What To Know About A Workers’ Compensation Claim

Workers’ compensation guarantees employees injured in their workplace that they’ll receive reimbursement for their medical expenses. It applies to individual state laws and is in place to avoid charges being filed against the workers’ employers for repayment. Under the current workers’ compensation statutes, almost all companies can’t operate until a workers’ comp insurance policy is secured.

Most people understand the basics of a workers’ compensation claim. The medical bills of the employee will be covered if they get hurt on the job. They’re’ also compensated for work they’ll miss over and above the statutory waiting period. However, there’s a little bit more to workers’ compensation that both employees and employers need to know.

Below are the five essential things to know about a workers’ compensation claim.

1. Table of Contents

   Toggle

   Employees Will Get Compensation For Both Lost Wages And Medical Bills

While employees aren’t able to work, they’ll receive a portion of their monthly income. Benefits for temporary wage loss within the healing period are provided to sustain them while recovering from the injury. It applies to both temporary total disability (TTD) and temporary partial disability (TPD). A doctor will determine and document the eligibility for temporary disability benefits. The employees will also receive coverage for all necessary and reasonable medical expenses.

Workers can choose to close the case completely by receiving both lost wages and medical expenses compensations. With this option, workers’ compensation future medical settlements apply and are given in a lump sum. Another option is to close one part of the compensation while leaving the other open. The medical benefits are often left open in this case. Note that retraining and vocational rehabilitation may also be covered.

2. The Work Injury Must Be Reported

Not only do employees have to report the injury, but they should also consider having it reported as soon as possible. Workers may only have a limited time to report the injury to their employer, depending on their state. For instance, Colorado gives just four working days to injured workers for them to provide written injury notification. Those who are employed in New York have 30 days to inform their employer after the date when they suffered an injury. Notifying the employer of a workplace injury is an important step in the workers’ compensation claim process.

3. Covered Injuries Vary

The coverage of a worker’s comp claim is meant to compensate employees for sustaining work-related injuries. Illnesses that are work-related may be included in the coverage in some states. Other states only allow certain illnesses to trigger coverage.

Note that an injury may not have to originate from only a single incident to be considered work-related. For example, an illness or repetitive stress injuries that are brought about by continued exposure to specific substances in the work environment may still trigger a workers’ compensation claim.

Sometimes, to be covered by worker’s comp, employees don’t necessarily have to be at the workplace. For instance, workers’ compensation may still cover injuries suffered because of completing work-related tasks as requested by the employer. However, injuries gotten while driving to and from work are generally not categorized as work-related.

4. Employees Can’t Sue Their Employer

Suppose a work-related illness or injury happens while on the job, employees can’t sue their employer. That’s because of the workers’ compensation functioning as a trade-off for employers and employees. An employee can’t sue their employer by receiving wage replacement and medical benefits. If there was intentional action from the employer to hurt the employee or the employer was reckless, that’s when the employee can sue.

5. Workers’ Compensation Laws Are Different In Each State

There’s a unique system for workers’ compensation in each state. Some states give the injured employee freedom to select their healthcare providers, while other states allow employers to direct their employees to a designed panel of physicians for medical treatment.

The need for employers to secure workers’ compensation insurance for employees is dependent on state laws. Type of work, type of business, and the number of employers are some of the factors that come into play. For example, some states don’t cover workers’ compensation for seasonal help, volunteers, or farmers.

Final Thoughts

It’s essential to note that not all claims for workers’ compensation are alike. Similarly, the benefits weren’t created equal. For workers, it’s important to familiarize themselves with their state’s workers’ comp program. Employees also don’t have to be afraid to seek outside support if they feel like something isn’t right. They can talk to a personal injury compensation lawyer to receive much-needed assistance. The time away from work may become less stressful if workers have all the right resources. It also leads to a more straightforward road to recovery.