What To Expect From Your Employer While Claiming Workers Compensation Insurance?
As per McClatchy-Tribune News Service, California’s workers’ compensation system pays employees who have suffered an injury or illness on the job, regardless of who is at fault.
For most workers, the onus is on them to prove the injury or illness was work-related. However, specific occupational injuries for law enforcement officers, firefighters, and correctional officers are presumed to have occurred during their employment, such as heart disease, hernias, pneumonia, cancer, and meningitis. Those injuries require the workers’ compensation system to pay for treatment and, in cases where a person dies, death benefits.
Worker’s Compensation Insurance Policy
A workers’ compensation insurance policy covers the costs of medical treatment such as physician visits, prescription medications, or surgeries. In addition, workers’ compensation insurance provides lost time or indemnity benefits. Indemnity benefits are calculated based on an injured worker’s weekly wage and determined according to California Laws, California Department Of Industrial Relations.
Following are the key benefits an employee can expect from worker’s compensation insurance:
Medical Expenses
Workers’ comp insurance provides coverage to help employees pay for medical expenses related to a work-related injury or illness, stated E.A. Gjelten, Legal Editor at Nolo. This can include emergency room visits, necessary surgeries, and prescriptions.
For example, if one of your electricians cuts their hand at a customer’s home, workers’ compensation insurance can help cover their hospital visit.
Missed Wages
Workers’ comp helps replace some of your employee’s lost income if they need time off to recover from a work-related injury or illness, from Insurance Information Institute.
For example, if your restaurant chef spills a pot of boiling water on your arm and you can’t work for two weeks, workers’ compensation coverage can help replace some of her lost wages.
Ongoing Care
Some work-related injuries or illnesses can be so severe that they need more than one treatment. They often occur again and again, even after the recovery after some intervals.
For example, if your warehouse employee hurts their back while lifting heavy boxes, workers’ comp insurance can help cover their ongoing care costs, like physical therapy.
Funeral Costs
In the unfortunate event, your employee loses their life from a work-related accident, workers’ compensation coverage can help cover their funeral costs and provide death benefits to your employee’s beneficiaries.
For example, your employee falls from a height and dies.
Repetitive Injury
Not all work-related injuries are the result of a single traumatic incident. Repetitive injuries, like carpal tunnel syndrome, can take months or years to develop.
For example, your receptionist develops carpal tunnel syndrome after years of typing with poor ergonomics, workers’ comp can help cover treatment costs and ongoing care bills.
Disability
Some work injuries may be severe enough to temporarily or permanently disable your employee. Workers’ compensation coverage can give your disabled employees benefits to help pay their medical bills and replace some of their lost wages.
For example, your foreman loses the use of one of his legs and is partially disabled because of a work-related accident. He’s unable to return to work and needs continued medical and financial support. Workers’ comp can help cover his treatment costs and supplement his missed wages through disability benefits.
Lawsuits Related To Work Injuries
Workers’ compensation insurance typically includes employer’s liability insurance. This policy protects the employer from a lawsuit claiming a worker was injured by the employer’s negligence. If an employee sues, it can help pay for:
Attorney’s fees
Court costs
Settlements or judgments
For example, a restaurant chef suffers third-degree burns while trying to put out a grease fire. She blames the restaurant for failing to provide a fire extinguisher and adequate safety training. The case goes to court; the restaurant’s workers’ comp policy pays for the cost of hiring a lawyer and the eventual settlement.
What Does Workers’ Compensation Insurance Not Cover?
Injuries caused by intoxication or drugs
Injuries from company policy violations
Independent contractor injuries
Injuries claimed after firing or layoff
Wages for a replacement worker
OSHA fines
The Bottom Line
If you’ve suffered an injury or illness because of your job in California, you should claim benefits under California’s Workers Compensation Act.
Once you file the claim and in case it’s declined, you should begin the appeal process to receive the treatments needed for your injury.
