When you go to work, you think you’re covered, but accidents can happen. You might have an accident at work or develop an occupational disease. It’s important to understand your state’s workers’ compensation system.
What Are Workers’ Compensation Benefits?
Workers’ compensation is a type of insurance that benefits workers who are injured on the job. These benefits may include medical treatment, reimbursement of medical bills, and disability benefits. They can also cover death benefits for dependents. These benefits are designed to cover some expenses incurred by an injured worker.
Typically, insurance companies sell workers’ compensation insurance to employers. The cost of this insurance, known as a premium, varies depending on the kind of work being done and the safety record of the company, among other things. Some larger businesses could be self-insured, which means they give workers’ compensation directly.
In most situations, injured workers receive workers’ compensation insurance regardless of who is at fault for the injury. These benefits act as insurance, preventing the employee from suing the employer for compensable injuries.
Situations Not Covered by Workers’ Compensation
Workers’ compensation insurance is intended to cover work-related accidents, but there are limitations. Compensation can be refused if:
- The injury occurred due to the worker’s intoxication or drug use.
- The worker was hurt while committing a major crime.
- The injury occurred while the worker was not on the job.
- The injuries are self-inflicted, such as if the worker started a fight.
States can order an injured worker to submit to drug and alcohol tests and deny workers’ compensation if the tests show the worker was under the influence at the time of the injury. Most of these situations will be revealed during the investigation after the employee files a claim.
What Costs Does Workers’ Compensation Cover?
Workers’ compensation may cover numerous expenses associated with workplace accidents. Despite typically low premiums, workers’ compensation insurance provides the following coverage:
- Medical Care: This includes doctor visits, surgeries, medications, and other treatments.
- Disability Benefits: If an injured worker is temporarily or permanently unable to work, they may receive disability benefits. Those with impairments may be eligible for benefits for temporary total disability or permanent disability.
- Rehabilitation Costs: If an injured worker needs rehabilitation, they can ask for compensation. This might include retraining costs.
- Death Benefits: If an employee dies as a result of a work accident, their dependents can receive death benefits.
Wage benefits typically make up about two-thirds of an employee’s average weekly wage. The right to wage compensation arises after a few days of work are missed due to an injury or illness. Doctors approved by the workers’ compensation system or your employer can take you off work and decide when you can return, either part-time or full-time.
Remember, if a person makes a workers’ compensation claim, they cannot sue the employer.
Coverage for Long-Term and Permanent Injuries
Yes, long-term and permanent injuries are covered under workers’ compensation. These can include permanent total disability, in which the accident prevents the worker from working at all, or permanent partial disability, in which the worker is partially but permanently impaired. Carpal tunnel syndrome and back issues brought on by repeated movements are two examples. The impact of certain workers’ long-term exposure to dangerous chemicals or substances might only be understood for a while.
Suing Your Employer for a Workplace Accident
You usually cannot file a lawsuit against your employer for an injury sustained at work if you obtain workers’ compensation. Providing benefits without going to court is the concept underlying workers’ compensation. The creation of workers’ compensation provided an option to pursue a personal injury claim.
In some states, you can sue an employer for negligent or intentional actions that caused an injury. Other states may allow a wrongful death lawsuit if the injury causes the worker’s death. Generally, if you choose to do this, you give up your right to workers’ compensation. If successful, the court may award significant damages, including punitive damages, medical expenses, lost wages, pain and suffering, and emotional distress.
Protection from Retaliation
No. Generally, it is illegal for an employer to fire an employee for filing a workers’ compensation claim. This is considered retaliation, and most states prohibit it by law. If an employer retaliates against an employee for filing a workers’ compensation claim, the employer should be reported immediately to the local workers’ compensation office.
Get Help from a Professional Workers’ Compensation Attorney
Understanding workers’ compensation can be difficult because there are so many rules. Dealing with the insurance company can also take time and effort. If you were injured at work and your employer is contesting your workers’ compensation claim, you probably need legal help.
A workers compensation lawyer in Waukesha, WI can help you understand your legal rights and ensure you get the medical benefits you deserve. They can help you navigate the workers’ compensation system and determine the extent of your benefits. Skilled in workers’ compensation law, they can provide valuable legal assistance.
An experienced workers’ compensation attorney can provide peace of mind while you pursue your claim.
