If you’re hurt at work, the theory is that worker’s compensation will pay your lost wages, but it’s not always as simple as that.
Every state has its own worker’s compensation guidelines, but in general, below are seven important things to know.
1.) Worker’s Comp May Cover an Injury or An Illness
The first thing to know about worker’s compensation is that it may cover an injury or an illness, which could include anything from a sprain or strain that you get while lifting to a slip and fall or, perhaps in rarer cases an infectious disease that you contract at work.
Some accidents aren’t covered, however, which include intentional or self-inflicted injuries or an injury sustained while voluntarily participating in an activity if you’re not on duty.
Worker’s compensation can also cover illnesses that develop long-term because of the environment you work in, such as exposure that leads to lung disease.
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2.) Almost Every State Requires Workers Compensation Insurance
Every state except Texas requires companies to have workers’ compensation insurance. They might have this through a private insurance company or the state. The business can also elect to be self-insured.
Each state varies in the particular requirements for employers and what’s covered.
If an employer doesn’t have the level of insurance required by their state, they may have to pay the benefits out of pocket and pay penalties to the state.
While states require it, that doesn’t mean that even in a required state that every employer has to have worker’s compensation coverage. There are varying factors such as the type of business and how many employees a business has that play a role.
3.) Worker’s Compensation Protects Employees But Also Employers
Yes, worker’s compensation provides a level of protection if you’re an employee and you’re hurt or get sick at work. It covers your lost income and it may also cover unexpected medical expenses or disability benefits.
However, worker’s compensation also protects employers. It covers the costs associated with treating an employee’s illness or injury rather than the employer having to pay it themselves or worry about being sued.
4.) There Are Things Businesses Can Do to Reduce Premiums and Claims
As an employer, there are steps you can and should take to reduce what you pay in premiums and also to lower your claims.
First, if you can reduce your claims, you’re going to reduce your premiums. To reduce your claims, you need to regularly assess the safety of the work environment. Make sure that you’re frequently checking on equipment to make sure it doesn’t need to be repaired or replaced, offer the right safety gear to your employees, and train everyone thoroughly.
Having an employee health and wellness program can also reduce employee injuries at work.
5.) Some States Have a Maximum Benefit Window of Seven Years
The length of benefits available depends on the state you live in, but it ranges from three to seven years usually. That doesn’t mean that if the benefits period goes up to seven years, you’re going to be out of work for that entire time. It’s just a general window. Every situation is unique.
6.) Employees Can’t Sue
This was touched on a bit above, but if you’re hurt at work, and you receive wage replacement and medical benefits through worker’s compensation, you can’t then sue your employer. That’s the trade-off and the benefit of worker’s compensation from the perspective of the employer. They’re shielded from lawsuits in these cases.
The only time there might be an exception to this would be if the employer behaved recklessly or intentionally did something to hurt an employee.
7.) The Process Is Handled Primarily By the Employer
With worker’s compensation, if you’re hurt or become ill at work or because of your work, you should speak to your human resources manager. A formal claim is then created by either the employer or the employee.
The HR team will provide an overview to an employee about what to expect in the claims process and will tell them more about how their wages are going to be supplemented while they can’t work.
Then, there’s a claim filed with the employer’s insurance provider. The claim should be filed no longer than 48 hours after the injury or illness.
The employer stays in touch with everyone throughout the process until the claim is either approved or denied and then the insurance provider lets the employer know the status of the claim.
If the claim is approved, the employee should keep receiving medical care until they’re cleared to return to work.