Workers’ compensation is necessary for nearly every business, and it’s important for both employer and employee to understand the ins and outs of the insurance. If an accident happens, employees should be able to receive the help they need in a way that doesn’t drain the company’s savings.
Workers’ compensation provides monetary assistance when an employee is injured on the job. There are five categories for workers’ compensation:
- Wage replacement benefits. Depending on state laws and the injury, workers’ compensation provides a portion of the employee’s wages for as long as they are unable to work.
- Medical treatments. Medical treatment coverage helps pay for doctor’s visits. Be careful of the 90-day rule when it comes to medical treatment. Within the first 90 days after the injury, the employee must seek treatment at one of the medical providers the employer recommends. The employer must have this list of medical providers available where the employees can easily see it. After the 90 days following the injury, the employee can seek treatment wherever they’d like. If these rules aren’t followed, an insurance company may deny a workers’ compensation claim.
- Vocational rehabilitation. In drastic cases, some employees may no longer be able to work the job at which they were injured. After filing a workers’ compensation claim for such an accident, insurance may pay for vocational rehabilitation, or schooling and training required for the employee to prepare for another job outside of their initial field.
- Disability. Disability benefits from workers’ compensation vary depending on the type and severity of disability caused by a work-related injury. Permanent disability that a doctor decides won’t improve over time may count as maximum medical improvement. If you have extreme limited movement or ability to work, you may have permanent disability benefits for the rest of your life. There are two sides of permanent disability: permanent total disability and permanent partial disability. Permanent total disability concerns total blindness and the loss of both arms, hands or legs. Permanent partial disability concerns broken body parts or smell losses, such as the loss of a toe or finger.
- Death and funeral services. In the unfortunate case that an employee passes away due to a work-related injury, benefits will be given to the late employee’s family for compensation and to pay for funeral services.
When an employee files for workers’ compensation, the employer must then file the claim with the carrier that provides their company’s workers’ compensation insurance. An insurance company representative will investigate the accident. It doesn’t matter who caused the injury, as workers’ compensation is a no-fault insurance. It’s crucial to take pictures and document every detail of the event and injury, as well as make sure other employees avoid the injury site until it is made safe.
Do I Qualify for Workers Compensation?
Deciding whether you qualify for workers’ compensation is a matter of analyzing the situation. If you are considered an employee of the company and are injured on the job (while performing work-related duties), you likely qualify for workers’ compensation.
Injuries that are usually covered beneath workers’ compensation include:
- RSIs (repetitive strain/stress injuries)
- Hearing loss
- Blindness/complete or partial loss of eyesight
- Stress injuries
- Work-related illnesses
- Pre-existing conditions*
*Workers’ compensation will usually only cover a pre-existing condition if the condition is worsened due to work-related activity.
Workers’ compensation won’t cover injuries that occur out of the office, either commuting to and from work or on lunch break. It also won’t cover accidents that happen due to an employee being under the influence of alcohol or drugs and won’t cover intentional injuries. When in doubt, consult your workers’ compensation lawyer.
Also Read: 3 Reasons You Need Employment Practices Liability Insurance