People spend a large chunk of time at work, and this means the potential to experience workplace accidents. Workplace accidents are an unfortunate part of business life, and they can get costly. Hence why companies are often required to have what’s known as workers’ compensation.
If you aren’t familiar with workers’ compensation, this blog post will point you in the right direction. Below, you’ll find an overview of workers’ compensation along with how the settlement process goes for these cases.
What is Workers’ Compensation?
Workers’ compensation is insurance that provides medical care and/or cash benefits to employees that get sick or injured as a direct result of their job. This insurance is not deducted from an employee’s payroll, and the premium fee is paid solely at the expense of the employer. Workers’ compensation aims to protect both employers and employees:
Employers are protected from liability for on-the-job illness or injuries, and they are safeguarded from facing most on-the-job lawsuits.
Employees are protected because they are guaranteed medical treatment, wage replacement, and/or permanent disability compensation in the event of serious injury or illness. Workers who got disabled due to an accident may also be eligible for a disability tax credit. Death benefits are provided to the employee’s dependents in the case of fatal injury.
Is Workers’ Compensation Required?
As of 2022, every state but Texas legally requires that businesses provide workers’ compensation to their employees. Even if workers’ compensation is not legally required, it is still in the interest of most companies to provide it for protection purposes.
Common Examples of Workers’ Compensation Accidents Claims
Though workers’ compensation covers a wide array of accident types, some accidents are more common than others. The most common workers’ compensation injuries are as follows:
- Slip & falls
- Overexertion and muscle strains
- Being struck by equipment and falling objects
- Crashes and collisions
Is There a Limit to Workers’ Compensation?
All commercial liability insurances have a cap on the amount of compensation that can be distributed. But, workers’ compensation works a bit differently. To understand the limits to workers’ compensation, we first need to understand Part A and Part B of the system.
Part A: Employee Benefits
Part A of workers’ compensation protects employees and their families in the case of serious or fatal injury. Employees are protected for a variety of needs including medical treatment, rehab programs, and long-term compensation if necessary. If you’ve been injured as an employee, know that employee benefits generally offer no limits or exclusions.
Claims can not be declined or denied unless the employer has evidence to prove that fraud has been committed.
Part B: Employer Benefits
Part B of workers’ compensation addresses employer liability, and unlike Part A, this part of the policy does have limits. Part B aims to protect employers by covering the cost of legal defense and other lawsuit-related expenses in the event that an employee files a lawsuit. Any money awarded to employees on a monthly basis – because of injury – is also covered in Part B.
The cap on Part B of workers’ compensation depends on the premium that the employer pays.
How to File a Workers’ Compensation Claim?
Once you’ve taken care of your immediate situation and have been treated for your injury, there are 5 steps to file a workers’ compensation claim. The steps are covered below.
Step 1: Report Injury to Employer
It’s important that you report your injury to your employer as soon as possible. Time limits vary by state, but expect the deadline to be around 30 days. Failing to report your work-related injury to your employer within your state’s deadline could void your injury from being compensated.
Step 2: Recieve Workers’ Compensation Paperwork From Your Employer
Once you alert your employer of your injury, they will provide you with the paperwork to fill out. Complete the paperwork and return it back to your employer. Unless mentioned otherwise, your employer is responsible to submit the paperwork to the insurance company.
There are also some specific procedures that are required by some states. To stay informed, we recommend speaking with a personal injury and workers compensation attorney or visiting the website of your state’s workers’ compensation agency.
Step 3: Wait for an Approval or Denial
Once the insurance company conducts their research, they’ll either approve or deny your workers’ compensation claim. The insurance company is required to tell you their verdict 2 to 4 weeks after the paperwork is sent.
If your claim is approved, you’ll start receiving the benefits you requested. If your claim is denied, you have the right to appeal. This is usually the time to get a personal injury or workers compensation lawyer involved in the situation.
Find What You Need on LegalStream
In the event that your workers’ compensation claim has been denied, there is still hope! We don’t want claimants to feel discouraged and to lose out on the workers’ compensation that they deserve.
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