Workers' compensation insurance policies cover the expenses associated with job-related injuries and illnesses. Although workers' compensation (or workers' comp) is regulated at the state level, most employers in the U.S. are required to carry a certain amount of coverage relative to the risks associated with the job. This section includes information about handling a claim, how to maintain adequate coverage without paying too much, links to state-specific resources and other topics pertaining to workers' comp from the employer's perspective.
Worker's Compensation: Employer Responsibilities
In most states employers are required to purchase insurance from their employees from a workers' compensation insurance carrier. In some states large financially solvent companies are allowed to self-insure, while very small companies may be exempt from carrying workers' compensation insurance at all. Unless they fall within limited exempt categories employers without workers' compensation insurance are subject to fines, criminal prosecution, and civil liability.
In addition to providing workers' compensation most states include additional duties. These may include;
· posting a notice of compliance at each job site,
· providing immediate emergency medical treatment for workers' injured on the job,
· furnishing further medical attention if a worker can't select a doctor,
· completing a report of the injury and submitting it the local workers' compensation board and their insurance company
· making a written report of every accident resulting in personal injury that causes a loss of time from regular duties beyond the working day or shift when the accident occurred or that requires medical treatment beyond first aid or two treatments by a doctor,
· complying with all requests for further information by the workers' compensation board or the insurance company.
An attorney also has a responsibility not to retaliate against workers who file compensation benefit claims. Acting against such an employee can result in civil actions against the employer for retaliation or "retaliatory discharge" if they are fired.
Handling a Claim: Employer and Employee Responsibilities
When an employee is injured while at work the employer has certain responsibilities and must follow certain procedures in order to avoid liability beyond that arising from the accident itself.
Employers must first attempt to avoid workplace accidents. If an employee is injured the employer must file the required report with the company's workers' compensation carrier and cooperate with the carrier and their attorneys when they investigate the matter. The employee must be permitted to seek treatment and must be welcomed back to work when they are well enough to resume employment. The employer is also responsible for assisting the state workers' compensation board in curbing fraud.
Employees also have responsibilities when an accident happens on the job. Workers must act responsibly at work. The employer is not responsible where workers are intoxicated, committing a crime, or knowingly violating a policy or code. Employees must also report workplace injuries as soon as possible. This may include filling out forms or reports about the incident. Employees must seek treatment promptly, since minor injuries can become serious without treatment. Employees must responsibly manage information provided by the employer and workers' compensation carrier. They should cooperate with any requests made by the insurer and be responsible for their actions in and outside of work since insurance companies may hire private investigators to prevent fraud. Finally, employees are responsible for determining how to proceed with their claim.
The Purpose of Workers' Compensation
Workers' compensation is a form of employer insurance that's meant to provide injured employees with an efficient and quick way to receive money for work-related injuries. Note that it's usually irrelevant whether the employee or the employer was at fault for causing the injury; if the employee was injured while on the job, then he or she can file a claim for workers' compensation benefits (subject to a few exceptions that are discussed below). Because an injured worker and his or her family can experience sudden hardship caused by the unexpected loss of income, workers' compensation benefits are intended to provide injured workers with a way to pay bills and medical costs during the recovery period. The system involves a trade-off: Injured workers receive payments quickly, but these payments are capped. An employer is protected from lawsuits, but must provide benefits to injured workers (through workers' compensation insurance) even if the employer wasn't at fault.
Set Payment Amounts
It's important to keep in mind that workers' compensation benefits are typically capped by law, with the payment amount decreasing over time as the employee heals and begins to resume his or her job duties.
Types of Injuries
Common injuries include hurting one's back in a fall or from lifting heavy objects, burns or respiratory ailments related to the use of chemicals, and injuries from traffic accidents. Also, workers who suffer injury from repetitive motions (for example, a wrist injury caused by typing) can usually file for workers' compensation, and some stress-related injuries may be covered. Keep in mind that workers' compensation insurance generally covers all injuries incurred during the performance of job duties, including injuries that occur at an off-site location (for example, during business travel). However, injuries that are caused by employee misconduct, injuries that occur outside the scope of work, and injuries caused by "acts of God" are not covered.
Workers' compensation benefits pay costs associated with medical care, lost wages, and retraining if the injury forces the employee to seek a new position or line of work. Note that workers' compensation payments don't account for any pain and suffering that the injured employee might experience.
Workers' Compensation vs. Civil Lawsuit
If the injury is caused by the employer's purposeful disregard for employee safety, the injured worker can usually choose to file a lawsuit rather than proceed with a workers' compensation claim. If the employee is successful in the lawsuit, he or she might recover more money than through a workers' compensation claim, and he or she may be able to seek attorney's fees and punitive damages.
How an Attorney Can Help
Although workers' compensation laws are meant to provide injured workers with fast relief, the claim process can nonetheless be complicated and involve time-sensitive deadlines and a great deal of paperwork. If you've been injured at work and want to file a claim as soon as possible, an attorney can help. This section provides a link for injured employees to consult with an attorney who specializes in workers' compensation law.
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