What Can Workers’ Compensation Cover?

Workers’ compensation is the insurance policy that most employers are required to carry to reimburse their employees for various expenses if they are injured on the job.

Workers’ compensation coverage can be used to meet a variety of needs that arise when an individual is injured on the job or suffers from an illness because of exposure to certain chemicals while at work. One pervasive example of a work-related illness is mesothelioma in individuals who worked with asbestos products. Common injuries that occur are broken bones, sprains and dislocations from falls and collisions.

Examples of the monetary needs the workers’ compensation can cover include the following:

Medical Expenses Medical bills, rehabilitation costs, prescription drugs and disability aids such as wheelchairs all fall under the “medical expenses” category. Your medical expenses may be fairly straightforward, consisting of a surgery and its follow-up medication, or it can be a far-reaching range of issues such as psychological counseling, multiple prescriptions and a lifetime disability.

Vocational Rehabilitation If you need to receive job training to rebuild your skills in preparation to reenter the workforce or you need to develop a new set of skills because your injury has made it impossible to go back to your old occupation, workers’ compensation can pay for your vocational rehabilitation. This can include educational courses, training or assistance with finding a new job.

Lost Wage Coverage When you are out of work, you and your family can potentially suffer from the lack of income as you recover. Fortunately, workers’ compensation can provide you with a portion of your salary while you are out of work. In most cases, this portion is two-thirds of your normal salary. This is also sometimes known as disability coverage.

The amount and duration of disability coverage an employee may receive depends on whether his or her disability is permanent or temporary and the extent to which it impairs his or her ability to work. This latter classification is divided into two categories: partial and total disability. If an individual is only temporarily unable to work, he or she receives weekly benefits. For those suffering from long-term or permanent disabilities, the compensation may come in the form of a lump sum.

Who is Required to Provide Workers’ Compensation?

Most, but not all, employers in the United States are required to provide workers’ compensation benefits for their employees.

The requirements for employers to provide workers’ compensation coverage for their employees varies from state to state. When you start at a new job, find out if you are entitled to receive workers’ compensation if you are injured. In most cases, your company’s size and industry determine whether it is required to provide its employees with workers’ compensation coverage. Another reason to ask this question and receive a guarantee in writing is to avoid misclassification. Independent contractors are not employees and thus not entitled to receive workers’ compensation. There have been cases of employees being classified as independent contractors as a way for the company to avoid providing workers’ compensation and other benefits.

All federal employers are required to provide workers’ compensation coverage for their employees.

Who is Entitled to Receive Workers’ Compensation?

Any employee whose employer meets the requirements above is entitled to receive workers’ compensation if he or she is injured in a work-related accident. Independent contractors are not entitled to receive workers’ compensation if they are injured on the job.

To receive workers’ compensation coverage, an individual’s injury must have been caused by an accident that happened because of another party’s negligence while the employees was working in compliance with company policy. If the employee’s claim somehow falls outside of these parameters, his or her claim may be denied. Examples of scenarios where an employee’s claim may be denied include the following:

  • The employee was at fault for the accident. This can be because he or she was under the influence of alcohol or drugs when it occurred, he or she was not following the correct safety procedures, or he or she was acting with recklessness or negligence.
  • The employee purposely injured him or herself in an attempt to seek workers’ compensation.
  • The accident occurred while the employee was not working. For example, if an accident occurred while the employee was out to lunch or before he or she clocked in to work, his or her claim for workers’ compensation may be denied.
  • The employee sought workers’ compensation after he or she had been terminated or laid off.
  • The employee waited too long to notify his or her employer of the accident. Although the specific length of time varies from state to state, all injured employees who plan to seek compensation must notify their employers of their plan to do so. Usually, this time frame is about a month. If you do not notify your employer and have him or her file your claim on time, you can lose the opportunity to seek compensation for your injury-related needs. If you are part of a union, you must also notify your union representative of your injury and plan to seek workers’ compensation.

Seeking Workers’ Compensation After a Workplace Accident

Workers’ compensation is a form of insurance. Just like filing any other type of insurance claim, such as a personal injury or homeowner’s insurance claim, you need to procure as much evidence as possible to prove that you have been injured and you need monetary compensation for your economic losses. Do this by taking photographs of the accident site and your injury, gathering witness testimonies and keeping documentation of all of your interactions with doctors and other healthcare professionals.

After you have received medical care for your injury and notified your employer of your plan to seek compensation, contact an experienced workers’ compensation attorney to represent your claim. In most instances, your case will be decided with a court hearing. An experienced workers’ compensation attorney can represent your interests during this hearing to help get you a workers’ compensation settlement that adequately meets your needs.