Written by Avvo Staff

Workers' compensation benefits explained

The US Department of Labor requires large employers to pay for workers' compensation insurance. This ensures employees are covered for work-related injuries and illnesses. However, employees who work for small businesses may not have the same coverage. Laws will vary from state to state.

How are workers' compensation benefits awarded?

When you become injured at work, you should seek medical attention immediately. As soon as you’re able to, file a workers' compensation claim. Make sure to describe in detail what happened during the incident, and list all the injuries you received.

Your employer is required to give you the necessary workers' compensation forms and then send your claim to the insurance carrier. Your employer will also inform the insurance carrier when you have returned to work.

Most of the time, your workers' compensation benefits won’t be contested, and you’ll receive payment for your lost wages and treatment for your injuries. However, larger workers' compensation cases may result in trial due to the cost of compensation. If your workers' compensation claim goes to trial, you’ll have to present your case in court.

You’ll be asked questions about your injury and how it occurred. Your medical treatment will also be noted by the court. The defense attorney may attempt to prove that your injury was partly the result of a preexisting condition. Since you may not know why some of the questions you are being asked are relevant to your case, hiring an employment attorney can be beneficial if your case goes to trial.

Medical benefits

Workers' compensation pays for your hospital bills and other medical expenses related to your injury. Sometimes there are other cash benefits depending on your state. It doesn't matter whether the injury was your fault or not. You're generally covered by workers' compensation insurance unless you weren't following company policy and were aware of it. However, you're often required to see a doctor appointed by your employer's insurance.

Sometimes, workers' compensation may hesitate to pay for ongoing medical care, such as physical therapy and other types of rehabilitation. If you're having trouble receiving the benefits you deserve, you may need to consult with an attorney.

Temporary disability benefits

Sometimes injuries at work lead to temporary disability. For instance, breaking a leg might make you unable to perform essential job duties for a few months. As a result, you may receive disability payments during the time you are unable to work.

Typically, temporary disability payments are about two-thirds of your regular salary. However, this varies from state to state, and your employer may have different policies related to temporary disability payments. This also depends on whether you have a partial disability or total disability.

Permanent disability benefits

Workers' compensation also covers long-term problems and illnesses caused by your working conditions. For instance, repetitive stress injuries, such as chronic back pain and carpel tunnel syndrome, could be covered. Sometimes, heart ailments and lung disease are also covered when these conditions result from long-term abuse on the job.

The amount of money you are eligible to receive for permanent disability benefits depends on the extent of your injuries and whether you have a partial or total disability as a result.

Death benefits

When someone is killed on the job, workers' compensation typically pays a death benefit to the surviving family members. Again, the amount varies from state to state. Typically, the death benefit is determined by the worker's current pay, but sometimes there is already a set amount.

What won't be covered by workers' compensation benefits?

Workers' compensation covers most injuries at work, even when the employee is at fault. However, some exceptions to this coverage exist, including the following:

  • Injuries caused when an employee violated company policies
  • Injuries caused while a worker was committing a serious crime
  • Injuries caused from fighting with others when the employee started the fight
  • Injuries caused from intoxication or illegal drug use

An employer cannot tell you not to file a workers' compensation claim. You can also receive protection from any retaliation by your employer if you file a workers' compensation claim.

Hiring a lawyer

If you think your employer has treated you unfairly, consider consulting an employment attorney. While you don't necessarily need an attorney, Georgia worker's compensation attorney Lisa Morgan Edwards says that hiring a lawyer means "you should get more in the way of a settlement even after paying a lawyer a 25% fee."

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