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Worker’s compensation: how does it work


As an employee, you and your coworkers comprise a valuable asset to your company. Without you, they wouldn’t be able to perform the various job functions that keep the wheels turning.

So, what happens when a valuable employee becomes sick or injured on the job?

This is where the worker’s compensation kicks in. A form of insurance, it’s designed to take care of:

  • Medical expenses
  • Rehabilitative costs
  • Some lost wages
  • Death benefits for some workers killed on the job
  • Legal expenses of the employer if the employee decides to sue in relation to the incident

Although the precise rules vary by location, most companies with employees are required by law to carry worker’s compensation insurance. Even if they aren’t required to carry it as can often be the case for sole proprietors and independent contractors, it can still offer excellent protection in the right industry.

How a worker’s compensation claim is made

The process for filing a worker’s compensation claim involves five general steps. The initial reporting protocol varies by state, but it typically involves the employee first reporting to the employer that an accident or illness has occurred. If they fail to make this report in a specified period of time, they forfeit their eligibility for benefits.

Once the employer has been made aware of the situation, the following steps will be set into motion:

  • The employee will seek medical attention. Not only is this necessary to protect their health, but it also establishes a file documenting the illness or injury.
  • The employer will provide all the necessary forms to the insurance company including contact information and claims details.
  • The employer will file a claim with the insurance company making note of deadlines and providing all the necessary paperwork.
  • If the claim is approved by the insurance company, the employee will begin receiving benefits to cover expenses related to their illness or accident.
  • Once they receive medical clearance, the employee may return to work.

Each circumstance should be viewed as a learning opportunity, and it’s highly recommended the employer offer the necessary training in the future to ensure something similar doesn’t happen.

Protecting your rights

As is typically the case, insurance companies want to collect premiums, not pay benefits. That’s why they’re always looking for a loophole to prevent them from having to do so. It’s up to you to ensure you cover your bases to best ensure the outcome you seek in your worker’s compensation claim. There are several steps you can take to ensure you protect your rights including:

  • Immediately report the incident to your employer.
  • Request a DWC-1 form from your employer and fill out the top section.
  • Write down any witnesses to the incident who can validate your claims.
  • Make sure you seek medical attention even if the injury or illness seems minor.
  • Ask your employer if they have a Managed Care Arrangement that restricts your freedom in choosing your medical provider.
  • Keep an accurate log of all discussions related to your illness or injury including all discussions with your employer.
  • Keep track of all transportation costs related to your medical care.
  • Ask your employer if they have any work you can do that’s accommodating if you are given restrictions by your doctor.
  • Don’t reach out to your private health insurance until you confirm worker’s compensation will not be made available in your situation.
  • Follow your doctor’s orders.
  • Do not provide any recorded statement to insurance companies without the presence of an experienced worker’s compensation attorney.

How worker’s compensation protects your employer

Just because you’re considering filing a worker’s compensation claim doesn’t mean you’re undermining the importance your job has on your life. After all, it’s what gets the bills paid, and you may have a very positive outlook on your future with the company. Don’t let this dedication stop you from filing the claim that will provide the compensation you deserve.

Worker’s compensation is designed to protect the employee and employer alike. Employers are aware that dangers lurk in every industry and that employees hurt on the job will take an average of eight days off due to their injuries. That’s why they prepare ahead of time with the insurance necessary to prevent them from having to cover these expenses out-of-pocket. It’s nothing personal, and, ultimately, it makes your employer aware of potential issues that need to be corrected going forward.

What to do when it’s not enough

What do you do when your claim is approved, but the benefits just aren’t enough to make ends meet? Each situation is unique, and payouts depend on variables. You can see this example for a few scenarios including benefit amounts for varying degree of disability. When the amount you’re awarded isn’t enough to make ends meet, it’s a good idea to speak with a worker’s compensation attorney to begin the process of fighting for more.

Preventing future problems

Your accident can be the necessary turning point that protects you and your coworkers in the future. Following your accident, just a few steps your employer can take to ensure something like this doesn’t happen again include:

  • Provide safety training sessions that not only teach but also refresh employees on the proper way to conduct themselves on the job.
  • Development of an environment in which employees feel comfortable bringing safety concerns to the attention of their superiors.
  • Provide a good understanding of the company’s worker’s compensation plan to all employees so everyone has an equal opportunity to file a claim should that ever become necessary.

Making for a safe work environment for all

If you’re facing a work-related illness or injury that impacts your ability to do your job, it can be very stressful. Your very livelihood is at stake, and you need the peace-of-mind in knowing things will be okay as you recover. That’s the very reason worker’s compensation exists.

As you go through the process, understand that you’re providing your employer an opportunity to improve on their current business practices and make for a safe work environment for you and the rest of your team.



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