Workers’ Compensation FAQs

Basic Workers’ Compensation definitions

Workers compensation is a business type of insurance that most employers are required by law to carry. Workers compensation provides compensation to employees who have an illness or an injury that is related to their job. The federal government runs a workers compensation program for federal employees, as well as certain other kinds of employees. Although similar, every state has its own programs and laws in regard to workers compensation.

Wages are a payment that is made by an employer to an employee for labor or services performed by the employee on behalf of the employer. Wages usually consist of a monetary payment according to contract on an hourly, daily or weekly basis or by what is known as a piecework basis. A fixed weekly or monthly wage is usually referred to as a salary.

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Employer Questions

Although laws vary from state to state, if you are an employee of a limited liability company, or LLC, you are covered by workers compensation. This is true regardless of whether you are a full time, part time or regular seasonal employee or a family member who is an employee.

In every state except Texas, all employers, with few exceptions, are required by law to carry workers compensation insurance. Although the laws vary from state to state, some of the exceptions include sole proprietors and limited liability companies (LLC) with no employees. In some states in certain situations, employers with domestic workers, farm and agricultural workers, seasonal or casual workers, undocumented workers or loaned or leased workers are not required to provide workers compensation insurance.

In some states, volunteer firefighters are covered by workers compensation if you are injured during the course of your work as a firefighter. You need to check the workers compensation laws in your state to see if you are covered.

In most states, your employer is required to allow you to go back to the job that you had when you were injured or an equivalent job. However, this is true, only if such a position is available.

In some states, you are covered by workers compensation insurance. In other states, you may not be covered. Your employer’s responsibility to provide workers compensation insurance depends on the number of employees that are employed, the kind of business it is and the type of work you are doing. Certain kinds of workers are excluded in most states, which include domestic workers, farm workers and casual or seasonal workers.

In most instances, because you were a volunteer and not an employee, you are not eligible to receive workers compensation benefits. However, some states allow organizations to have the option of providing workers compensation coverage to their volunteers.

Yes, part-time employees are covered by workers compensation.

The uninsured employers fund is a fund that pays workers compensation benefits on a valid workers compensation claim that is filed by an employee who is injured while working for an illegally uninsured employer. When an injured worker files a valid workers compensation claim, the uninsured employers fund pays the injured worker’s compensation benefits as if the uninsured employer had been covered by workers compensation insurance.

Although the specifics of what an employer should do vary from state to state, there are some general first steps that your employer should take that are valid across the country. After making sure that you have received the medical attention that your injury requires, your employer should make sure that a First Report of Injury, or similar document, is filled out and sent to the company’s workers compensation insurance company.

Workers compensation is what is known as a “no-fault” type of insurance. Although there can be exceptions, what this means is when it comes to workers compensation, fault is not an issue. If you were injured in an accident while you were performing your job for your employer, you are eligible for workers compensation benefits; regardless of whose fault the accident was.

If you are an independent contractor, you are not eligible for workers compensation benefits. However, some employers misclassify employees as independent contractors in order to avoid paying workers compensation premiums and payroll taxes for them. You need to check and see if you are really an employee.

General Questions

Workers compensation covers most, but not all, job-related injuries. Injuries that are not covered by workers compensation include injuries that result due to an employee using illegal drugs, being intoxicated, being guilty of conduct that violates company policy, committing a serious crime, starting a fight or having self-inflected injuries.

Workers compensation covers future problems if those problems stem from your job-related injury. There is no time limit for workers compensation medical benefits. As long as you need treatment for your injury, workers compensation will pay for that treatment. However, if you settle your claim for a lump sum, you may be giving up your rights to future medical benefits that you may need, especially if your condition gets worse.

If you were doing something for your employer in the course of your employment, even though you were not in the office, you would be covered by workers compensation. However, if you were on your way to or from work, or you were away from the office for a purely personal reason that had nothing to do with your employment, you would not be covered by workers compensation.

If you have been injured on the job, the first step that you should take to get workers compensation benefits is to get the medical attention that you need for your injury. As soon as your injury will allow you to do so, you should let your employer’s (supervisor, manager, boss, foreman) know about your injury. Depending on the state that you are in, you and/or your employer will have to fill a form out to send to your employer’s workers compensation insurance company in order to file a claim for workers compensation benefits.

Yes, you can still file a workers compensation claim. However, you should always report your injury to your employer as soon as you possibly can, even if you do not think that you were hurt. When you do not report your injury on the same day that it happened, you can lose or seriously hurt your rights to receive workers compensation benefits.

Although the details of what is covered varies from state to state, workers compensation benefits include paying for all of your necessary medical care as long as you need it and lost wages, which usually amounts to about two-thirds of your regular salary. In addition, workers compensation benefits include as needed; retraining, rehabilitation, partial and total, temporary and permanent disability, and death benefits for your loved ones (spouse, children, parents and/or siblings) in the event that you die on the job.

Although details vary in each state, if your job-related accident accelerates or aggravates your pre-existing condition, you can receive workers compensation benefits. In other words, if your job-related injury makes your previous condition worse, you can get workers compensation benefits.

Medical Questions

This depends on the workers compensation laws of the state that you live in. In some states, you are required to go to a doctor that is chosen by your employer or your employer’s workers compensation insurance company. In other states, you are allowed to use your family doctor or any doctor you choose that is within a network determined by your employer’s insurance company, your employer or your state.

If your job-related injury is minor, and/or you know that co-workers have been treated fairly and have not had any problems getting the workers compensation benefits that they were entitled to when they were injured on the job, you probably do not need to hire an attorney. However, if your work-related injury is serious or your employer threatens you or has a reputation for trying to prevent workers compensation claims, you should hire a workers compensation attorney. Also, workers compensation laws can be a confusing maze of legal procedures and rules. So, it is a smart idea to have a workers compensation attorney on your side.

Yes. Your employer or your employer’s workers compensation insurance company has a right to schedule you a medical evaluation that is referred to as an independent medical examination (IME). If you do not go to an IME, you may forfeit your workers compensation benefits.

Although the details vary from state to state, you should be paid for follow up medical appointments. This is provided that they are in connection with your job-related injury and they occur during your regularly scheduled work hours.

Money and Expenses Questions

Your employer pays for workers compensation insurance coverage. Your employer is not allowed to deduct the cost of workers compensation insurance from your pay. It is illegal if your employer does so. Your employer’s workers compensation insurance company pays the workers compensation benefits that you receive when you are injured on the job.

You are entitled to receive wage loss benefits for as long as you are disabled and unable to work. There is no time limit on wage loss benefits.

While the specific laws vary according to the state that you live in, your employer usually only has to pay you for the hours that you actually worked. If your employer does this, the day that you were injured is regarded as the first day of your disability. If your employer pays you for the entire shift, the next day is considered to be the first day of your disability.

You should not receive any medical bill for medical care that is reasonable and necessary in connection with your work-related injury. However, should you receive medical care that is not approved by your workers compensation insurance company, you may be responsible for that bill.

Although it varies from state to state, the weekly wage loss amount that you receive usually amounts to around two-thirds of your regular salary. The amount of money that you get from workers compensation will depend on how long it takes for you to recover from your work-related injury and when you are able to return to work.