When an employee is injured on the job, employers face several challenges. How do you ensure employees receive the care they need while protecting your company from potential legal action?
Workers’ compensation insurance is one way to mitigate the risk of an on-the-job injury, but it’s important to understand how it works and your responsibilities as an employer. While most employers are required to carry worker’s compensation insurance, there are still many questions about the specifics of the coverage and how it works.
Cerity is here to help. We’re a leading provider of workers’ compensation insurance in the United States, and we’re here to help you navigate the complexities of the worker’s compensation system. In this blog post, we’ll explain what workers’ compensation is, how it works, and answer some frequently asked questions about the system.
What Is Workers’ Compensation, And How Does It Work?
Workers’ compensation is a type of insurance that covers injured employees’ medical expenses and lost wages. It is typically required by law for employers to have workers’ compensation coverage for their employees.
When an employee is injured on the job, they report the injury to their supervisor or HR department. The employee may be required to see a doctor or other medical professional for treatment. If the injury is work-related, the employee can file a claim with the employer’s workers’ compensation insurance provider to cover the cost of medical treatment and lost wages.
The employer’s insurance provider will review the claim and determine its validity. If the claim is approved, the employee will receive financial compensation for their medical expenses and lost wages. The employee can appeal the decision or seek legal counsel if the claim is denied.
Employees injured on the job are entitled to workers’ compensation to cover their medical bills and to prevent disputes between employers and employees over the cost of the injury. It is a no-fault system, meaning the employee does not have to prove that the employer was at fault for the injury to receive benefits.
What Benefits Are Covered By Workers’ Compensation?
- Medical treatment: Workers’ compensation pays for the reasonable and necessary medical treatment related to the work injury or illness. This may include hospital stays, surgeries, medications, and physical therapy.
- Lost wages: Workers’ compensation will cover a portion of their lost wages during an employee’s absence from work due to injury or illness.
- Disability benefits: Worker’s compensation may provide ongoing disability benefits if an employee suffers a permanent disability.
- Rehabilitation services: Workers’ compensation may cover the cost of rehabilitation services, such as physical therapy or job training, to help an employee return to work.
- Death benefits: Workers’ compensation may benefit the surviving family members if an employee dies due to a work-related injury or illness. These include funeral expenses and a monetary payment to help with the loss of income.
However, in some circumstances, workers’ compensation may not be available. These may include:
- Injuries or illnesses that are not work-related: Workers’ compensation only covers injuries or illnesses directly related to the employee’s job duties. If the injury or illness is not work-related, it may not be covered by workers’ compensation.
- Self-inflicted injuries: If an employee intentionally injures themselves, their injury may not be covered by workers’ compensation.
- Injuries sustained while engaging in horseplay or other reckless behavior: Horseplay or other reckless behavior may disqualify an employee from receiving workers’ compensation benefits.
- Injuries sustained while under the influence of drugs or alcohol: Workers’ compensation benefits may not be available to injured employees under the influence of drugs or alcohol.
How Do I Know If My Business Needs Workers’ Compensation Insurance?
No matter how careful you are, accidents can still happen at work. The National Safety Council estimates that workplace accidents occur on average once every seven seconds. Employers can limit litigation costs by purchasing workers’ compensation insurance that protects employees against workplace injuries and illnesses.
The specific requirements for workers’ compensation insurance vary by state, so it’s important to check with your state’s workers’ compensation board or agency to determine if you are required to carry this insurance. In general, however, if you have employees, you are likely required to have workers’ compensation insurance.
Even if it’s not legally required in your state, carrying workers’ compensation insurance is a good idea to protect your business and your employees. Workers’ compensation insurance can help you avoid costly legal battles and improve your employees’ morale by demonstrating that you care about their well-being.
What Should an Employee Do When They Are Injured at Work?
When an employee is injured on the job, he or she should report it to a supervisor immediately. The injury should be reported by providing the date, time, and details about how it happened.
It is also best to report any injury as soon as it occurs. If a job-related illness or injury continues to worsen over time, it should be reported as soon as possible after diagnosis.
How Do I File for Workers’ Compensation?
Report an injury or illness if :
- Your employee is injured or becomes sick due to their job
- The worker is hurt while performing a duty related to the workplace
If one of your employees is injured on the job, ensure that he or she gets proper medical treatment. If necessary, call an ambulance or take them to the emergency room. Approve their request for time off from work if recovery requires it.
You’ll need to gather a lot of information before filing a claim. The actual information you’ll need can vary from state to state, but there are some general documents that employers and employees may be asked for when applying for compensation:
- Company name and location, policy number
- Injured employee information (name, date of birth, address and phone number, SSN, gender)
- An overview of the incident (date of the incident, type of injury, the exact part of the body injured, cause of the injury, number of days the employee is expected to miss, return date, witnesses, etc.)
Depending on your state of operation, this process can differ. Business owners may be required to notify their workers’ compensation insurance carrier within a certain period.
Workers’ compensation coverage is an important part of protecting your employees and ensuring you have the coverage you need. Contact your insurance company or state workers’ Compensation office if you have questions about your worker’s compensation coverage.