Individuals, when hurt on the job, should not be forced to pay for any treatment they must have as a result of their illness or injury. Workers’ compensation coverage functions to pay any bills associated with their medical care. Furthermore, it replaces a portion of the wages of the worker while they are receiving this treatment and cannot work. Most states require business owners to maintain this type of coverage.
Although business owners purchase workers compensation insurance to comply with the law, they often don’t understand what they receive under the policy. When an employee files a claim, the business owner doesn’t know what to do. The following guide provides a basic overview of this program and what every business owner must know about workers comp insurance.
The Benefits of Workers Compensation Insurance for Employers
This insurance policy safeguards employees and the employer while protecting the business from financial harm. When an employee sustains an injury or becomes ill on the job, the insurance policy steps in and pays their medical expenses and part of their lost wages. Furthermore, most policies include a provision that pays a death benefit in the event a worker is killed on the job.
Depending on the policy selected, the insurer might also step in and cover any legal fees, settlements, or judgments resulting from the incident. Some policies do not include this provision, and an employer may wish to purchase stop gap insurance to cover these fees if an employee files a lawsuit.
The Benefits for Employees
A worker injured on the job might find they cannot work for an extended period. This policy covers part of their missed paychecks, so they aren’t completely without funds. The policy pays out even when it is determined the employee is responsible for the incident that led to their illness or injury.
Filing a Claim
When an employee sustains an injury on the job. this injury or illness must be reported to the employer immediately. States put a time limit on when a claim can be filed, and the employer and employee must ensure this deadline is not missed. The employee bears the responsibility of filling out the necessary paperwork.
This paperwork must include the date and time of the injury along with the surrounding circumstances. Once this information has been gathered, the employer files the claim. Be prepared to share additional paperwork as the claim proceeds.
Insurers typically want the completed claim form along with a report of the injury shared with the workers’ compensation board in the state. At the same time, the employee should obtain medical care for the injury. If the injury is severe, ensure that medical care is sought immediately. The paperwork may be completed after the treatment has been received.
The treating doctor fills out a medical report documenting the injury. This information is needed for compensation for any related medical bills. Send this document to the insurer. Many employers believe they don’t have to report injuries that occur on the job unless a workers’ compensation claim is filed. This is incorrect. Every illness or injury must be reported to the proper authorities.
Upon receipt of the paperwork, the insurer approves or denies the claim. If the claim is approved, the employee has options. They may take the payment or enter negotiations for a structured or lump-sum settlement. When the insurer denies a claim, the employee retains the right to file an appeal.
The Next Step
The employer must determine whether to bring a temporary replacement until the employee can resume their duties. The option of offering the employee modified duties remains open, although this depends on the nature and severity of the injury or illness.
When the employee returns to work, the insurer needs to be informed. At times, the employee can never return to work, as their injuries are permanent. When this is the case, permanent disability payments will be paid to the employee.
Workers’ compensation insurance is essential in today’s world. Never forego this coverage, as doing so could lead to the demise of a business. If a claim must be filed, reach out to the state Department of Labor or the insurer for help. Doing so ensures all steps are completed correctly and the claim is resolved in a timely manner.