The Top 10 Things To Know About Workers Compensation
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Every 7 seconds, an American worker gets injured on the job. It's a heartbreaking statistic, with OSHA going to great lengths to help make workplaces safer and more healthful for workers across the country.
But despite OSHA's great efforts and achievements over the years, 5,250 workers still lost their lives on the job in 2018. Millions more suffered non-fatal injuries due to work-related incidents.
A workplace injury can dramatically change your life. Most people involved in workplace injuries experience significant physical, mental, and financial adversities.
If you have been injured at work, workers’ compensation, can help lessen your suffering. Workers’ compensation laws go back to the early 20th century. Today, almost all businesses with employees in all but two states are required by law to have workers’ compensation insurance.
But what exactly is workers’ compensation and what does it cover? Who pays for it? Are all employees eligible for workers’ compensation?
If you are asking yourself these questions, you’ve come to the right place. In this comprehensive post, we tell you all you need to know about workers’ comp insurance. Keep reading to learn more.
What Is Workers’ Compensation?
Workers’ compensation refers to insurance that offers medical benefits and wage replacement to workers who suffer work-related injuries or illness. This cover helps safeguard both employers and employees from financial losses arising from a job-related injury suffered by the workers.
What to Know About Workers Comp
Legislation surrounding workers’ compensation has evolved dramatically since the law was passed more than a century ago. Workers’ comp benefits also vary from state to state, which makes this insurance cover a little difficult to understand for some people. In this section, we help demystify things for you.
Here are some important facts about workers’ compensation.
1. States Administer Worker's Comp Programs
Organizations typically pay into their respective state’s compensation funds. Those that don’t do so purchase self-insurance to cover compensation benefits to workers who get injured or ill while on the job.
As we mentioned earlier, all states except two require companies to carry workers’ comp insurance. The two exceptions are New Jersey and Texas, where coverage is elective.
The cost of coverage can differ significantly depending on several factors. These include:
Your state’s compensation laws
The size of the business
The type of work done by employees
The nature of risks involved in the job
As an employee, you aren’t responsible for contributing to workers’ comp premiums.
2. Types and Levels of Coverage Differ
While almost all US businesses need workers’ compensation cover, the type and level of coverage can differ depending on the state. The state defines employees that require compensation as persons hired or appointed by employers for remuneration. These people include independent workers.
States can differ when it comes to:
The employees covered
Statutes of limitations
Excluded injuries
Employers’ defenses against compensation claims
Employers in some states have the option to carry or not carry employers’ coverage insurance. Opting not to have this coverage leaves can leave your business open to personal injury lawsuits by your employees.
3. In Most States, You Can Self-Insure
Currently, only four states don’t allow organizations to purchase private workers’ comp insurance. These states are Ohio, Washington, North Dakota, and Wyoming. In these states, employers are required to buy coverage through their insurance fund.
In states where employers can self-insure for coverage, there are specific requirements for qualification to do so, depending on the state. For instance, in Colorado, individual businesses can self-fund for coverage. Groups or pools of businesses can also qualify to buy private workers’ compensation insurance in this state.
In certain states, independent contractors can be exempt from workers' comp laws. In Florida, members of an LLC can file an application to be excluded from these laws. In Arizona, sole proprietors working for an employer who carries workers' compensation can be exempted from purchasing this insurance.
4. Incidents, Long-Term Injuries, and Illnesses Are Covered
Workers' compensation benefits are meant to help an injured or ill worker by replacing their wages until they get back to work. These benefits also include:
Medical coverage, including the required drugs
Rehabilitation programs, including mental counseling
Disability benefits
Death benefits to help the worker's dependents
Many workplace injuries or illnesses happen over time. A good example is a repetitive stress injury, such as a carpal tunnel. Black lung, which is an illness caused by long-term exposure to an unsafe workplace environment, can also be covered by workers’ comp insurance.
5. Premiums Depend on State Rates and the Employer’s Previous Experience
Workers’ comp rates can vary significantly depending on employer classification and state. A report comparing workers’ comp premiums by employer classification and state is released every two years. The latest report came out in 2018.
The amount an individual employer pays as compensation premiums depends on their gross payroll. The number and severity of injuries and illnesses experienced in this type of job also determine the cost of coverage. For instance, trucking companies generally pay more than clerical offices.
6. On Some Occasions, You Can Sue Your Employer for a Workplace Injury
Workers' comp benefits don't typically allow an employee to file a lawsuit against their employer. However, there are circumstances in which you can still sue your employer for a work-related illness or injury.
For instance, you can file a lawsuit if you are sure that the injury or illness was intentional on your employer’s part. Another instance that allows you to file a lawsuit when the injury or illness was outside your job assignment’s scope.
7. Not All Workplace Injuries or Illnesses Are Covered
Certain workplace injuries are considered to be outside the scope of workers’ comp insurance. These include:
Self-inflicted injuries
Where the worker violated business policy
Injuries that occur during criminal incidents
Injuries that occur when the employee isn’t on the job
In each of the cases above, workers’ compensation does not pay benefits.
8. Your Employer May Not Discriminate Against You for Filing a Comp Claim
Both state and federal whistle blower laws forbid any form of discrimination against workers who opt to file workers’ comp claims. That means your employer may not fire, retaliate against, or otherwise discriminate against you for filing a claim.
9. Workers’ Comp Fraudsters Get Caught
Cases of cheating in workers’ comp are surprisingly common. The term for this type of fraud is malingering. To avert the rising cases of workers’ comp cheating, there are sophisticated fraud divisions always on the lookout for suspicious activity.
Both employers and employees can be involved in workers’ compensation fraud. Examples of fraud by employers include:
Under-reporting the total number of employees
Mis-classifying some workers as non-employees
Common examples of workers’ comp fraud by staff include:
Falsely claiming injuries
Double-dipping, which mean collecting both SSD benefits and workers’ compensation at the same time
While people may get away with fraud for a while, chances are good that they’ll get caught eventually. When that happens, it could mean hefty fines or even jail time.
10. Employers Must Handle Workers’ Comp Information Appropriately
Federal and state laws require employers to keep records and file reports related to workers’ compensation. Employers also need to provide relevant information to their employees. Generally, an employer must:
Clearly display a notice to workers at strategic places
Report all lost-time injuries
Keep an updated record of occupational diseases
Adhering to the above requirements helps avoid unnecessary misunderstandings between employers and their staff.
Should You Hire a Workers’ Compensation Attorney?
While it is not required by law to hire a lawyer for workers’ compensation when filing a compensation claim, it’s a smart move. Workers’ compensation lawyers have a good understanding of how workers' compensation law works and can help you get a decent compensation as quickly as possible.
So, how do you identify a workers’ comp attorney you can trust? Here are a few tips to guide you as you consider your options.
Consider Their Public Image
Choosing a workers’ comp lawyer attorney with a reputable public image is essential. The best way to find such a lawyer is by asking for recommendations from your relatives, friends, and co-workers. People you can trust are most likely to offer unbiased information on an attorney, unlike advertisements.
Inquire About Experience
You want to work with an attorney who offers you the best chances of receiving compensation. That's why it's important to look for an attorney with considerable in-field experience. Don't be afraid to inquire about their track record in handling claims like yours.
Observe Their Customer Service Skills
During your initial meeting with your potential lawyer, observe how the law firm’s staff handles you and other clients. Does your prospective lawyer come across as business-oriented and standoffish?
You want to work with a friendly, respectful attorney who seems genuinely willing to help you.
Now You Know Everything About Workers’ Compensation
While no employer or employee wishes for work-related injuries to happen, accidents occur. Companies that have a workers’ compensation policy ensure that their employees are covered in case the unexpected happens. As an employee, it helps to be informed about workers' comp insurance, so it's easier to take appropriate action should it become necessary.
Would you like to read more great content on workers’ compensation benefits? Please keep visiting our blog.