Nearly every state in the US mandates that employers carry workers compensation, often shortened to workers comp. These policies protect employees from the costs of medical expenses and lost wages as a result of a job site injury.
Since many people are not completely sure what workers comp involves and how it works, here is a list of responses to frequently asked workers compensation questions:
What Does Workers Comp Provide?
Coverage can vary by policy and state laws. Generally, if someone has an injury that is covered by workers comp, they are entitled to make a claim and receive compensation for:
- Medical costs
- A portion of lost wages or benefits, usually equaling two-thirds of the total
- A one-time disability benefit based on a permanent disability rating as determined by the doctor
- Costs for vocational rehabilitation, including on-the-job training or job placement assistance
Keep in mind that most states have workers comp provisions where accepting workers comp waives the employee’s right to sue for the injury — unless there are unusual or extreme circumstances.
What Situations Are Covered By Workers Comp?
Workers comp applies only to injuries that happen as a direct result of work duties, including:
- Injuries as a result of accidents at the workplace
- Injuries as a result of the workplace environment, such as back strain after heavy lifting or illness after exposure to chemicals
- Injuries as a result of workplace duties, such as computer-related repetitive stress injuries that do not reveal themselves until off the job
- Injuries occurring during official business travel
What Situations Are Generally Not Covered By Workers Comp?
- Travel to and from work while off-duty or not on official business, i.e. your daily commute
- Injuries that happen while the employee is intoxicated or under the effects of drugs
- Deliberate self-inflicted injuries
- Injuries as a result of felony activity
- Injuries occurring after a fight started by the employee
- Injuries unrelated to job duties, such as horseplay or anything in violation of company policy
- Injuries claimed after the worker has been terminated or laid off
- Injuries to self-employed independent contractors
What Do I Do if I Have an Injury I Think Is Covered By Workers Comp?
Inform your supervisor or most-accessible superior immediately. Even if you do not require immediate medical attention, an injury report must be filed both with the company paperwork and with the insurance provider.
Be sure to include a detailed narrative of how the injury occurred, whether it was the result of one incident or repetitive strain. Usually, the superior and not the employee will file the report, so double check the wording to ensure accuracy.
Failing to file a report of the injury within 24 hours can often waive your right to file a claim. When seeking treatment, determine if you are limited to a certain doctor or health care service provider as a requirement of the workers comp policy.
Keep detailed records of your expenses, including travel to seek medical attention and any sort of costs incurred as a result of holding to the doctor’s suggested rehabilitation program, such as purchasing a special pillow. You may not be entitled to recover every bit of your costs, but without documentation you will be unable to attempt to claim them at all.
How Do I Know if My Employer Has a Workers Comp Policy?
Chances are if you work with one or more other employees, your employer has a workers comp policy. You can always ask them what type of policy they have and what employee classes or injuries it covers. Employers are also typically required by the state to post clear signage as to filing for workers compensation, who the policy carrier is and what the stipulations are.
As an Employer, Am I Required to Provide Workers Compensation?
Generally, yes. Laws vary from state to state, but in almost 100 percent of states, workers compensation is required if you have one or more regular employees. This requirement does not apply to independent contractors.
Some states have thresholds or loopholes, such as only requiring coverage if you have a certain amount of full-time employees. Texas is one of the few states that allows employers to completely opt out of providing workers compensation. Keep in mind, though, that one of the benefits for providing workers comp to employees is that it can protect employers from liability in most situations.
Workers compensation policies are designed to protect both workers and employers. They give both parties peace of mind to work on the job without worry of costly injuries or lawsuits. Make sure that your company provides the extent of workers comp insurance as required by state law, and consider adding coverage to the policy for common workplace risks or potentially expensive injuries.