Mississippi Workers' Comp Claims: Eligibility, Filing, and Appeals
Understand how workers' comp works in the state of Mississippi.
In Mississippi, private employers with five or more regular employees must carry workers’ compensation insurance. As in other states, the workers’ compensation system in Mississippi is a no-fault system that compensates injured workers for medical bills, lost wages, and permanent impairments resulting from their injuries. To take advantage of these benefits, injured workers must follow certain procedures required by Mississippi law.
Who Is Eligible for Workers’ Comp Benefits?
Most employees are covered by workers’ compensation in Mississippi. However, there are a few exceptions for employees engaged in certain types of work. For example, workers’ comp does not cover farm workers, domestic workers, or those who work for non-profit organizations.
Workers’ compensation covers all injuries or illnesses that happen in the course and scope of employment, including traumatic injuries and occupational illnesses. Traumatic injuries are those that result from a one-time accident at work, such as a broken bone from a slip and fall. Occupational diseases are injuries or illnesses that occur over a period of time, including injuries caused by repetitive movements at work (such as carpal tunnel syndrome) and illnesses developed from exposure to toxic substances at the workplace (such as cancer from exposure to asbestos).
What Should I Do if I’m Injured at Work?
To receive workers’ comp benefits, you must report your injury to your employer. You should do so as soon as possible, but no later than 30 days after your injury. Your claim for benefits may be denied if you fail to give notice and your employer does not already know about your injury. Once your employer has notice of your injury, it will notify its insurance company. The insurance company will then decide whether to accept or deny your claim.
How Do I Get Medical Treatment?
In Mississippi, you can seek treatment from a doctor of your choosing. This doctor may refer you out to one specialist without seeking approval from your employer’s insurance company. However, all other referrals will need to be approved by the insurance company.
What Benefits Can I Receive?
All reasonable and necessary medical treatment related to your work injury will be covered through workers’ comp in Mississippi, including the cost of doctors’ visits, hospital bills, prescriptions, and prosthetic devices. You’ll also be reimbursed for the mileage you incur in traveling to and from medical appointments. In addition to medical benefits, you will also be eligible to receive disability benefits.
Temporary Disability Benefits
If you need time off from work while you are recovering from your injuries, you can receive temporary total disability benefits. These benefits are two-thirds of your average weekly wages, up to a maximum set by state law each year. For 2016, the weekly maximum is $468.63. You will receive these benefits until you are able to return to work or until your doctor finds that your condition has improved as much as it is going to (this is called “maximum medical improvement”). However, if neither has occurred, benefits will typically end after 450 weeks.
If you are able to work while recovering from your injury, but you’re earning less than you normally do, you can receive temporary partial disability benefits. These benefits are two-thirds of the difference between your average weekly wages before the injury and your wage-earning capacity after the injury, subject to the same maximum mentioned above.
Permanent Disability Benefits
Once you reach maximum medical improvement (MMI), your doctor will evaluate you to determine whether you have a permanent disability. If your injury has left you permanently and totally disabled, you can receive permanent total disability benefits. These benefits are available only for the most serious injuries, such as the loss of both hands, arms, feet, legs, eyes (or a combination of any of two of these body parts). Permanent total disability benefits are paid at the same rate as temporary total disability benefits, for a maximum of 450 weeks.
If you have a permanent impairment, but you are not totally disabled, you can receive permanent partial disability benefits. These benefits are also two-thirds of your average weekly wage, subject to the same maximum as temporary disability benefits. How long you will receive these benefits depends on whether your injury is listed in Mississippi’s schedule of injuries.
Mississippi’s schedule lists injuries to certain body parts—such as a hand, arm, leg, foot, finger, toe, eye, and ear—and designates a maximum number of weeks for which benefits are paid. For example, the schedule allows a worker to receive benefits for 200 weeks for the total loss of use of an arm. If the worker has suffered only a 50% loss of use, he or she can receive benefits for 100 weeks.
Injuries not listed on the schedule are considered industrial disabilities to the body as a whole. You can receive two-thirds of your average weekly wages, subject to the same weekly maximum mentioned above. The duration of your benefits will depend on the severity of your disability and your loss of earning capacity. These benefits are available for a maximum of 450 weeks.
You may also receive up to $5,000 for any serious disfigurement or scarring to your face or head. However, these benefits are discretionary and not available until at least one year has passed since the injury.
What If My Claim Is Denied?
If the insurance company denies your claim, you can file a petition to controvert with the Mississippi Workers’ Compensation Commission. A hearing will be held before a workers’ comp judge, who will issue a written decision. If you disagree with the judge’s decision, you will have an opportunity to appeal the decision. For more information on the appeals process, see our article on appealing a denial of your Mississippi workers’ comp claim.