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Workers Compensation
Insurance
Workmans Comp is an important benefit for both
employers and employees. Being injured on the job
is stressful to both parties, and having insurance can
help.
Both employers and employees should be knowledgeable
about coverage and take the necessary steps to ensure
that the details of reporting job related injuries and the
circumstances that led to them are filed accurately and
in a timely manner. |
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Getting to Know Workers’ Compensation
Insurance
Neil works a full-time job as a stock clerk
at a grocery store. While doing the routine
inventory count one day, a load of stock
fell on him. The accident resulted in injury
to his back and has cost him the use of his
lower limbs. |
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After months of intensive care, treatment and
therapy, he suffers from depression and has to cope with
a permanent disability due to a spinal cord injury for
the rest of his life.
What happened to Neil can happen to anyone on the job.
If you ever get injured while working, there can be a
great impact to you, your family and finances. What
happens when you sustain a permanent disability or die
on the job? Can you afford losing your wages? Can your
family cope with the challenge of having diminished
income? How are you going to pay for care?
A Brief History
There used to be a time when the only way for injured
workers to recover compensation for injuries sustained
on the job was to sue their employers and prove the
injuries were caused by unsafe work environments. But
lawsuits are expensive and even those who earned a bit
more than minimum wages could not afford the costs
associated with filing legal action against their
employers. Often, they were left with no choice but to
accept what happened and bear the consequences of lost
wages, sustaining permanent disabilities and finding a
job or an alternative means to support their families.
Thanks to efforts of labor unions, today, employers in
all states of the US are required by law to provide some
form of workers’ compensation insurance. Workers’
compensation insurance laws first came about in Europe
and Australia; the United States followed shortly after.
Today, it is common in most industrialized countries.
Understanding It
What is workers’ compensation insurance? It is a form of
insurance paid out to workers or their families who are
injured or killed on the job. It mimics disability
insurance when paid out weekly in place of salaries and
wages as compensation for economic loss; as health
insurance when paid out as reimbursement for associated
medical expenses; and as life insurance when paid out as
benefits payable to the family of someone who dies at
work. All these benefits received by injured workers
sounds good but at what cost? The trade off for these
assured but limited benefits is the injured worker
giving up their right to sue their employers for
damages.
Although workers’ compensation insurance is believed to
improve working conditions and provide economic safety
nets for workers and their families, it is criticized
for restricting an employee’s right to seek legal action
against employers for negligence which effectively
reduces liability of said employers and insurance
companies as well.
If you do get injured on the job, should you be
compelled to accept your employer’s checks for workers’
compensation? Should you accept it? That’s your call.
Most employees don’t give this aspect of their
employment much thought when they are first signed on.
That’s fine. Just remember to evaluate it carefully,
consider your options before accepting payment and/or
consult your lawyer when or if you actually get injured.
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Information on Workers’ Compensation Insurance
Seeking employment is more than just sending out
resumes, interviewing and negotiating compensation
packages. Often, the most important aspects of
employment, besides your job description and
qualifications are the benefits included in your
compensation package. |
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One of the benefits of employment that employees often
do not give much thought to is workers’ compensation
insurance. Let’s get to know this benefit with these
facts:
1. Workers’ compensation insurance benefits employers as
well as employees. Although workers might think it
pretty good to receive money in case they get seriously
hurt while doing their job, the compensation insurance
is not an altruistic benefit provided by employers. In
fact, some might even argue it is more to the benefit of
employers as it protects them from lawsuits and legal
liabilities for negligence.
2. You give up a right when you accept your employer’s
workers’ compensation insurance. In exchange for
reimbursement for medical expenses, weekly payments in
lieu of wages or benefits paid to your family if you die
from work-related injuries or accidents, you give up
your common law right to sue your employers for
negligence.
3. Workers’ insurance laws vary from one place to
another. Even in the US, each state has its own set of
rules and legal requirements for workers’ compensation
insurance coverage. The common thing however, is it is
mandatory; All employers are required to provide some
kind of compensation insurance to its workforce. Stiff
penalties apply for those who do not comply with this
requirement.
4. Small businesses can offer workers’ compensation
insurance. As mentioned above, each state has its own
set of rules for implanting worker’s compensation
insurance requirements. In some states, depending on the
number of employees, some small businesses are not
legally mandated to provide this type of coverage. That
doesn’t mean however that these businesses cannot
provide workers’ compensation insurance. Many providers
have small business insurance packages that include
workers’ compensation insurance regardless of the number
of employees. Alternatively, small business owners can
come together to provide this type of coverage for their
employees.
Advantages of Providing Workers’ Compensation Insurance
From the employer’s perspective, providing workers’
compensation insurance work to benefit their business in
two ways. Firstly, it provides protection from
prospective legal action when an employee gets seriously
hurt while on the job. Secondly, it protects them from
unexpected, uneven, and uncertain future financial
obligations arising from legal liabilities to workers
injured on the job. These protections save employers and
their businesses millions of dollars in the long run,
especially if the risk of an employee getting hurt on
the job is ever-present.
Employees on the other hand, gain an economic safety net
not otherwise available to them. Accidents that leave a
worker permanently disabled or dead greatly impacts
economic resources of their families. Legal battles are
expensive and most workers’ are unable to afford it. In
cases they do, judgments are often in favor of employers
with rulings ordering minimal payments. In most cases,
accepting workers’ compensation insurance saves workers
the hassle of lawsuits and gives them and their families
a way to pay medical bills and restart their lives.
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Tips for Claiming Workman’s Compensation
So you were hurt at work. If you are employed in any
state in the United States or in most industrialized
societies, you may file a claim for workman’s
compensation. Your employers are very likely to have
worker’s compensation insurance in place that can pay
for your injuries and alleviate some of the financial
burdens that come with being injured.
Here are some tips on how to go about it:
1. Report the incident immediately.
You must let at least a supervisor know you have been
injured even if you don’t feel any pain. Do this as soon
as possible, as timeliness bears on your claim. Also, be
completely truthful about what happened. Insurance
companies go to great lengths to find out the truth.
They will hire experts if they have to so it is to your
advantage to stick to the facts.
2. Be as detailed as possible.
Recount events chronologically and provide as much
details as you can, including what you did before,
during and after you were hurt. Be thorough. Leaving out
anything will negatively impact your claim so be careful
with your written incident report. State clearly what
you intend to say. Keep in mind it’s easy to
misunderstand written accounts; you don’t want to leave
room for misinterpretation.
3. Keep a copy of the incident report you filed for your
personal records.
While Waiting
It may take a couple of months for your claim to be
processed and for you to begin receiving payments for
the injuries you sustained. What do you do while you’re
out of work and not receiving a regular pay check?
Especially if you’re seriously ill and in hospital, how
do you manage your finances during the wait period?
Here are some tips you might find useful:
1. Take out a loan.
If you do not have an emergency fund saved, you will
need funds to cover basic living expenses – utility
bills, rent, food, etc. Taking out a single loan to
cover these expenses while waiting for your workman’s
compensation payment is better than racking up credit
card bills or owing multiple creditors. It’s a cheaper
alternative and it’s easier to manage.
2. Notify creditors.
Yes, you have to let them know you have been injured at
work because this affects your ability to meet
obligations. You are unlikely to be able to pay your
dues as usual when you are not receiving regular pay
checks. Letting your creditors know about your situation
will save you a lot of money as creditors will help you
by working out a way to accommodate your needs; most
will not report or charge you with late payments if you
let them know.
3. Seek out your own doctor for treatment.
Doctors retained by employers and insurance companies
are there to protect their interests, not yours. This is
not to say they would not treat you or would not want
you to get you better. But it’s always best to be
evaluated by an expert who has your best interests at
the forefront. Although workman’s compensation is
a benefit incident to your employment, it’s a
legally-mandated benefit. Making sure your claims are
treated fairly is your own responsibility.
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Workman’s Compensation and Returning
to Work
It is unfortunate when an employee gets
injured on the job. Although employees are
aware or made aware of such risks at the
time they were hired, employers have the
moral obligation and legal responsibility to
ensure a safe work environment and to
compensate workers for work-related
injuries.
Although workman’s compensation insurance
benefits employers as well, they don’t like
paying any money to an unproductive
employee. They would want to reduce whatever
payments you’re entitled to, or have you
return to work as soon as you possibly can.
You, on the other hand, would naturally want
to take your time to recover and want to
maximize your benefits under your workman’s
compensation.
Here are some things you need to know about
your workman’s compensation and returning to
work after sustaining work-related injuries:
1. See your own doctor for treatment.
Employer-retained or insurance
company-retained doctors do not necessarily
have your best interests in mind. They are
there to protect your employer’s interest
and serve their needs. It’s better to see a
doctor you already have a relationship with
or who has your best interest at heart.
Medical opinions vary as legal opinions do.
A doctor with no ties to your employer or
their insurers works to your benefit.
2. Finding alternative employment will not
disqualify you from receiving workman’s
compensation. If you’re unable to return to
work at full capacity and your employer does
not have light-duty work, you may be
required to find alternative employment. If
you do find another employer and you are
able to perform the job they hired you for
at full capacity, you will not lose your
workman’s compensation benefits entirely.
All your medical bills related to the injury
will be paid for by the insurance company.
3. Work part-time if you can. Yes, even if
you are receiving less than your workman’s
compensation. The workman’s compensation
will pay you the difference. Your checks
from the insurance company will come at
every pay period.
When to Involve Lawyers
Because employers and employees stand on
opposite ends where actual claims for
workman’s compensation are concerned, you
may need to call a personal injury lawyer.
But when do you go shopping for one?
Give your employer a 21-day reprieve. An
insurance adjuster should call you within 21
days of filing your incident report to set
up workman’s compensation. If you don’t hear
back from them, by all means, call them.
Have your copy of the incident report handy
as you may be asked questions relating to
it. It is important to give your employers
the chance to give you the benefit without
involving lawyers.
After the 21-day period and if you have not
heard back from your employers or from an
insurance adjuster after attempting to work
with them, or when they’re denying your
injuries, or if you are dissatisfied with
the benefits you are offered, seek legal
advice. You do not give up your right to
seek legal action for damages due to
negligence unless you accept your employer’s
workman’s compensation.
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