Workers compensation in an insurance program
Workers compensation is an insurance program managed by each state in the nation. Workers compensation covers both public sector and/or many state and local government workers. If you experience an injury or illness related to the workplace, workers compensation may assist in paying for medical treatments and recover a portion of lost wages. When receiving this financial assistance from workers compensation, you agree to surrender rights to sue the employer for money damages in most situations. Employees of workers compensation insurance-covered employers are eligible to submit a workers compensation claim. Each state’s laws define the term “covered employer” and determine exceptions if any to specific types of employees.
For instance, in the states of Minnesota and Michigan, each employee must have workers compensation insurance. There are no exceptions to the law. In comparison, the state of Missouri requires only those businesses with at least five employees to carry workers compensation insurance. Unpaid interns or volunteers or independent contractors who do not provide emergency services are not required to carry workers compensation insurance by most states. Injured Iowan workers should consult an experienced Iowa workers compensation lawyer to learn more.
Processing Workers Compensation Claims
Specific procedures and time requirements vary according to the worker’s state. In general, the injured or sick worker must report the illness or injury to his/her employer within a month of incidence. The employer may offer claim forms or explain where to obtain them.
The employer is typically responsible for filing the worker’s claim and any supporting documents to the insurer. In most states, the employer also notifies the worker’s compensation agency. The insurer notifies the worker when the claim is approved or denied. If approved, the insurer also provides additional instructions regarding the benefit payments to be received.
Types of Workers Compensation Benefits
Workers compensation falls into five categories of benefits including:
• Medical care and treatments and any related costs
• Lost income and wages, typically not greater than two-thirds of the employee’s weekly income
• Permanent disability compensation if the injury or illness prevents the worker’s ability to perform certain tasks
• Vocational rehabilitation/training if the worker may have the ability to perform a different type of job in the future
• Death benefits, including a lump sum benefit to survivors and funeral costs
Workers approved for benefits receive a single lump sum payment or structured payments received over a certain or indefinite period. For instance, lost income/wage benefits are usually provided as structured payments over a one or two year period.
With lump sum payments, workers may be required to sign a legal agreement that voids certain rights, including the right to request reimbursement for additional medical treatment, on receipt of payment.
Workers always have the right to accept benefits or reject the insurer’s proposed settlement offer by engaging an experienced workman’s compensation lawyer to litigate the settlement in court.