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After you have been injured on the job, you may want to know about the next steps, especially when it comes to getting compensation for medical expenses and lost wages.
Most of the time, you can get financial assistance during these difficult times. From qualifying for benefits to initiating the claim, let’s look at a few vital details that you need to know when it comes time to get your benefits.
What Is Workers’ Comp?
According to the U.S. Bureau of Labor Statistics, employers reported 2.8 million nonfatal workplace injuries and illnesses in 2022. The National Safety Council also stated that there was a 5% rise in workplace preventable deaths, from 4,472 in 2021 to 4,695 in 2022. In these cases, employers or their surviving family members may recover benefits.
In almost all states, workers’ compensation benefits provide financial support to injured or ill employees due to work-related causes. The main parts of workers’ compensation include medical expenses, lost income, disability benefits, and death benefits.
When workers are injured, their medical treatment is covered by workers’ compensation medical benefits. They will receive compensation for any doctor visits, hospital stays, surgeries, medications, and rehabilitation related to the injury. With that, employees receive the medical attention they need to recover from work-related injuries or illnesses.
However, with that amount of time away from work, workers will lose out on their wages. Workers’ compensation can help to cover some of those losses. If an employee is unable to work due to an injury or illness, workers’ compensation wage replacement benefits provide partial salary replacement during the recovery period. That can alleviate the financial burden on the employee and their family while they are unable to work.
Sometimes, the work-related illness or injury does not allow workers to return to full capacity in their previous role or job. In these cases, they may be allowed to participate in vocational rehab or obtain disability benefits, which may include:
- Temporary total disability benefits are available for employees who are temporarily unable to work.
- Temporary partial disability benefits are for employees who can work at reduced capacity.
- Permanent total disability benefits are provided for permanent disabilities preventing any work.
- Permanent partial disability benefits are available for lasting impairments that allow some work.
If the worker passes away, family members may be able to receive workers’ compensation death benefits. These benefits cover all funeral expenses and provide financial support to surviving dependents. While the benefits cannot replace the loss of a loved one, they can give some financial support to the family of the deceased employee during such a difficult time.
Who Can Receive These Employment Benefits?
Workers’ compensation can provide assistance when a worker has suffered a work-related illness or injury, but not everyone will qualify. There are a few requirements that individuals must meet:
Employee Status
No matter if you work in industries with the most workers’ compensation claims or one without a reputation for dangerous work, you are entitled to benefits if you meet certain criteria. If you want to collect workers’ competition, you will need to be classified as an employee.
Generally, independent contractors and freelancers are not covered under workers’ compensation benefits.
Employer Coverage
For employees to qualify for workers’ compensation benefits, their employer must have workers’ compensation insurance. Most employers in the United States are mandated to carry this type of insurance. Most states also provide workers’ compensation benefits regardless of your immigration status.
Some states have created agencies or public funds to provide benefits for injured workers whose employer did not have workers’ compensation coverage at the time of the injury. Thus, even if your employer was uninsured, you may still be able to recover benefits for your work injury.
Work-Related Injury or Illness
There are several injuries covered by workers’ compensation, ranging from minor temporary injuries to lifelong illnesses.
To get coverage for an injury or illness, it should be tied directly to your job, whether it’s a physical injury sustained during work hours or an occupational disease developed due to work-related activities.
Compliance With Deadlines
Workers who want to receive benefits will need to act promptly. They will need to report the incident or illness immediately, and then take steps to file their claim.
Keep in mind that the state has its own specific rules and criteria governing workers’ compensation benefits. However, many of them follow the same regulations to file and receive these types of financial assistance.
How To File a Workers’ Comp Claim
If you have been hurt on the job or suffered a work-related injury, you will need to act immediately. The first step is to alert your employer. You should keep a record of who you notified, and ask for a copy of any injury report that is created. With that, you will have documentation that the injury or illness resulted from employment, not another off-duty cause.
When reporting the incident, make sure to offer a clear and detailed account of how the injury occurred or when the illness was first noticed. This will help to assess the work-related nature of the incident.
At this time, you will need to get immediate medical attention. Whether you believe the injury is severe or not, you will need to have a complete evaluation. During this time, a healthcare provider can determine whether your injury or illness is related to your employment.
After this, your employer will begin the process of filing the claim in your state. Most of the time, they will start the initial paperwork, but it will be up to you to complete the process.
For that reason, you will want to gather all the necessary information and documents when filing for workers’ compensation. Remember to keep all medical records, bills, and reports related to your treatment. These documents can help you recover your expenses.
When filing a workers’ compensation claim, you may need to contact your state’s workers’ compensation agency. They are responsible for overseeing work injury claims and making sure your employer complies with state regulations. If your state requires paperwork to pursue a workers’ compensation claim, you should complete all the required paperwork accurately and quickly, providing detailed information about the incident and the extent of your injuries.
Once your claim is submitted, the insurance company will investigate the validity of it. During this process, they may request additional information or documentation to support your case. You should cooperate fully and provide any requested details right away, however you may want to contact a lawyer to be sure that the insurance company is entitled to everything they are asking for.
Once the investigation is complete, you will receive a decision regarding your eligibility for benefits. If your claim is approved, you should receive the benefits you are entitled to.
If your claim is denied, you will likely have to file it with your state workers’ compensation agency for a formal opinion from a Judge or other similar decision-maker. There are deadlines for all legal claims, including workers’ compensation claims so you will want to move as quickly as possible if your claim is denied.
If you encounter challenges during this process, you should seek legal advice from an attorney specializing in workers’ compensation.
Does a Claim Replace Other Legal Actions?
Workers’ compensation benefits are an alternative to filing a lawsuit against the employer. Remember that workers’ comp provides benefits regardless of fault. So, even if your actions contributed to the injury, you are still entitled to benefits.
However, workers’ compensation benefits do not cover general damages such as pain, suffering, mental anguish, or anxiety. These types of damages are often associated with personal injury lawsuits, but they’re not applicable when a worker is covered by workers’ comp.
While most employees are prohibited from suing their employer because they receive workers’ compensation benefits, there are situations in which they may still be able to pursue third-party claims. For example, if a work-related injury was caused by a defective product or the negligence of a party other than the employer, the injured employee may have the right to file a claim against that third party.
Workers’ compensation claims are meant to provide much-needed relief when you have been injured on the job. By understanding your rights and acting quickly, you can get the compensation you are entitled to.
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This website was created and is maintained by the legal team at Thomas Law Offices. Our attorneys are experienced in a wide variety of personal injury and work injury cases and represent clients on a nationwide level. Call us or fill out the form to the right to tell us about your potential case. We will get back to you as quickly as possible.
