How Workers Compensation Insurance Works?

Truck Accident Lawyer

Worker’s compensation insurance deals with all those employees that get work-related injury or illness. When an employee gets injured during work, he can file a worker compensation claim that benefits him. This means worker comp is the only remedy available for workplace injuries.

Besides covering medical expenses, the workers’ compensation also replace the wages from lost work time. The workers’ compensation promotes employee safety, supports companies, and gets them back to work or transitional work.

Different states have different laws about how much an employee should be paid out in case of an accident at the workplace. Generally, workers’ compensation covers two-thirds of an employee’s wages, but it doesn’t limit here. Besides wages, the insurance also includes medical treatment of injury, medical care, wage replacement, compensation for permanent injuries, and vocational rehabilitation.

What Injuries Are Covered?

Workers’ compensation insurance compensates all those employees who suffer from work-related injuries. It may occur by a single accident or not; those injuries that do not happen through a single incident include illness resulting from continuous exposure to chemicals in the work environment.

Workers compensation also covers all the work-related injuries even if it is not in the company. Before giving the benefits to the employee drug or alcohol test, if the result is negative, only then can he avail the insurance. So, workers’ compensation insurance covers:

  • Slip and falls at work.
  • Injury to the lungs for inhaling toxic substances.
  • Injury due to chemical spill.
  • Carpal tunnel.
  • Back injuries from repetitive movement.

What Injuries Are Not Covered?

The Workers’ compensation insurance necessarily covers not all the injuries; there are some exceptions. A few conditions of injuries are discussed below that are not covered:

  • If the accident happens while driving to and from work.
  • If an employee is revealed to be under the influence of drug/alcohol through the test.
  • The employee was violating company policy.
  • Self-inflicted injuries or intentional acts.
  • The employee was not on the job.

Covered Employees

The parameters for covering employees vary in each state. To purchase workers’ compensation insurance the employer must have some minimum number of employees that is allocated by state. Majority of the state excludes all the domestic workers, agricultural workers, and seasonal workers. Other then this, all the individual contractors are also excluded from the workers’ compensation.

Filters By The Employers

Before establishing compensation, the injured employee had to sue his employer to pay his medical expenses and recover the wages. The most common defenses used by employers are the following:

  • It may happen that the fellow worker’s negligence caused the injury.
  • The worker’s negligence contributes to an accident.
  • The injury is the result of the danger zone of the workplace.
  • A worker has taken drugs or alcohol that causes injury.
  • Workers compensation always have a check on these filters and then give benefit to his employees.

Who Pays for Workers’ Comp?

Employees take benefits from the Workers’ Compensation, but surely they don’t pay for it. The employer has to pay the insurance company for the coverage.

The process begins as the incident happens to the workers. The worker has to inform the employer about the injury within a specified time; otherwise, the employee won’t be able to take benefit from the insurance.

As your worker reports you about his injury, the employer will claim for workers’ compensation. All the benefits and payments are provided to the employer through the agency responsible for processing the claim.

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