Workers Compensation FAQs

Workers’ compensation laws protect injured workers in the event of an accident, disability or death, providing benefits, medical treatment, and lost wages. A lifetime benefit may be awarded for permanent injuries. Each state has different laws regarding workers’ compensation awards and settlements. Workers compensation is no-fault, meaning benefits are paid regardless of fault in the accident. There are several types of workers’ compensation award settlement types. Here are some basic facts and benefits, requirements, awards, settlements and workers’ compensation lawsuits.

Benefits

Workers compensation provides benefits to injured employees, including medical payments, disability income, rehabilitation expenses and death benefits. Rules on compensation vary from state to state.

Non-covered Injuries

Not all injuries to employees are covered under a workers’ compensation policy. Exclusions include injuries caused by willful misconduct, law violations and failure to comply with safety regulations.

Family Member Benefits

Benefits may be paid to individuals other than the employee who will be affected because of the injury. If an injured worker dies, the spouse and children will receive benefit payments.

Requirements

Workers compensation is a federally mandated coverage in all but two states: Oklahoma and Texas. Some states do not require coverage for domestic employees or for employers with less than three employees.

Maritime Employees

Because of the unique risks involved with maritime employment, the federal government has provided these employees special coverage through the Longshore and Harbor Workers Compensation Act. This covers employees working as harbor workers, shipbuilders and ship repairers.

According to Occupational Safety and Health Administration (OSHA) statistics, the top workplace accidents causing injuries or fatalities are transportation accidents, equipment operation, exposure to harmful substances, falls, fires, explosions, and workplace violence. Worker’s Compensation coverage protects injured workers regardless of fault, paying their medical expenses and compensating them for lost wages.

Stipulated Finding and Award

Stipulated finding and award settlement types are ideal for workers who remain employed by the company they worked for when injured. The case may be reopened at a future date if the worker requires additional medical care. Stipulated awards are entered into voluntarily by both parties. The award amount is based on the doctor’s determination of the level of disability. The level of disability is calculated in a percentage and determines the amount of compensation an injured worker will receive. The injury may be determined to be either temporary or permanent. The employee may be required to obtain your medical care from the company’s or insurance company’s preferred provider network. In the case of a permanent disability, the worker can begin receiving payment for treatment before the case is settled.

Compromise and Release

If a compromise and release settlement type is decided upon, the case will be closed and no payments over time will be made. Such settlements are reached when an injured worker chooses to pay for future medical needs himself or has other health insurance she wishes to use for these payments. A compromise and release settlement generally totals more than the amount of permanent disability the worker would have received over time. The amount is calculated taking into consideration future medical needs that may arise. It is within the rights of an insurance company to reduce the amount paid to the injured employee by 3 percent per year if they pay the entire settlement at once, even though most insurance companies do not choose to do this. The amount of the award is based on the doctor’s recommendations for future care that may be needed by the injured worker.

Structured Workers’ Compensation Settlement

The structured workers’ compensation settlement is similar to the compromise and release settlement. A structured workers’ compensation settlement closes the file and releases the employer from further obligations. Periodic payments are made to the injured worker. According to WorkersCompensation.com, the insurance company generally either purchases an annuity from a life insurance company to cover the payments or transfers the obligation for these payments to a third party, which then purchases an annuity.

Workers compensation is designed to compensate employees for injuries received while on the job regardless of fault. Before workers compensation laws were established, workers were at an employer’s mercy should they be unfortunate enough to experience a workplace accident. The Employer’s Liability Act of 1908 was the first workers’ compensation law passed in the United States. Currently, all states with the exception of Oklahoma and Texas have mandatory workers’ compensation requirements.

Lawsuits

If an injury is the result of employer negligence or your employer intentionally causes you injury, a suit can be filed against him, bypassing the worker’s compensation system. Damages you may receive include mental anguish, pain and suffering and other punitive damages