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Workers Compensation laws are essential to understand for both employees and employers of a state. A workers’ compensation insurance helps to keep employees covered from unforeseen injuries at work. Whether it is a car accident during a client visit, a slip and fall on the office stairs or an injury incurred due to a consistent workplace hazard, knowing workers’ compensation better will help you recover your losses. Here are some of the frequently asked questions-
Workers’ Compensation laws differ from state to state in the US. While some states may need an employer to opt for work comp. insurance when they hire their first employee, there are others where it is optional. Texas and South Dakota are the two states where workers’ comp is an optional requirement for employers.
Workers compensation covers medical expenses and partial lost wages during the period of recovery for a work-related injury/sickness. In addition, death benefits are paid to those involved in fatal accidents and have lost their lives.
The state laws for workers compensation does offer rights to victims, and they are-
There are a few other rights, such as the right to choose your doctor or switch the doctor, but that varies from state to state.
As the law suggests, workers compensation covers most work-related injuries or sickness. However, if you were intoxicated or doing illegal drugs, your compensation claim can be denied right away. Also, workers compensation does not cover self-inflicted wounds from workplace fights or injuries caused by an activity that violated your employer’s rules.
Workers’ Comp benefits for covid-19 largely depend on the nature of the job and the state laws. It is difficult for an employee to trace their covid-19 infection origin and connect it to the workplace, so the nature of the job and industry plays a significant role. Such claims can move forward only when the employee can show evidence that he/she has contracted covid-19 from their workplace or due to their job role. For the frontline workers in this pandemic period, the claim process is simplified when infected with covid-19.
This depends on the state laws and requirements of your employer’s work comp policy. Communicate with your employer on whether you can see your doctor or you need to stick to the doctor suggested by your employer.
Also, even if you must select a doctor from your employer’s list, you can check with another doctor after some time to get a second opinion. The insurance company offering you the coverage might want to get a check-up done by their doctor if you happen to choose your doctor.
Workers’ compensation pays for the treatment, diagnosis, and recovery from an injury or sickness that resulted from work. The victim would also be eligible for temporary disability payments for the period in which he/she cannot work due to the injury/illness or if he/she has faced a permanent disability.
One of the major purposes of the workers’ compensation insurance is to offer benefits to the injured or ill workers without proving at-fault parties. However, some norms restrict the benefits of work comp. For example, if the person is found with a self-inflicted injury or has been involved in a fight at the workplace which caused the injury, he/she is not eligible for any compensation. Also, if the person is found under the influence of an illegal drug, the benefits stand cancel.
If you can perform the same duties after recovery, your employer must hire you back for the available position. If someone has been employed for that position in the interim period, you should be absorbed in any other relevant vacant post in the organization. On the other hand, if you are flexible to switch to a new role, your employer can offer you any other vacant position.
In work comp, it is essential to file a claim and report the injury as soon as possible. Here are some of the instances when you should opt for filing a claim-
You should immediately take some time off work if the injury is major. After you report it to your employer, ask for the list of doctors they want you to visit. Once you have seen the doctor and have evidence to prove that the injury or illness is due to your workplace, you should go ahead and file a claim. However, there are numerous information that you need to have before filing a claim. While these requirements vary from state to state, here are some of the general requisites for filing a claim-
Different states have their own set of laws for workers’ comp cases. Therefore, you should file your claim before the deadline for filing the claim as per your state law.
Generally, at the federal or state level, the money from workers’ compensation is not taxable. However, if the employee has been receiving retirement benefits, Supplemental Security Income (SSI), or Social security disability insurance (SSDI), a part of the money from work comp. is taxable then. Remember that every state has different work comp laws, and proper research on the existing laws is essential before filing the compensation claim.
For someone receiving workers’ compensation, they remain eligible for all of the programs mentioned above. However, given the kind of workers’ compensation you receive, your benefits under other programs can be affected. Contact your employer’s office to know about your eligibility for long-term disability and other unemployment insurance coverage benefits. If your employer denies you compensation from other programs, you can choose to take your case the legal way with the help of experienced work comp lawyers around you.
While defining the term independent contractor might be difficult, there are specific criteria that the court considers for the classification of employees. Some employers would intentionally misclassify an employee as an independent contractor to avoid work comp and other payroll responsibilities. An independent contractor has complete control over the work they do and the way they do it. If your employer –
DWC form is exclusively for the state of California. It is handed out to the employees when they wish to file a workers’ compensation claim in California. Once you complete the claim form, which is the DWC-1 form, you are done with the first step. Remember that you are not taking any legal action; it is just a claim for the benefits. According to California state law, the workers’ compensation is a no-fault system in which benefits are cleared regardless of who was at fault.
The kind of payment system you will be subjected to depends on whether you can return to work in full capacity or a lighter job role offered by your employer. You will likely receive regular, and continuous workers’ compensation benefits in case of at least ONE of the below mentioned situations-
When you suffer from a permanent impairment but not a total disability, you can be subjected to regular weekly permanent disability benefits if you do not take a lumpsum amount. In most states, these weekly payouts will be based on the extent of your disability or a percentage of your wage before the accident. For example, according to California Labor Code [1], the weekly compensation amount should be two-thirds of the total wage you received at the time of injury.
In such a case, you can file a claim. However, you or your attorney needs to prove that the medical condition you had was aggravated by work or job duties. For example, if you already had a knee injury, your employer might deny your claim for knee replacement surgery coverage. You and your attorney will have the work to prove that your knee condition has worsened over the time you have been working in the organization due to the nature of your job responsibilities.
Different type of benefits has their time limit for filing. So if you are filing for one benefit, it doesn’t necessarily mean that you get an extension on other benefits; the clock keeps ticking.
For medical benefits, it is suggested to file the claim within a year from the date of the accident. If your employer has already paid for your medical benefit once, an extension of 3 years is provided for asserting the claim.
Indemnity benefits or claims for a weekly payout should be filed within a year from the date of the accident that caused the injury. However, in case your employer has already paid your indemnity benefits, you can still file a claim for Permanent Total Disability (PTD), Permanent Partial Disability (PPD), or Temporary Total Disability (TTD) within a year of the last payment for indemnity benefit.
Based on the severity of the injury faced, you may want to seek help from an expert work comp attorney. The bigger your injury is, the bigger the chances of expenses and financial losses are, so having an expert attorney by your side is essential. Often, the insurance company or the employer might want to turn down your claim or try to offer you compensation lower than what you asked for; this is where having a workers compensation lawyer will help your chances of getting the correct claim amount. Also, it is always better to let experts deal with the legal side of things while you take the time to focus on quick and effective recovery.
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