How much do you know about worker’s compensation? Here are 10 basics of worker’s compensation that all employers should know. These general rules apply to most states, but you should familiarize yourself with local laws. Did you know that:
- Workers’ Compensation is the primary insurance policy that applies when an employee is injured in the course of his employment, regardless of who is at fault or negligent. In insurance terms, this means that workers’ compensation is considered the exclusive remedy.
- Some exclusions do apply, like cases of self-infliction, injury caused by intoxication, and war. If these circumstances are proven, those claims can often be denied.
- In some states, an aggravation of a pre-existing condition can be considered a work comp injury if that aggravation occurred in the course of employment.
- Employees are required to report an injury to the employer within a specific time frame. If reported later than the state’s statutory requirement, then the claim can be denied. In most states, the statute of limitations is 2 or 3 years.
- Aside from emergency response teams, volunteers are generally not considered employees and therefore, not covered by workers’ compensation insurance. However, undocumented workers and minors can be considered employees.
- A waiting period applies for wage loss benefits. If an employee can return to work before that waiting period expires, the employee is not eligible for wage loss benefits. A claims cost-savings to the employer. That waiting period varies by state.
- If a treating physician releases an employee to work, but with restrictions, and the employer has alternate work available that meets those restrictions, the employee may not be entitled to wage loss benefits. You should discuss recover-at-work options for each claim with the assigned claims adjuster and the treating physician.
- The state’s worker’s compensation governing body determines the employees’ work compensation benefit rates each year.
- In some states, you can dictate where an employee seeks treatment for a work-related injury, and in others, you cannot. If employees are crossing state borders or employers have locations in multiple states, they should familiarize themselves with the laws of those states. Often, neighboring states will have different regulations in place, for example in Wisconsin employers can dictate care, but in Illinois, they cannot.
- Statistically, the sooner an employee returns to work after an injury, the sooner he or she will recover from that injury. This will lower the individual claim costs which will lead to a lesser overall insurance cost is to the employer. Conversely, the longer an employee is off work, the lesser the chance he or she will ever (YES – EVER) return to work. Employees failing to return to work greatly rise the claim cost and the cost to the employers’ insurance premium increases exponentially.
Worthy Insurance is here to help you understand the basics of workers’ compensation and navigate through the claims process. Our risk management team and claims department are readily available to discuss the complexities. Give us a call or an email today!
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