Workers' Comp: Overview of Benefits
Every year, millions of people in the United States become sick or are hurt at work. Fortunately, many of those harmed through job-related injury or illness are entitled to workers' compensation benefits. Workers' compensation benefits generally include medical expenses, partial wage replacement and death benefits (for families of deceased employees).
If you are hurt or fall ill at work, it is important that you find a lawyer who specializes in workers' compensation as soon as possible. Workers' compensation claims are sometimes the only legal recourse for these types of injuries. If your claim is not filed properly, you risk losing some or all of the benefits to which you are legally entitled.
Workers' compensation medical benefits generally include all reasonable and necessary medical treatment following your work illness or injury. Some programs allow workers to choose their treating physician(s) while other programs require workers to obtain medical treatment through a contracted health care network or list of physicians pre-approved by your employer or workers' compensation insurance carrier. However, emergency care should always be covered no matter who the provider. Covered medical expenses should include:
- Emergency treatment
- X-rays, MRIs and other diagnostic testing
- Doctors visits
- Hospital care
- Travel expenses/mileage reimbursement
Medical care (including any co-payments) should be paid directly by the employer or insurance provider, not the employee. If you are having trouble getting the care you need, are being billed or harassed for payments, or otherwise have a problem with your medical benefits, speak to a Workers' compensation attorney right away.
Disability payments are a key component of workers' compensation. These payments recompense employees for a portion of wages that are lost due to work-related injury or illness. Disability benefits are typically classified as temporary or permanent and partial or total. Employees may receive more than one type of disability (but not at the same time) during the recovery process.
Generally, temporary disability benefits begin to accrue when an employee misses more than a few days of work (typically 3-7 days). If an employee is partially disabled (i.e., able to return to work part-time or in a limited capacity) he or she may be eligible for temporary partial disability. Though the amount varies, it is sometimes calculated as two-thirds of the weekly wage times the percentage of disability or half of the difference between the average weekly wage before the injury and the average weekly wage after. Temporary total disability is paid when an injured worker is unable to work at all during the recovery period. Typically, this benefit equals two-thirds of the employee's average weekly pay (with some limits on the total benefit).
There are usually time limits for temporary disability benefits but generally it is intended to last until the employee has reached "maximum medical improvement" and can return to work, or the employee becomes eligible for permanent disability.
If a physician determines that an employee will never fully recover from his or her on-the-job injury or illness and will always be limited in his or her ability to return to work (sometimes called "permanent and stationary") he/she may be eligible for partial or total permanent disability benefits. Typically, permanent disability is seen with a chronic condition such as asthma and back pain or a catastrophic injury such as traumatic brain injury. Permanent disability is complicated and is based on many factors besides wages such as:
- Which body part(s) are affected
- Degree of injury
- Level of pain
- Future work restrictions
- Expected future medical care
Permanent disability may continue in weekly installments, as a lump sum or a combination thereof. Often there is a hearing to determine the settlement. It is important to have an experienced workers' compensation lawyer advocate on your behalf to ensure you receive the full benefits you are due.
According to the Bureau of Labor Statistics, in years 2008 and 2009 alone there was a combined total of almost 10,000 work-related fatalities. Though no amount of money can compensate for the loss of a loved one, workers' compensation death benefits can provide financial assistance to dependent family members. This generally includes the surviving spouse and children (where applicable) but may also be extended to parents, grandparents, siblings and other relatives if it can be proved that they are financially dependent. Death benefits usually include burial expenses and a portion of lost wages (e.g., 70 percent) but will vary in every circumstance, so it is best to speak with a knowledgeable workers' compensation attorney to learn more.
Workers' Compensation Attorney
The exact nature and amount of workers' compensation benefits vary depending on the case and the state where the workers' compensation injury occurred. To learn more about the workers' compensation benefits you are legally entitled to, contact a workers' compensation lawyer.
In some states, minor employees (under 18 years old) are entitled to as much as double the workers' compensation benefits available to the rest of the workforce.