Workers' Compensation FAQs
What benefits are typically available under workers’ compensation?
There are three major components to workers’ compensation:
| Medical expenses – the cost for hospitals, doctors, medical treatment, etc. |
| Disability pay – either temporary while you are getting back to normal, or permanent if you will never fully recover. The amount varies, but can be as high as two-thirds of your normal pay. |
| Vocational rehabilitation – if your injury renders you unable to perform the usual duties of your occupation, you may need re-training so that you can enter into a new trade or business. Also, you may need physical therapy to get your normal strength back. If you qualify for returning to work you may be eligible to be paid workers’ compensation while you retrain. |
What should I do if I am injured on the job?
After injury or illness occurs, it is the employee’s responsibility to complete a claim form and to submit it to either the employer or the state workers’ compensation agency/board. Immediately notify your employer and complete a Notice of Injury form. Normally, an employer will have the claim forms available. The employer will submit the claim to the insurance company. The employer is given an opportunity to respond to the claim. If he does not contest the claim, payment of medical bills and wages will be made by the insurance company. A hearing can be scheduled if the employer contests the claim to determine whether, or how much, compensation is owed to the employee.
If an employee is receiving workers’ compensation benefits, but returns to work, does the employee still get to receive workers’ compensation benefits?
The answer to this question is “maybe.” If the returning to work enables the employee to receive wages equal to or greater than he or she was earning prior to the injury, then it is likely benefits will be stopped. If, however, the employee is still experiencing a wage loss greater than 20% of pre-accident earnings, due to his or her injury, he or she may continue to receive temporary partial wage loss benefits, although the benefits will most likely be for a lesser amount.
What kinds of injuries or illness might be compensated by workers’ compensation?
Injuries or illnesses are typically covered only when they “arise out of and in the course of employment.” There needs to be a nexus between the accident that caused the injury/illness and the scope of your employment duties. Examples of compensable injuries are those caused by lifting heavy equipment, slipping on a wet or oily surface, defective machinery, or fires or explosions.
Illnesses that “arise out of and in the course of employment” can be covered under the workers’ compensation system where the working conditions present unusual or extraordinary risks of contracting an illness – such as computers, where workers may experience carpal tunnel syndrome. Careful inquiry into the hazards arising out of the scope of your employment can determine whether the illness is one that is common to everyday life, as opposed to risks of illness that are present in your particular employment situation.
If an insurance company’s doctor treats me initially, do I have the right to see my own doctor at some point?
State workers’ compensation systems establish technical and often tricky rules in this area. Often, you have the right to ask for another doctor at the insurance company’s expense if you clearly state you have a problem with the one the insurance company provides. There is sometimes a waiting period before you can get a second doctor.
Who pays for the workers’ compensation coverage?
Workers’ compensation is typically carried solely by the employer, which usually purchases workers’ compensation insurance. The cost of workers’ compensation coverage cannot be charged to the employee.
