Overview

Workplaces are often a hub of accidents and injuries depending upon the working atmosphere and the type of work. These two factors often determine the risk of injuries to an employee.

However, when I say workplace injuries, I don’t want you to infer that it’s all about accidents and related injuries. Workers’ compensation benefits is also about occupational illness like mesothelioma and exposure to harmful chemicals.

Even a safe workplace like an office may impose risks like carpal tunnel syndrome and back pain to an office secretary or an accountant.

Certain workplaces impose higher risks to their employees than others. According to the Occupational Safety and Health Administration (OSHA), construction sites contribute to roughly one out of every five work-related deaths in private sectors in the US.

In the year 2019, private industry employers have reported 2.8 million nonfatal workplace injuries and illnesses- says the Bureau of Labor Statistics (BLS).

Reports from National Safety Council (NSC) suggest that the number of preventable deaths in workplaces have increased 2% in 2019, totaling 4,572 cases.

I hope the data reflects how alarming workplace injuries are.

Common Work-Related Injuries

The below-mentioned are the common accidents that I am referring to as work-related injuries.

  • Slip and falls
  • Trip and falls
  • Auto accidents
  • Fire and explosions
  • Exposure to toxic chemicals
  • Stress and overexertion injuries
  • Electrocution

Workers’ Compensation Benefits

Crisply called Workers’ comp, workers’ compensation claim provides financial benefits to employees who get injured or sick from a work-related reason.

Workers’ compensation follows a no-fault system. The employee does not have to establish a fault factor to obtain workers’ compensation benefits.

Depending upon the law of each state, an employer is demanded to have worker’s compensation insurance to cover his employees. The compensation is paid from the insurance premium paid by the employer.

Most of the states require workers’ compensation insurance coverage for full-time employees. Some states demand it for contractors, temps and interns also.

Workers’ compensation for federal employees is processed by the Office of U.S. Worker’s Compensation Programs headed by the Department of Labor. Workers’ compensation benefits for employees working with private companies or state and local government agencies is regulated by the state workers’ compensation board. However, both of them are covered by dissimilar workers’ compensation regulations.

Proceeding with a workers’ compensation claim, the employee is no longer suing the employer for his injuries. On the other hand, the employer is compensating for the injuries sustained by the employee through the workers’ compensation insurance.

Damages Covered under Workers’ Comp Insurance

Workers’ compensation benefits would cover the following expenses incurred by the employee concerning a work-related sickness or injury

  1. Medical expenses

 Medical expenses in a workers’ compensation claim cover emergency room visits, ambulance charges, hospital visits, medication bills, and surgery costs. The only element to be established is that the medical expenses are connected with the work-related illness or injury. 

  1. Rehabilitation costs 

Rehabilitation expenses cover the costs of rehabilitation therapy sessions like physical therapy or occupational therapy required by the employee to overcome the injury. 

  1. Disability

Depending upon the injury or illness related to the work, the employee is entitled for compensation during the recovery period. The following are the types of disabilities granted under worker’s compensation claims.

  • Temporary partial disability
  • Temporary total disability
  • Permanent partial disability
  • Permanent total disability 
  1. Retraining expenses

Retraining expenses refer to the expenses incurred to train the employee to get another employment. This is applicable when the employee is unable to continue his current employment as a result of the injury.

  1. Lost wages

It is a part of workers’ compensation benefits to compensate the loss of income suffered by the employee due to the injury. 

  1. Death benefits

Workers’ compensation benefits also include death benefits to the dependents when the illness or injury results in the death of the employee.

Facing a misfortune at the workplace, may turn out life-changing. Especially when the victim is the sole breadwinner of the family. Loss of income, medical expenses, emotional trauma, financial burden everything together would leave him in chaos. Benefits covered by the worker’s comp claim would help the employee have a better living.

What determines the fate of Your Workers’ Comp Claim?

Attaining workers’ compensation benefits is not always easy as you imagine. The possibility of the claim and the amount you receive relies on the employer, the circumstances of the claim, severity of your illness, your employment status, wages you received etc.

Having discussed much about workplace injuries and workers’ compensation, let’s now get into the sum and substance and unearth the cornerstones of workers’ compensation benefits.

In simple terms, pursuing a workers’ compensation claim is to 

  • Report
  • Treat
  • Record
  • Claim

Reporting the Injury

The immediate step after sustaining an injury at the workplace is to report it in writing to the supervisor or manager whoever is in charge. Failure in reporting the injury on time stands out as a reason in the denial of many workers’ compensation claims.

The time limit to report the injury may vary from state to state. For instance, in Maryland, any workplace injury should be reported within 10 days of the incident.

Treating the Injury

Either it is a minor injury or a major illness, immediately seek medical care. This would not only help you in better recovery from the injury but also increase the chance of a better claim.

Medical bills, prescriptions, treatment plans everything turns out as a piece of evidence in your claim. Never miss the follow-up visits suggested by your physician.

Recording the Details

Claiming workers’ compensation benefits requires establishing that the injury or illness is work-related. The employee needs to substantiate the claim with supporting proofs.

Medical records, injury reports, and reports on missing work hours would be helping hands in proving that the injury is work-related. Expert Medical records review and analysis would assist the attorney in that aspect.

Claiming the Mishap

 Workers compensation law does not demand an employee to file the claim only with the support of an attorney. However, it is always advisable not to try your luck alone. It would be a smart choice to get the help of an expert workers’ compensation attorney to file the claim before the deadline.

The above-mentioned are the common guidance you may receive regarding a workers’ comp claim. Definitely, it is undisputed. Still,

Why some workers’ compensation Claims are denied?

I just want you to identify that there is much more to comprehend on each of those steps. Follow these tips would help you to have a smooth and breezy claim and end up in a well-favored compensation.

  1. If your injury is not witnessed by anyone around, communicate about your mishap to your co-workers. This would help you in the claim.
  2. Be consistent in your explanation of the accident. Tell the same story to whomever you report.
  3. Workers’ compensation law differs in each state and also varies accordingly to the nature of your employment and company policy. Carefully examine both state and company compensation regulations before proceeding with a claim.
  4. Get to know if your injury/illness is covered under workers’ compensation law. For instance, issues related to mental health like anxiety or depression may not be covered.
  5. Keep in mind that your employer, employer’s insurance company, and insurance adjuster would always try to underrate your injury and minimize the benefits.
  6. Never seek financial help from the employer outside the claim.
  7. The insurance adjuster may try to settle you and save the insurance company from huge compensation. Never give any statements or go for any settlements without the advice of a workers’ compensation lawyer.
  8. Apart from the medical records, photograph your injuries in each stage of your treatment process.
  9. Be vigilant if you are filing the claim after you have been laid off or fired from the work. In such circumstances, there are more chances for your claim to be denied.
  10. Communicate every minute detail regarding the injury to your attorney so that he could have a better case evaluation.
  11. If you suffer from any pre-existing illness, never try to hide it. That may question your credibility. Moreover, pre-existing conditions would not prevent you from claiming workers’ compensation benefits when your injury is work-related.
  12. Your claim may be denied if you refuse to sign the medical release form given by the insurance carrier. Medical release forms help the insurance company to retrieve your medical records from the healthcare provider. Contact your attorney before you sign the form.
  13. If your claim is denied, consult with your attorney and proceed with an appeal.

Conclusion

It could be stressful and worried when you are unable to work and your unpaid bills get piled up. Claiming workers’ compensation benefits would ease the financial burden and help you recover your health. Your claim would undoubtedly be less knotty with the directives we have discussed.

Rather than being stranded in the claim, seek legal help. Make sure you consult a physician approved by your workers’ compensation insurance so that your treatment is covered.

Some people easily get their workers’ comp claim and some get stuck. Which one are you? Hope you have an answer by now.