employer benefits, you can immediately access the PIP coverage you purchased with your automobile insurance.
PIP coverage is no-fault insurance, so you get that benefit from your own insurance company (not the insurance company for the at-fault party).
PIP Income continuation benefit
Under Personal Injury Protection (PIP) coverage for your auto insurance, you can file a claim with your own insurance provider for lost wages when you miss work due to injuries sustained in an accident. This is referred to as an “income continuation benefit” in your insurance policy.
NOTE: Income continuation is meant only as a substitute for wages not earned because you were injured in an accident.
Coordinating benefits
If you need to contact your employer for details about benefits information or forms, remember that our office can help. We can review details of your coverage and help coordinate benefits, and assist with documentation and any forms that must be filed.
Wage loss due to work restrictions
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After you have been off work, the doctor signs a release that allows you to return to work. If there are any restrictions due to an accident, the doctor must put that in writing.
No heavy lifting
In many cases, a doctor may specify that you are restricted to “light duty” work, as least temporarily.
Work restrictions often limit the amount of weight you can lift. That may be a limit of 15 pounds, about the weight of three reams of paper. If a job requires you to lift and move materials, restrictions can impact the amount of hours you can work or whether you can even do the job.
If your employer does not have any light duty work available, then the employer must state that in writing. Again, this is documentation required for the insurance company.
No long periods of sitting
In another example, computer work might not involve heavy lifting, but may require that you sit in the same chair in front of a computer for 8 hours a day. If that situation aggravates any injuries if you sit for more than 2 hours at a time, then your doctor must provide more details about work restrictions.
You can’t do the same job
For a serious injury, you may never be able to go back to doing the work you did before the accident.
For example, the tasks done by a pipe fitter make it a very physical job. That type of work generally does not require a college degree. Being hurt in an accident to the point where it’s not possible to lift heavy objects affects not only the employee’s ability to do the job, but may have a major life impact.
What if you are self-employed?
If you are self-employed, you might find yourself in a situation where you previously did everything yourself, but now cannot handle all the tasks.
Even if you continued working, you had to hire someone to do some or all of the work because of injuries sustained in the accident. For example, you used to take care of all inventory for a small shop, but now need someone to lift and move boxes, unpack items, stock shelves, and so on. That expense can be part of a claim.
Details about wage loss can be complicated
Our office has years of experience working with clients when they are dealing with work restrictions after an accident. Call our office if you have any questions about the details of your situation.
Documenting wage loss from an accident
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While doctors are accustomed to dealing with paperwork associated with injuries, you have to ask for documentation specifically for the insurance company.
Get it in writing
The documentation can be a letter, a memo, a note, or what is sometimes referred to as a disability letter or slip. Remember that an insurance company always requires documentation for their files. Whatever you call it, the paperwork must—at a minimum—include:
- The doctor’s name, address, phone, and medical licenses number
- The “from” and “to” dates that you will be out of work or have work restrictions
Make sure the documentation is complete
With the demands and time pressures of running a practice, a doctor may prepare documentation as quickly as possible. That could result in insufficient information, which may not support your case as well as it could. Call our office before your doctor’s appointment if you have any questions about what information should be covered.
What if you are self-employed?
Even if you are your own boss, you must still get any decision in writing from a doctor about injuries, work restrictions, or disability.
Documentation from the employer
In addition to the paperwork from the doctor, you must also get documentation from your employer to verify that you missed work on specific dates.
Who can figure out the impact on my earnings?
In cases that result in substantial wage loss, there must be additional documentation.
For example, you might require a physical capacity evaluation from a vocational rehabilitation counselor. That is an expert who figures out what you can do in the future based on the jobs you did in the past, your education, and experience. They identify any needs for retraining – which costs time and money – and even then, you might earn less than before.
You might also require the services of an economist to identify future loss of earnings.
Paperwork can be overwhelming – we can help
Taking care of all this paperwork can become an overwhelming task, especially when you are dealing with injuries.
Our office is familiar with all the nuances of documentation, with years of experience dealing with paperwork for lost income. We can help. Call today with any questions you might have.
Losing work after an accident
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You were hurt in an accident, and who wants to go to work when you’re in pain or feeling discomfort? Just thinking about what you have to deal with during the workday is enough to make you feel tired before you even get out of bed.
Taking time off work
If you do not feel well, you might decide to stay home for a few days after the accident. You need to know that you will not be entitled to any claim for wage loss without proper documentation.
Your boss may not require anything in writing if you take sick leave. And sending an email from home to your boss does not qualify as documentation for a wage loss claim.
You can’t just stay home and then make a claim
If you are not able to work due to injuries caused by an accident, it’s important to go to a doctor and get checked. If the injuries are enough to cause you to miss work or require any limitations on the kind of tasks you can do on the job, you must get that decision in writing from a qualified medical professional.
It’s up to the doctor
To justify a claim of lost income, it’s up to a doctor to determine your ability to work after an accident. That may range from a complete absence from work for an extended period of time to minor restrictions on the job.
In a majority of cases handled by our office, people injured in a car accident are out of work for short period of time – perhaps a few weeks or a month or two.
Tell the doctor about your job
Generally, details about your work are not part of a medical record, so you need to tell your doctor about the nature and scope of your daily activities on the job.
It’s also important to share any opinions about how you think the injuries you sustained in the accident might affect your ability to perform the job. The more information you can provide, the better.
We can help with paperwork
We can work with your doctor and employer to get the necessary getting documentation, so you can focus your energies on a complete recovery from your injuries.
What does PIP insurance cover?
By · CommentsAs a good citizen of your community, you purchased automobile insurance as required by state law. With that policy, you likely also purchased Personal Injury Protection (PIP) coverage.
Benefits of PIP coverage
Our earlier blog talked about the definition and scope of coverage of PIP insurance. But what benefits does that coverage actually provide when you’ve been injured in an automobile accident?
Medical expenses
You likely purchased Personal Injury Protection coverage with your auto insurance to help pay medical bills. That coverage is generally phrased as “ … reasonable and necessary costs associated with medical and hospital costs related to injuries suffered in an accident.”
That can include ambulance bills, hospital bills, bills from a surgeon or anesthesiologist, diagnostic studies (x-rays, MRI’s, CT scans, etc.), massage therapy, physical therapy, chiropractic treatments, acupuncture, prescription drugs, crutches, and so on.
PIP coverage varies from state to state for types of treatments that are considered reasonable and customary. For example, in Washington, acupuncture is a permissible medical treatment, while in California it is not.
Funeral expenses
What you may not realize is that PIP provides coverage to pay for expenses other than hospital costs and medical treatment.
Although no one likes to think about it, funeral expenses might result from a traffic accident. Some policies include a small death benefit.
Loss of Income
For example, if you are unable to work because of the accident, you may lose some or all of your income. Most PIP policies have a provision for loss of income (subject to the limits of the policy).
You may need to hire someone to do tasks that you are not able to do because you are injured, such as child care, house cleaning, or yard care.
Who does PIP cover?
PIP covers expenses of the insured, others in its vehicle at the time of the loss, and pedestrians struck by the vehicle, regardless of who was at fault. Remember, though, that expenses are covered only up to the dollar amount listed in the policy.
The at-fault driver does not pay
Even if it’s obvious that the other drive is at fault, your insurance company pays first.
However, even your insurance company will not pay for medical expenses or lost wages until the claim is settled – and that could take weeks or months. The at-fault party does not pay any expenses over and above your PIP coverage until you have first settled with your own insurance company.
As your medical treatments continue, the bills keep coming in. Your expenses add up, and the medical providers want to be paid.
We can help you understand the process, move the claim along, and assist with the paperwork. Call our office today to discuss of your situation and how we can help.
What is PIP insurance?
By · CommentsBy law, you are required to have insurance for your vehicle.
But as you look at insurance coverage—whether by talking to an agent or searching on the Internet—the terms of the policy seem like Greek to you. For example, what is PIP coverage?
What does PIP mean?
“PIP” is an acronym for Personal Injury Protection.
The Insurance Commissioner for the State of Washington states:
PIP is insurance coverage for medical and other expenses, such as wage loss and funeral expenses, which result from an auto accident, no matter who is at fault.
What does PIP cover?
Okay, that’s a pretty simple definition. But what does that mean to you in case you’re in a car accident?
For the State of Washington, the following are minimum benefits for PIP coverage:
- Up to $10,000 for reasonable and necessary medical expenses for each individual injured in an auto accident. This is available for up to three years from the date of the accident.
- Up to $200 per week for income replacement coverage. This is limited to one year, and starts after a person has been disabled for 14 days after an accident.
- Up to $2,000 for funeral expenses.
- Up to $5,000 for loss of services (payment to others for work you can’t do).
For the State of Oregon, Personal Injury Protection covers up to $15K of medical expenses, and only up to ONE year from the date of the accident. Income replacement for Oregon is a maximum of $1250/month.
Is PIP insurance required?
While Personal Injury Protection insurance is not mandatory coverage in the State of Washington, insurance companies are required to offer this coverage to you. If you do not want the coverage, you must reject it in writing. If you do not refuse PIP coverage, your insurance company must add it plus the cost to your auto premium.
Why do I need PIP if another driver is at fault?
Everyone thinks that, if another driver is at fault, then that person should pay for all expenses. While that is technically true, what if the other driver has no automobile insurance or liability coverage? And even if the at-fault driver does have insurance, there is no obligation to pay any expenses as you incur them. Getting paid from the other party for damages to you or your automobile happens only through settlement or a verdict (which can take weeks, months, or even years).
How much PIP coverage should I buy?
While the minimum benefits are available with all automobile insurance policies, we recommend that you purchase enhanced PIP coverage. You can increase the amounts of coverage with your automobile policy for up to $35,000 for medical expenses and a maximum of $700/week for wage loss. Be sure to discuss your needs with your insurance agent or company representative.
If you or anyone in your vehicle was injured in an automobile accident, call our office with any questions you might have about your insurance coverage.
Assess Vehicle Damage
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No one ever wants it to happen, but at some point you might be involved in an accident.
Cars, trucks, motorcycles, vans, and commercial vehicles all start, stop, and move along at various rates of speed. They are all equipped with mechanical, hydraulic, electrical, and electronic systems—all opportunities for failure.
Then there are drivers. Distracted, drunk, or with just plain bad driving habits.
Accidents happen
So accidents do happen. And vehicles and people get smashed up. Our blog today deals with looking at and appraising the damage and destruction to a vehicle involved in a personal injury claim.
Moving the vehicle
In a minor “fender bender”, of course, you might have been able to drive your vehicle. However, you should not move your vehicle after an accident unless it’s a safety hazard.
Cooperate with all law enforcement and emergency personnel at the scene of the accident. Do not move the vehicle or leave the scene of an accident until the police tell you it is okay to do so. They are there to keep everyone safe—not only the people and vehicles involved in the collision, but other drivers on the road.
Where did the tow truck go?
If the extent of the damage was such that your vehicle was towed, you need to gather some basic information. Be sure to do this before the tow truck driver leaves the scene of the accident with your vehicle!
- Name and telephone number of the tow company
- Name of the driver
- Tow truck number or license plate
- Location (street address) where they are taking the car
- Company policies (fees for towing and storage, hold period, liens against vehicle)
Disposal by the tow company
Tow truck companies usually charge separate fees for towing and storage. Always ask about the cost of fees applied for each day the vehicle is held in storage. Did you know that, if payment is not made, a tow company can file a lien and sell the vehicle? The periods vary by state and local law.
If you are in the hospital or possibly waiting for a paycheck to clear the fees, be sure to communicate with the tow company or have someone do so on your behalf. Our office is happy to help. Making arrangements can avoid the loss of your vehicle.
Insurance company access
Although a body shop can prepare an estimate, at some point the insurance company will want to take a look at the vehicle to assess the damage and take photographs. Cooperate with any requests and provide access to the vehicle. If the car is in storage, authorize access for the insurance company representative. They need this information to resolve your claim.
As always, we are here to help. If you have questions or need assistance in working on your personal injury claim, call us today.