Whether you’re a business owner or a worker, there are many things you need to know about workers’ comp benefits.
Workers’ compensation pays for medical care and cash benefits for time lost from work. In addition, it also pays death benefits for employees who die due to a workplace accident.
Medical Benefits
Workers comp offers medical benefits to injured employees with work-related injuries or illnesses. These can include emergency room visits, surgery, and prescriptions.
Unlike health insurance, workers’ comp does not generally require deductibles or co-payments. This means that many injured workers can visit as many physicians and specialists as they like without worrying about out-of-pocket costs.
Some workers’ compensation programs also offer death benefits for employees who die due to a work-related injury or illness. Between 1993 and 2013, fatalities accounted for less than 0.5 percent of cases involving cash benefits and between 2 to 3 percent of total payments in NCCI states (NCCI, 2013).
In addition to medical care and hospital treatment, workers’ comp provides wage loss benefits for workers who cannot work due to an occupational injury. These benefits replace lost wages and cover a portion of an employee’s living expenses.
To receive workers comp benefits, an injured worker must file a claim. They can then submit receipts for medical and travel expenses related to their work injury. The claims adjuster will review the records and decide on the appropriate compensation benefits. If there is a dispute, a workers’ compensation law judge will decide. Once the claim is approved, cash benefits will begin.
Temporary Disability Benefits
Some companies offer workers’ comp benefits to protect their employees if they get sick or injured while on the job. This type of disability insurance helps provide income to cover essential expenses during recovery and allows workers to return to work without worrying about their finances.
These benefits depend on the coverage plan, but generally, they pay between 40 and 60 percent of your weekly salary. This is a great way to keep you financially secure while you recover from a workplace injury or illness, but make sure to find out what the maximums are in your state.
If a worker suffers an injury that prevents them from working, the compensation company will offer temporary total disability (TTD) benefits to compensate for lost wages. These benefits may continue until the doctor determines that a worker’s disability has reached maximum medical improvement or MMI.
Temporary partial disability (TPD) benefits are also paid when a worker can’t perform the same job as before because of a work-related injury or illness. These benefits usually last for a certain number of weeks before the employee reaches MMI and is eligible to receive permanent total disability benefits.
If you need help claiming your workers’ comp benefits, talk to an experienced attorney. The laws regarding these gifts are complex and vary from state to state.
Permanent Disability Benefits
If your injury or illness has left you unable to work, you may be entitled to permanent disability benefits. The laws governing these awards vary widely by state, but they are intended to cover you and your family when you can no longer earn an income.
A worker classified as partially disabled may receive weekly payments equal to two-thirds of the difference between what they earned before their injury and what they currently earn at a new job. These weekly payments continue for a maximum of 500 weeks.
When workers are permanently disabled, they may be awarded a lump sum, a series of weekly checks, or other cash benefits. Depending on the severity of the injury, these benefits can provide you with enough money to cover your expenses and help you get back to everyday life.
In most states, the degree of a worker’s impairment determines the amount of an impairment benefit. However, in about 19 states, the approach is different.
Instead of relying on an impairment rating, these states compensate for unscheduled permanent partial disabilities by examining the extent of a worker’s loss of earning capacity. This approach is called the “bifurcated” approach.
This area of workers’ compensation law can be complicated and confusing. Whether you’re dealing with an insurance company or a claimant, hiring an experienced attorney who understands the rules and how to protect your rights is important.
Lost Wages Benefits
If you cannot work after being injured or diagnosed with a work-related illness, workers’ compensation will pay you money for the time you are not earning a wage. These benefits may only cover part of your wages, however. They can only be obtained through a lengthy and complex process with the assistance of an experienced workers’ compensation lawyer.
The lost wages benefit is paid until you can return to work or until your injury or illness has reached maximum medical improvement. You are not eligible to receive these benefits for the first seven days of your disability, but you can get weekly checks after that.
Supplemental Earnings Benefits (SEBs) are also available if you cannot perform your work due to your injury or illness. This type of lost wage benefit is based on the difference between what you made before your injury and what you can earn now.
This is usually a two-thirds wage replacement, although there are exceptions depending on the year of your injury and the jurisdiction in which you live. This type of benefit is capped at a specific percentage of your average weekly wage and is subject to a minimum and maximum set by law.
In addition to these types of benefits, you may also be entitled to a so-called “dependent allowance.” The insurance company will pay you a percentage of your average weekly wage to compensate for your dependents’ losses from not having their parent or spouse with them.
