Workers’ compensation can seem like the most elusive form of insurance. How does it work? What does it actually cover? And how does the claims process work? This article will go into each of these questions to help you better understand workers’ compensation.
What is Workers’ Compensation?
Workers’ compensation is a form of insurance that provides wage replacement and compensation for medical bills in the case that an employee is injured during the course of their employment. This form of insurance not only protects the worker, but it also protects the employer.
While this insurance assures workers that they will be properly cared for in the case of injury, they are also required to waive the right to sue their employer. What does this mean? Basically, when workers waive the right to sue their employer, they waive the possibility of being awarded a potentially larger sum than they could receive otherwise.
However, the employer in turn waives the employees burden of proving the employer was at fault.. For the employer, waiving the employee’s right to sue ensures that they will not have to deal with costly and painful lawsuits. Practically all states in the United States require employers to have some form of workers’ compensation.
What Does It Cover?
While every state has different laws governing to what extent workers’ compensation is required to cover employees, there are some general guidelines. Typically, workers’ compensation will cover medical expenses, lost wages, and funeral costs.
When it comes to medical expenses, employers are usually required to reimburse you for any ER visits, check-ups, prescriptions, or surgeries that are directly resulting from the work-related accident. Once the employer accepts the claim they will generally pay for medical services directly.
In situations where the injury is more enduring, workers’ compensation will also give you more enduring reimbursement. For example, if a construction worker fell from a roof and broke his neck resulting in paralysis and the need for in-home care, workers’ compensation would likely cover the ongoing cost.
In addition to covering medical expenses, workers’ compensation also covers lost wages due to time away from work. The way this compensation works varies by situation. But generally, workers’ compensation ensures that you will receive a fair wage for necessary time off to recover.
Finally, in the rare and painful case of death, workers’ compensation will cover funeral costs and provide death benefits to dependents..
How Does a Claim Work?
There are two main steps to putting your claim through the system. First, you will want to report the incident to your employer as soon as you become aware of the injury. And second, you’ll need to file the claim.
Reporting the incident may look a little different depending on the state that you live in but generally, there is a 30-day window after the accident occurs in which you can report the injury. After that window, you may not be eligible to receive compensation.
To prove that your injury should be covered under workers compensation you must demonstrate that your injury was connected to work. In legal terms, this means that you have to show both that your injury arose out of your employment and that it occurred during your employment.
These requirements are more straightforward when it comes to on-the-job injuries such as cutting your hand using a tool at on your job..However, it gets a little trickier when it comes to illnesses that develop over time or injuries that occurred outside of an obvious workplace setting. In situations like these, you will want to look up the specific laws for your state that govern when an injury is covered by workers’ compensation and how that compensation works or consult an attorney.
After you’ve gone through the process of reporting your injury, your company will then give you paperwork to fill out to file the claim. After you’ve filled out this paperwork, it will typically be sent to the employer’s insurance company and/or to the state to be filed and processed.
If your employer does not dispute the claim that your injury was work-related, your claim will be processed, and you they will start paying your medical bills and compensating you for time off work. If your employer disputes your claim, you will have to file a claim with the labor commission, most likely with the help of an attorney..
When it comes to workers’ compensation, you want to know that your back is covered. This guide can give you a foundation to better understand how workers’ compensation works. But be sure to do your research regarding your state’s laws as well as the coverage offered by your employer to ensure that you understand what compensation you are entitled to in case of injury.