The Basics of Workers’ Compensation Programs

November 27, 2019 | Uncategorized | By Personal Injury Legal Directory | 0 Comments

While many workers know whether their employer carries workers’ compensation benefits or not, they may not understand what this program entails until they need to use it. The United States Department of Labor requires that employers who have more than a certain number of employees carry a workers’ compensation benefits program. This ensures that workers are covered in the event of a work-related illness or injury. 

How do workers’ compensation benefits get awarded to an employee?

An employee who is injured at work should get medical care right away. He or she must inform their direct manager about the incident, then complete paperwork to apply for workers’ compensation benefits. The employer’s insurance company will review the claim and either approve or deny coverage. Depending on the type and severity of the injury, the employee will receive certain types of benefits. 

Can I just wait to see if I sustained any injuries first?

There may be instances where a workplace accident happens, but an employee isn’t sure if they sustained an injury from it right away. Perhaps they took a fall but got up just fine without an issue. In the days to follow, bumps, bruises, and pain may finally start to be felt. It is important to report an accident even if you don’t know if you are injured, so you don’t hinder your chances of being eligible for coverage later on.

What kinds of benefits may an employee get under workers’ comp?

An employee may receive coverage for medical care and wage replenishment if they are deemed unable to work based on doctor’s orders. Under workers’ comp, the employee won’t have to pay for care related to their injury, such as copayments for doctor visits, treatments, x-rays, medication, surgery, etc. 

In what instances may a claim get denied?

Workers’ compensation programs were designed to meet in the middle between both an employee and an employer’s best interests. The focus of workers’ comp isn’t to place blame on either party, and it also helps to alleviate worker and employer tensions. The employee gets the care they need, and an employer gets to avoid a lawsuit. Instances where a claim may get denied include:

  • If the employee didn’t file workers’ compensation in a timely manner (usually within 30 days after the injury accident is the deadline).
  • The employee was found to be under the influence at the time of the workplace accident.
  • The employee had instigated a fight while on the job, which led to injury.
  • The employee was not performing a task within the scope of his or her employment when the injury accident occurred. 
  • Proof shows that the employee had purposefully injured themselves in order to collect workers’ compensation. 
  • Injuries that were caused when violating company policies. 
  • Injuries caused when the employee was committing a crime. 

How do I know whether I need help from an attorney?

Some workers’ compensation claims are handled appropriately and with respect for the employee, so obtaining an attorney may not be needed. However, if you find yourself enduring retaliation, being fired, receiving a demotion, experiencing workplace hostility, or any other adverse treatment since using workers’ compensation benefits, then it may be time to get help from a legal professional. Contact a workers’ compensation lawyer, like a workers’ compensation lawyer in St. Lucie, FL for more information today. 

Thanks to the Law Offices of Franks, Koenig, & Neuwelt for their insight into the basics of workers’ compensation programs.