Understanding the Basics of Workers’ Compensation Insurance Benefits is essential for you and your employees. Many business owners must fully understand what it is and how it works before signing up for workers ‘ comp coverage. Workers’ compensation systems were designed to provide partial medical care and income protection for employees injured or ill. Most employers buy coverage through private insurers or state-certified compensation insurance funds.
Medical Benefits
Workers’ compensation insurance benefits include medical expenses and lost wages. Employees can also receive disability benefits if they are injured on the job. Typically, these benefits are paid without regard to fault. The most common type of workers’ compensation benefit is cash benefits, which supplement an injured worker’s salary while out of work. These benefits vary by state and can be as high as two-thirds of an injured worker’s average weekly wage. Medical treatment includes hospitalization and surgery but is not limited to a specific dollar amount. However, you should not be billed for treatment unrelated to your work injury or illness. A doctor should submit a treatment plan and estimate of costs before a procedure is performed. This helps to control costs by reducing the risk that an insurer will reject a claim. It would be best to keep receipts for all travel expenses incurred due to your injuries, including mileage, public transportation, and the cost of treatment at the doctor’s office or hospital. These expenses should be submitted to your insurer in the form of a Claimant’s Record of Medical and Travel Expenses and Request for Reimbursement (C-257). Other workers’ comp benefits include vocational rehabilitation, which helps workers return to work. The program also provides death benefits to the workers’ families if they die from work-related injuries or illnesses.
Temporary Disability Benefits
Temporary disability benefits are cash payments that replace lost wages for a certain period while the worker recuperates from an injury or illness. These benefits differ according to the severity and duration of the disability. Generally, temporary total disability (TTD) benefits are paid when an injured worker cannot return to their pre-injury job or another job for the same employer. In most cases, TTD benefits terminate once the injured worker reaches maximum medical improvement or MMI. Some states also offer temporary partial disability (TPD) benefits for injuries that keep an employee off work longer than they could have expected. These are also known as wage or time loss benefits in some jurisdictions. TTD and TPD benefits are usually not considered taxable income in most states. However, the laws are complicated in many places. This is why speaking with a skilled workers’ compensation lawyer is essential before deciding whether you’re entitled to workers’ comp or short-term disability benefits.
Permanent Disability Benefits
In many cases, workers’ compensation will pay medical bills and perhaps provide temporary disability benefits until a worker fully recovers from their injury. However, some employees suffer permanent and lasting effects of their injuries and cannot return to work. These employees may receive permanent disability (PTD) benefits. These benefits are based on several factors. The disability rating is based on the medical evaluator’s medical condition report, the injured worker’s age, the injured worker’s occupation, the degree to which the job causes the disability, and how much reduced future earning capacity the worker will have. The amount of a worker’s weekly permanent disability benefit is based on two-thirds of their average pre-injury wage, not to exceed a maximum set by the state. These benefits will continue until a worker can no longer earn any wages or until they can return to work in some other capacity, whichever comes first. The degree of a worker’s disability varies considerably from state to state. Some jurisdictions use a bifurcated approach, compensating workers for their disabling losses in four groups, depending on the nature of their disabilities and whether they are permanent. Others use a wage-loss method, paying workers for their disabling loss of earnings as compared to the preinjury wage.
Death Benefits
When a loved one dies in a workplace accident or occupational illness, surviving family members may be eligible to receive workers’ compensation death benefits. These benefits help surviving spouses and dependent children maintain economic stability during this difficult time. Those who qualify for death benefits must prove that the worker’s death occurred during their job. In addition, the end must be a compensable injury, not an accident outside of the workplace and unrelated to the employee’s employment. Under workers’ compensation laws, a worker’s surviving spouse and dependent children can receive weekly cash benefits equal to two-thirds of the deceased worker’s average weekly wage. Funeral expenses and up to $10,000 in burial costs are also covered. Surviving spouses can continue receiving these weekly benefits until they remarry. Dependent children can also continue receiving these benefits until they turn 18 years old or until 500 weeks after the worker’s death, whichever is longer. The eligibility requirements for death benefits vary from state to state, so it’s essential to consult with a knowledgeable attorney near you.
