An Essential Guide on the Basics of Workers’ Compensation Coverage
Workers’ compensation insurance coverage is undoubtedly the most popular insurance policy taken by businesses and employers. The coverage covers medical costs, lost wages, and other damages incurred by employees who sustain workplace injuries. Unfortunately, many employees don’t understand this coverage option and how they can benefit from the policy. Besides, those who’ve tried accessing the benefits for injuries sustained complain of delays and denied claims.
As per the U.S. Bureau of Labor Statistics report, fatal work injuries totaled 140 in 2021 for Michigan.
If you’ve also sustained workplace injuries, understanding the basics of workers’ compensation laws can help you access the much-needed support from your employers’ insurer. Consulting Michigan workers’ comp lawyers can increase the chances of being compensated.
When Should You Seek Compensation?
All employees who sustain workplace injuries because of employer negligence, poor working conditions, and other viable reasons should claim monetary damages. Employers should provide employees with maximum workplace protection and improve workplace safety. Therefore, employers who violate this duty are held accountable for their failures.
An Essential Guide on the Basics of Workers’ Compensation Coverage
However, employer negligence doesn’t guarantee total compensation. The court may void your settlement for various reasons. For instance, your compensation may be canceled if pre-existing conditions partially contributed to your injuries or health issues. Therefore, you should differentiate between a pre-existing injury or trauma caused by work conditions and an existing health condition diagnosed after a work-related accident.
What Does Workers’ Compensation Pay For?
Injured employees are eligible for the following benefits from workers’ compensation cover:
1. Medical and healthcare-related expenses
The primary benefit of workers’ compensation insurance is compensating employees for medical costs resulting from workplace injuries. However, medical expenses for injured employees only apply to injuries sustained at work. Workers’ comp insurance has no maximum benefit limit for medical care coverage, unlike other insurance policies.
Injured employees are eligible for the total costs incurred from:
- Payment of medical care service providers, including doctors, nurses, physiotherapists, and other healthcare providers.
- Purchase of medical equipment, such as oxygen, walkers, and wheelchair, where necessary.
- Medical bills associated with hospital stays and surgeries
2. Rehabilitation costs
Workers’ compensation also covers the costs of vocational rehabilitation undergone by the injured employee before resuming work. Employees who sustain serious injuries may require physical therapy or retraining to continue work. Some may benefit from therapy sessions for their mental health. Rehabilitation services ensure that injured employees cope better with the aftermath of workplace incidents.
3. Lost wages and disability benefits
Workers’ compensation also compensates employees for their lost wages, especially if the injuries sustained make it impossible for victims to work. Lost wages are often calculated based on the employee’s weekly wage for the period before the accident. Victims with temporary and permanent disabilities also enjoy these benefits.
The employees’ disability status determines payment for lost wages. The insurance company provides compensation based on the severity of the employee’s injuries. Injured employees also enjoy these benefits for a period determined by the severity of injuries, recovery time, state laws, and disability status.
4. Funeral and survivor benefits
Some workplace accidents can turn fatal, especially in dangerous work environments. If such happens, unfortunately, the insurer calculates and determines the amount payable to family members of the deceased employee. However, unlike medical costs, which don’t have a maximum limit, death benefits have a maximum limit.
Survivors of the employee, mostly children and spouses, receive an amount determined by the employers’ workers’ compensation insurer. Survivors can use these benefits for expenses the worker’s comp policy hasn’t covered.
Which Accidents Are Not Covered by Workers Comp?
While workers’ compensation insurance covers a wide range of work-related injuries, there are limits. The state can also impose drug and alcohol testing for injured employees, which can deny injured employees compensation benefits. Injured workers can also be denied compensation if:
- There’s evidence the injuries were self-inflicted
- The injuries didn’t occur while at work
- Occurred because the employee violated specific laws
It is also worth noting that employees of independent contractors, volunteers, casual workers, business owners, farm workers, and maritime workers are excluded from workers’ compensation benefits.
The Bottom Line
Workers’ compensation policy was designed as an alternative to personal injury lawsuits. However, some states allow employees to sue their employers for injuries caused by workplace recklessness or negligence. Workers’ compensation lawyers can help you file compensation claims if you’ve suffered workplace injuries.
