One of the worst things that can happen in the workplace is an accident, like a slip, fall, or a mishap involving factory machines or heavy machinery. A worker can sustain minor injuries, like wounds, cuts, or abrasion, and major injuries, such as bone fractures, amputated body parts, or spinal cord injury. In the worst case, some employees die in the workplace, most especially in confined spaces with low oxygen levels, and other hazardous working environments dealing with chemicals, solvents, and toxins.
If you or your loved one was injured in the workplace, you need to know about the best way you can be compensated. One way to ensure that you know what direction or course of action you’ll need is to keep yourself abreast of worker compensation law, especially laws governing your state.
In this post, you’ll learn more about the general commonalities of worker compensation laws, which will serve as your comprehensive guide before taking any legal actions.
What Is Workers’ Compensation?
Workers’ compensation refers to a form of insurance that provides medical benefits (hospitalization and rehabilitation costs) and wage replacement to employees who were injured in the workplace. Also, it pays death benefits to the employee’s family, who was killed on the job.
If you or your loved one has been severely injured at work, you can always get expert legal advice and help from a workers compensation lawyer. Seeking legal advice is crucial before collecting your workers’ compensation benefits.
What Are The Workers’ Compensation Benefits?
The weekly benefits that an injured employee gets for workers’ compensation claims are only paid if the workplace injuries are severe enough to prevent the worker returning to work temporarily or permanently. The workers’ compensation benefits you’ll receive will depend on the state where you reside, the severity of injuries, and whether you can go back to work in the short term or long term.
1. Open Claim
When it comes to an open or active workers’ compensation claim, the types of workers’ compensation benefits that an employee will regularly receive depend largely on the person’s ability to go back to work. This includes light-duty positions that are offered by the employer.
Here are the workers’ compensation benefits for an open claim:
- Time Loss Compensation: This workers’ compensation benefit applies to temporary total disability, in which an employee who is unable to return to work immediately due to injuries can be eligible to receive regular time-loss compensation benefits. It’s usually paid twice a month. Depending on the laws of the state, the amount that the worker will receive is 66 2/3 percent of wages from the date of injury, which also includes the amount that the employer contributes to the employee benefits.
- Medical Bills: The doctor will bill the employer or the insurance company directly. The medical bills’ amount won’t affect the loss of earning power benefits or the amount of time-loss benefits that the employee is eligible to receive.
- Loss Of Earning Power: This worker’s compensation benefit is not available in all states. It is given to a part-time employee, or a worker with a light-duty position such as a low-paying job, who cannot return to work temporarily after sustaining a workplace injury. The employer will pay a portion of the difference between the worker’s wages at the time of injury and the amount that the person is currently earning.
2. Closed Claim
An employee with a settled or closed workers’ compensation will receive regular workers’ compensation benefits given in only the following situations:
The employee was declared permanently disabled and was given a pension.
The worker is partially permanently disabled and qualified to receive a weekly permanent disability benefit, which was structured in a settlement agreement.
Here are the workers’ compensation benefits for a closed claim:
- Pension: It’s a lifetime pension benefit that is given to an employee who is permanently disabled due to a workplace injury. The worker won’t be able to return to work or handle continuous employment because of the work-related injury, disease, or illness. In many states, pension benefits are less than the amount of time-loss compensation or temporary disability benefit for an open claim. This pension benefit is usually paid once a week, once a month, or twice a month, depending on the state. Workplace fatalities happen, that’s why in some states, the surviving spouse continues to receive the benefits even if the employee is already dead.
- Weekly Permanent Disability Payments: For employees with a permanent impairment, they can get regular weekly disability benefits if a lump sum settlement is not agreed upon. It is usually based on the employee’s wages before the incident or how disabled the worker is.
- Structured Settlement: With a structured settlement agreement, an employee can still receive continuous payments as part of the workers’ compensation claim, even if the claim has been closed.
What To Do If Injured In The Workplace?
To make sure that you’ll get the fairest amount of workers’ compensation benefit, you have to know what to do if you got injured in the workplace.
Here are the things you have to do if you got injured while doing your job:
- Immediately Report The Injury: Make sure to report your illness or injury to your supervisor, company doctor, and to your HR department. You should be given immediate medical assistance, and an incident report should be filled out. There’s something wrong if you don’t get a call from a workers’ compensation insurance adjuster or no paperwork has been filed.
- Visit A Medical Provider: If you don’t have your company doctor readily available and your case is an emergency, you can go wherever the ambulance will take you. For non-emergency cases, follow the suggested clinic or hospital of your employer to ensure that all your bills will be covered.
- Tell The Doctor That You Sustained Workplace Injuries: The medical paperwork should show that the injury was sustained at work. In this way, the insurance company or the employer receives the bills and not the employee.
- Ensure Complete Info In Your Medical Records: Your medical records must include all details about your injury, including the circumstances that led to the injury and involved body part.
Good-To-Know Facts About Workers’ Compensation
1. Workers’ compensation claims usually cover lost wages and medical expenses but don’t compensate for an employee’s pain and suffering. On the other hand, a personal injury lawsuit can financially compensate an injured employee for their pain and suffering after an accident.
2. An injured worker can sue his employer after the injury if the latter is reckless or has contributed to or caused the injury. If you choose this course of action, you need to first waive your right to receive workers’ compensation benefits.
3. Once an employee collects their workers’ compensation benefits, the right to file a lawsuit has been given up. However, you can still file a personal injury lawsuit for an at-fault third-party.
4. Workers’ compensation benefits are usually exempted from taxes, which also includes payments to survivors.
5. You may still receive benefits even if you return to work, which is usually included in a permanent partial disability. The same also holds true if you’re now earning less than your paycheck before the injury.
6. It’s possible that you still get paid for workers’ compensation benefits and social security (reduced or taxed) at the same time.
7. Even if an employee is not physically present in the workplace, workers’ compensation can still be awarded if the injury was sustained “within the scope of employment”, such as attending an employer-sponsored event or running errands at the employer’s request.
8. Workers’ compensation benefits are paid by private insurance companies and not the state. The claims are handled by an insurance adjuster.
9. Before you settle for a workers’ compensation, make sure to consult a lawyer to ensure that the amount offered is justifiable and fair based on your existing injuries and possible health and work situation in the future.
Here’s how a workers’ compensation lawyer can help you:
- A good compensation lawyer provides expert legal advice about your claim, and can negotiate the amount you deserve to get for your workers’ compensation benefit.
- Gather all possible evidence to prove your claim and demand a higher compensation amount as needed from the insurance company.
- Provide the best legal option for you, whether you should agree to settle or file a lawsuit to get the best compensation. A workers’ compensation lawyer can escalate the matter and take it to court.
10. It is best to talk to your employer early on to know what form of workers’ compensation benefits the company has in place. In this way, you’ll be ready if an untoward incident happens in the workplace and you’ll find better options when it comes to employment and career growth and development.
Conclusion
Worker compensation law is a broad legal matter. While it varies from one state to another, there are general commonalities, including handling open and closed workers’ compensation claims and benefits available for each.
Timelines and some details can be different, but all worker compensation laws were created to ensure that the injured employee’s rights are protected. Keeping in mind the above-mentioned information about workers’ compensation will help you determine the best course of action for your case.
Throughout the year, our writers feature fresh, in-depth, and relevant information for our audience of 40,000+ healthcare leaders and professionals. As a healthcare business publication, we cover and cherish our relationship with the entire health care industry including administrators, nurses, physicians, physical therapists, pharmacists, and more. We cover a broad spectrum from hospitals to medical offices to outpatient services to eye surgery centers to university settings. We focus on rehabilitation, nursing homes, home care, hospice as well as men’s health, women’s heath, and pediatrics.
