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What is Workers' Compensation?
Workers’ compensation insurance provides medical and wage benefits to people who are injured or get sick on the job. The coverage is considered to be social insurance because it relies on a social contract between management and labor, wherein in exchange for purchasing workers’ compensation insurance, business owners are protected from lawsuits from injured workers. Workers' comp is mandated by each state and the wage and medical benefits vary by state.
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How Does it Work?
Within 1 working day of an employee reporting an injury, their employer is required to authorize up to $10,000 in medical treatment while the administrator reviews the claim. Once approved, the insurance company will pay for all medical costs associated with the injury as well as disability benefits.
If the injury prevents a worker from returning to their job, he or she will receive a voucher to help pay for retraining for a different job. If an employee dies from a work-related injury, workers’ comp will make payments to the worker's dependents and pay up to $10,000 in burial expenses.
What are the Most Common Workers' Comp Claims?
Injuries that commonly result in workers' comp claims include:
- Sprains and strains (30%)
- Lacerations or puncture wounds (19%)
- Bruising or contusions (12%)
- Inflammatory injuries- e.g., tendonitis and plantar fasciitis (5%)
- Broken bones (5% of all claims annually)
Related Article: Disability Benefits & Workers' Compensation
How Much Does Workers' Comp Pay?
In most states, if you are injured on the job, you are entitled to receive two-thirds of your pre-tax gross wage. This is set by state law and also has a maximum allowable amount. For example, the maximum allowable amount in 2018 in California was $1,215.27 per week for a total disability. This amount is adjusted annually, and there is a minimum amount that is eligible to be paid.
Related Article: Can You Work While on Workers Compensation?
How Long Do Most Workers' Comp Settlements Take?
The entire workers' compensation settlement process -- from filing your claim to receiving your first check -- can range from 12-18 months, depending on the details of your case and whether you have legal representation.
Related Article: When Will Workers’ Comp Offer a Settlement?
What is the Longest You Can Be on Workers' Comp?
Some states limit the length of time an injured employee can receive workers' comp benefits. This can range from 3 to 7 years. However, there is not usually a limit on permanent disability benefits. Some states do stop weekly benefits when an employee reaches the age of 65.
FAQs
How does workers' compensation handle pre-existing conditions?
Workers' compensation can cover pre-existing conditions if workplace activities significantly aggravate or worsen the condition. Documentation and medical evidence are crucial to proving the workplace's impact on the pre-existing condition.
What is the waiting period for receiving workers' compensation benefits?
The waiting period for workers' compensation benefits varies by state, usually ranging from a few days to a week. Benefits are retroactive to the first day of injury if the disability lasts beyond a specified duration.
Can an employee choose their own doctor for workers' compensation claims?
Whether an employee can choose their own doctor depends on state laws and the employer's workers' compensation insurance policy. Some states allow employees to select their doctor, while others require visiting an approved medical provider.
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- 5 Types of Workers Comp Adjuster Tricks
- How Long Do Workers' Comp Settlements Take?
- What to Do After an Injury at Work?
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