How Does Worker’s Compensation Work?

On February 7, 2010, in Attorney, by Daniel Mikes

Worker’s Compensation programs were enacted to benefit both employees and employers. Employers are shielded from lawsuits and can thus control their costs through insurance designed to cover payments for claims. Employees receive compensation in the form of monetary payments as well as coverage for at least part of their medical expenses. Worker’s Compensation laws vary from state to state, but most facets are the same.

In the majority of the states, companies purchase coverage from insurance companies. Only a handful of states utilize a public plan, which is funded by mandatory payments from employers. Other states have a hybrid program. Under these arrangements, employers are to contract with insurance companies for coverage. Those that cannot obtain coverage in this manner, such as those rejected by private carriers as high risk, will pay into a public plan.

As a rule, employees who are unable to work due to a job related injury or illness can receive weekly or monthly payments. In most instances, these do not constitute amounts equal to salary but instead are a set percentage. Under some plans, these payments can continue for as long as the employee is ill or hurt, with no time limit. However, in some states there is a point at which monthly payments are discontinued and one lump sum payment is issued.

Expenses for doctors, hospitals, and medication are normally covered to at least some extent. Under some programs, all medical costs directly related to the claim are paid in full, while others pay only a percentage. Physical therapy and rehabilitation are also included.

Should an employee be deemed fit for work in a different position other than the one held prior to the accident, most states furnish training for the new job. For example, someone whose previous position required standing all day, but who can no longer do so, might be trained as a computer operator. If an employee refuses to accept the training or the position may have to forfeit future benefits.

Anyone injured in the workplace should report such injury immediately to a member of management. The manager or supervisor will obtain statements from all who witnessed the incident. The injured worker will usually be tested for drugs, since alcohol or illegal drugs are normally grounds for denying a claim. Normally, there are doctors and hospitals designated by the employer or his insurance company for treatment throughout the claim period.

Employees receiving Worker’s Compensation payments are expected to make an effort to recover by following medical instructions, including any recommended therapy programs. In most states, they can be dropped from the program for refusing to attend re-training classes. They can also find payments stopped if they are found capable of doing light duty work and they refuse to work.

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