Workers’ Comp FAQs

Whether you’re an employer or an employee, you need to be well versed with worker’s compensation insurance and regulations thereof. By workers’ comp or worker’s compensation insurance, we refer to the coverage used by companies to safeguard themselves in the event that an employee, worker or laborer is hurt, injured or sick during or as a result of the job. In essence, this helps protect employees from the exorbitant costs that incur as a result of work related injuries. 

While this may seem to be a very simple concept there are some very common questions that arise. We’ve made an attempt to answer these questions to the best of our capabilities here:

What can be counted as a work related injury? 

While this answer depends largely on the nature of your business, it involves the following:

  • Slips and falls
  • Improper lifting injuries
  • Car accidents or accidents while on business trips or commute
  • Manufacturing plant accidents
  • Business related health hazards

This is not an exhaustive list, but it includes some of the more common incidents that often constitute work related injuries.

What does workers’ compensation insurance cover?

While this would vary from insurance provider, it usually covers medical expenses, lost wages, ongoing care costs and funeral expenses if an employee dies as a result of a work-related accident or illness. Be sure to check your insurance document before signing to have a better understanding of all that is covered by the policy. 

What does workers’ compensation insurance not cover?

There are certain injuries wherein the company is not liable to make any compensation to workers in the event of injury or illness. Some of them are:

  • Injuries received in fight started by an employee.
  • Injuries incurred as a result of being intoxicated at work
  • Injuries incurred by intention in an attempt to defraud the company for compensation.
  • Emotional injuries not accompanied by physical workplace trauma

Aside from this, an investigation is conducted by an independent party to assess whether compensation is required for a claim raised. That being said, many companies and insurance providers are recognizing that emotional injuries also deserve compensation. Do check your policy document for this. 

How can an employee make a claim?

If an injury or sickness occurs as a result of the job, the employee must report it to their manager or supervisor immediately or as soon as possible. When the injury is reported, the employee must include date, time and a detailed description of the situation that resulted in the injury. If they know the cause of the injury, that must be mentioned too. In case of an illness that can get worse with time or that can be fatal, the diagnosis report, doctor’s report and other supporting documents like x-rays or sonograms must also be attached. The goal is to give as much information as fast as possible so as to kick start the investigation for the claim.

Who has to have the workers’ compensation insurance?

In most states, companies having more than one employee are required by law to carry workers’ compensation insurance. Texas is the only state except from this law. Thus most corporations would take care of the workers’ comp to meet their compliance standards.

THE LAW OFFICE OF MIKE R. GREEN PLLC

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