How Does Workers Compensation Insurance Work?

workers compensation

According to Wikipedia, workers’ compensation is ‘insurance providing wage replacement and medical benefits to employees injured in employment. It is in exchange for the mandatory relinquishment of the employee’s right to sue their employer for the tort of negligence.’

All employers must carry workers’ compensation insurance unless they operate in certain low-risk professions such as domestic service, farming, fishing, or construction.

How Does Workers Compensation Insurance Work?

legal representation

Workers compensation insurance covers a vast range of potential injuries and illnesses, which include:

  • Fatalities
  • Loss of limbs
  • Shattered bones
  • Burns and scalds
  • Head injuries
  • Stress
  • Skin disorders
  • Paralysis

How Does a Worker Claim Workers’ Compensation?

workers compensation attorney

Workers injured at work can claim workers’ compensation by:

  1. Informing their employer about the injury and need to see a doctor
  2. Contacting their insurer about making a compensation claim
  3. Making an appointment to consult a GP for treatment and a complete medical examination

An employer must pay for all reasonable medical expenses. And be ready to compensation and let the employee work on modified duties they are capable of it.

Employees are entitled to weekly compensation payments during their time off work, but only for as long as is necessary.

Employees should also consult a workers’ compensation attorney in Glendale. While it’s possible to make a claim independently, a lawyer’s expertise and knowledge speed up the process.

When Will the Claim Be Settled?

early claims

The employee should settle claims as soon as possible after receiving a medical certificate from their doctor. This certificate confirms the nature of their injury and its date of occurrence.

Furthermore, the employee should make proper claims on time and have all the necessary documentation ready. They should also avoid delaying returning to work on modified duties. Settling a compensation claim is so much quicker and easier this way.

Who Pays for Workers’ Compensation?

The employer has to pay all premiums and expenses associated with their worker’s comp insurance policy. So, it should include the costs of any medical certificates, reports, investigations, and examinations needed to settle their claim.

Furthermore, the claims compensation amount is usually paid directly in the form of a lump sum.

What Is an Average Workers’ Comp Payout?

The employee’s insurer or workers’ compensation provider provides information on current and past awards for similar injury claims. As with most other aspects of insurance, the value of an injury claim will depend on a wide range of factors, including:

  • The nature and severity of the injury or illness;
  • The body part affected;
  • Any absences from work and impact on their job;
  • The employee’s age, occupation, and wage;
  • The total duration of the case

What Is Workers’ Compensation Fraud?

telemedicine

Workers’ compensation fraud occurs when an employer or employee deliberately defrauds the insurance company. They do it by either exaggerating the nature of the claim or failing to disclose a pre-existing medical condition.

However, employees should use workers’ compensation only for injuries and illnesses that are proven to have been suffered in the course of employment.

It is illegal for anyone to make false claims or provide misleading information on the claim. Anyone who commits fraud faces up to 10 years imprisonment and a fine of $180,000.

So, employers who encourage or assist employees in committing fraud also risk prosecution.

How Do I Improve My Chances of Getting Workers’ Compensation?

Employees can improve their chances of receiving worker’s compensation by proving that their employer has breached their duty of care towards them. Referring to Glendale workers’ compensation lawyer also improves the chances of receiving workers’ compensation.

Scroll to top