Even with stringent safety procedures and thoroughly trained employees, workplace accidents can still happen. Most states mandate that businesses provide workers’ compensation to prevent workplace accidents. However, very few employees know what to do if they’re injured on the job. If you sustained an injury during working hours, this guide to workman’s compensation can help you out.
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What is Workman Comp?
Workers’ compensation, or workman’s comp or workers’ comp insurance, is a no-fault system that pays for medical care and part of an injured worker’s lost wages. It protects employers from lawsuits filed by employees, and it’s required by law in most states. Employers must purchase workers’ comp insurance or meet strict state-certificate self-insurance requirements to avoid paying into the system.
It was initially referred to as “workman’s accident insurance,” but as the system spread, the name was changed. It is commonly known as a “compensation bargain” because it limits both parties’ rights and obligations in the event of an injury. Workman’s comp covers only those injuries or illnesses that are a proximate result of workplace activities.
How Do I File a Claim?
When an employee reports a work-related injury or illness, it is crucial to provide proper medical care and file a workers’ compensation claim with their employer. It is also essential that the employer provides them with the proper paperwork and forms to file.
Deadlines for filing vary by state, but ideally, it should be as soon as possible.
Once the claim is approved, the insurer will commence providing benefits. It is not unusual for claims to be denied the first time. In that case, injured workers should seek legal advice from workman’s comp lawyers as soon as possible. An experienced attorney can help ensure all necessary steps, including appealing a denial, are taken. They can also assist in navigating the often complicated workers’ compensation process.
Who is Covered by Workman Comp?
Workman’s comp, also called workers’ compensation or workman’s comp insurance, covers employees for medical treatment and a portion of lost wages after a workplace injury or disease. Its monetary limit is usually equal to an employer’s state-required statutory obligation. Unlike most other types of health insurance, workers’ comp will cover an employee’s care until they reach “maximum medical improvement” or the condition has been deemed fully healed and stable.
Many states require that businesses carry workers’ comp coverage. However, if a business has few employees or meets other requirements, they may choose not to get it. The exceptions to this rule are often particular, such as domestic workers in private homes and volunteers. Also, staffing or temp agencies typically have coverage for employees they place with special employers. But if those employees are injured on assignment with a regular employer, the question of who is responsible for the coverage can become complicated.
What Happens if My Claim is Denied?
You can request a hearing with a workers’ comp judge if your claim is denied. During this hearing, you can present additional evidence, such as medical records and bills, photos of your injury, repair estimates, and other relevant information. It is also a good idea to speak with an attorney before the hearing, as they can help you prepare and gather all necessary evidence for your case.
The insurance company must then review the claims information and submit a written decision to you within 30 days.
