What Does Workers Compensation Cover?

what workers compensation covers

Workers compensation is a type of insurance generally carried by employers that covers employees’ medical expenses and lost income resulting from an injury that occurred in the course of employment, as well as additional payments if it is determined that the injury has resulted in some type of permanent impairment. It does not provide for pain and suffering or other damages.

Types of Workers Compensation Benefits Paid

As an injured worker, you have a right to benefits to pay for your medical expenses resulting from a work-related injury. This also includes transportation to medical appointments. In addition, it can include payment for vocational rehabilitation if job re-training is required—for example, if your injury prevents you from performing the job you performed before the accident and training is required to place you in a different position.

The amount of weekly income benefits received is calculated based on a percentage of your average wage for a certain number of weeks before the accident, including overtime, in combination with a schedule of benefits that provides a value on your injury or impairment based upon the body part or parts that were injured. These schedules vary widely among the different states, and many states have also imposed a cap or maximum limit that they will pay for weekly benefits regardless of your earnings, be it wages or salary.

Calculating and Limiting Workers Compensation Benefits

Each state imposes different limits on workers compensation benefits. These limits restrict the length of time you can receive weekly payments from workers compensation as a replacement of your income. This can depend upon whether the injury is classified as a temporary injury or a permanent one. If a medical assessment reveals that the injury is not going to improve over time, even with additional medical treatment, your injury may be classified as a permanent disability. 

If you are deemed disabled, the total benefits you receive will also depend upon whether the permanent disability that results from the injury is considered partial or total. If you are determined to have a partial disability, it means that you can work, but perhaps not in the same capacity as before the accident, and you may be required to do only desk or light-duty work. Total disability means that you can no longer work at any type of employment, in any capacity.
Permanent disability benefits do not have a time limit, but may end at a specific age, and not all states provide permanent partial disability benefits.

Disputes with the Workers Compensation Insurer

If your employer or their insurer disagrees with the medical diagnosis or determination of impairment provided by your treating medical doctors, they may request that you be examined by a doctor of their choosing. You must comply with such requests in order to receive your workers compensation benefits, but many states impose requirements on these exams to protect you. These may include requiring that you be given a copy of the report within a specified period of time, that the physician conducting the exam must be board-certified in a specialty appropriate for your injury, and/or that you be allowed to bring your own representative or physician to the exam.

If, after conducting the medical examination, the workers compensation insurer argues that your medical treatments are not necessary or that your medical condition is not a result of an injury that occurred in the workplace, you may need to bring a claim before the state workers compensation board to get your benefits paid. To find a qualified workers compensation lawyer who can help with your workers’ compensation claim, simply summarize your legal issue on our website and let interested attorneys come to you.

Additional Workers Compensation Resources 

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Posted - 09/12/2017