Workers' Compensation FAQs

workers compensation faqs

Basic Workers' Compensation definitions

Employer Questions

Answer: Workers compensation is a form of insurance program that most businesses carry. Workers compensation provides medical and wage assistance to employees who sustained work-related injuries. State laws vary from state to state in regards to worker’s compensation matters.

Answer: Wages are an amount of money that is paid by an employer to an employee for labor or services performed by the employee on behalf of the employer. Wages are a monetary compensation based on a contract based on an hourly rate multiplied by number of working hours.

Answer: Although laws differ from state to state, if you are an employee of a limited liability company, or LLC, you are covered by workers compensation policy unless the employer states otherwise.

Answer: In majority cases, a volunteer is not eligible to receive worker’s compensation benefits. However, some states provide worker’s compensation benefits to volunteers who got hurt in the course of their duties.

Answer: In every state except Texas, all employers, with few exceptions, are required by law to maintain workers compensation insurance. Although the laws vary from state to state, some of the exceptions include sole proprietors and limited liability companies (LLC) with no employees. In some states in certain situations, employers with domestic workers, farm and agricultural workers, seasonal or casual workers, undocumented workers or loaned or leased workers are not required to provide workers compensation insurance.

Answer: Yes, part-time employees are included under the worker’s compensation law.

Answer: In some states, volunteer firefighters are eligible to receive workers compensation benefits if you are injured during the course of your employment. Laws vary from state to state so it is important to check the policy in your state.

Answer: The uninsured employers fund is a fund that pays workers compensation benefits on injured workers that works for an illegally uninsured employer.

Answer: Your employer is obliged to allow you to go back to the job after an on-the-job injury. However, this is true, only if such a position is available.

Answer: There are limitations to what an employer should do depending on what the State provides. After making sure that you received the proper medical attention that your injury requires, your employer should file submission of the First Report of Injury on your behalf, and have it sent to the insurance company.

Answer: In some states, you are covered by workers compensation insurance. In other states, you may not be covered. Your employer's responsibility to provide workers compensation insurance depends on the number of employees that are employed, the kind of business it is and the type of work you are doing. Certain kinds of workers are excluded in most states, which include domestic workers, farm workers and casual or seasonal workers.

Answer: Workers compensation is what is known as a "no-fault" type of insurance. Although there can be exceptions, what this means is when it comes to workers compensation, fault is not an issue. If you were injured in an accident while you were performing your job for your employer, you are eligible for workers compensation benefits; regardless of whose fault the accident was.

Answer: If you are an independent contractor, you are not eligible for workers compensation benefits. However, some employers misclassify employees as independent contractors in order to avoid paying workers compensation premiums and payroll taxes for them. You need to check and see if you are really an employee.

General Questions

Answer: Workers compensation covers most, but not all, job-related injuries. Injuries that are not covered by workers compensation include injuries that result due to an employee using illegal drugs, being intoxicated, being guilty of conduct that violates company policy, committing a serious crime, starting a fight or having self-inflected injuries.

Answer: Workers compensation covers future problems if those problems stem from your job-related injury. There is no time limit for workers compensation medical benefits. As long as you need treatment for your injury, workers compensation will pay for that treatment. However, if you settle your claim for a lump sum, you may be giving up your rights to future medical benefits that you may need, especially if your condition gets worse.

Answer: If you were doing something for your employer in the course of your employment, even though you were not in the office, you would be covered by workers compensation. However, if you were on your way to or from work, or you were away from the office for a purely personal reason that had nothing to do with your employment, you would not be covered by workers compensation.

Answer: If you have been injured on the job, the first step that you should take to get workers compensation benefits is to get the medical attention that you need for your injury. As soon as your injury will allow you to do so, you should let your employer's (supervisor, manager, boss, foreman) know about your injury. Depending on the state that you are in, you and/or your employer will have to fill a form out to send to your employer's workers compensation insurance company in order to file a claim for workers compensation benefits.

Answer: Yes, you can still file a workers compensation claim. However, you should always report your injury to your employer as soon as you possibly can, even if you do not think that you were hurt. When you do not report your injury on the same day that it happened, you can lose or seriously hurt your rights to receive workers compensation benefits.

Answer: Although the details of what is covered varies from state to state, workers compensation benefits include paying for all of your necessary medical care as long as you need it and lost wages, which usually amounts to about two-thirds of your regular salary. In addition, workers compensation benefits include as needed; retraining, rehabilitation, partial and total, temporary and permanent disability, and death benefits for your loved ones (spouse, children, parents and/or siblings) in the event that you die on the job.

Answer: Although details vary in each state, if your job-related accident accelerates or aggravates your pre-existing condition, you can receive workers compensation benefits. In other words, if your job-related injury makes your previous condition worse, you can get workers compensation benefits.

Legal Questions

Answer: In exchange for receiving prompt workers compensation benefits, you are not allowed to take legal action against your employer. However, there are exceptions where an employee who has a work-related injury is allowed to sue their employer. For example, if your work-related injury is caused by your employer's reckless, intentional or illegal action, you have a right to refuse the workers compensation process and sue your employer.

Answer: If your job-related injury is minor, and/or you know that co-workers have been treated fairly and have not had any problems getting the workers compensation benefits that they were entitled to when they were injured on the job, you probably do not need to hire an attorney. However, if your work-related injury is serious or your employer threatens you or has a reputation for trying to prevent workers compensation claims, you should hire a workers compensation attorney. Also, workers compensation laws can be a confusing maze of legal procedures and rules. So, it is a smart idea to have a workers compensation attorney on your side.

Answer: Attorney fees in workers compensation cases are handled on what is known as a "contingency" basis. What this means is that you do not owe an attorney any fees unless they win your case. The attorney is then awarded a percentage of what you receive, which varies from state to state, but is anywhere from around 10% to 35% of what you are awarded.

Answer: No. You are not permitted to waive your right to be covered by workers compensation insurance. Any waiver agreement that you enter into with your employer is invalid. You will still be covered by workers compensation insurance.

Answer: Yes. Your employer can dispute your workers compensation claim. In fact, your employer may dispute a workers compensation claim that he or she knows is a valid claim.

Answer: Workers compensation lawyers work on a contingency basis. This means that you do not owe any attorney fees unless the attorney wins your case. The lawyer is paid a percentage of what you are awarded. The percentage varies from state to state, but is anywhere from 10% to 35% of what you are awarded.

Answer: Each state has its own specific procedure for filing a workers compensation claim. However, the procedure usually involves you and/or your employer filling out and filing a specific form with your employer's workers compensation insurance company and/or your state's workers compensation board or industrial commission.

Medical Questions

Answer: This depends on the workers compensation laws of the state that you live in. In some states, you are required to go to a doctor that is chosen by your employer or your employer's workers compensation insurance company. In other states, you are allowed to use your family doctor or any doctor you choose that is within a network determined by your employer's insurance company, your employer or your state.

Answer: You do not have to pay for any necessary and reasonable medical expenses, and there is no deductible. Your employer's workers compensation insurance company is responsible for paying all of your necessary and reasonable medical expenses for as long as you require medical care that is connected to your job-related injury. Also, if you require medical care in another city, you are permitted to receive reimbursement for your mileage expenses.

Answer: Yes. Your employer or your employer's workers compensation insurance company has a right to schedule you a medical evaluation that is referred to as an independent medical examination (IME). If you do not go to an IME, you may forfeit your workers compensation benefits.

Answer: Although the details vary from state to state, you should be paid for follow up medical appointments. This is provided that they are in connection with your job-related injury and they occur during your regularly scheduled work hours.

Money an Expenses Questions

Answer: Your employer pays for workers compensation insurance coverage. Your employer is not allowed to deduct the cost of workers compensation insurance from your pay. It is illegal if your employer does so. Your employer's workers compensation insurance company pays the workers compensation benefits that you receive when you are injured on the job.

Answer: You are entitled to receive wage loss benefits for as long as you are disabled and unable to work. There is no time limit on wage loss benefits.

Answer: While the specific laws vary according to the state that you live in, your employer usually only has to pay you for the hours that you actually worked. If your employer does this, the day that you were injured is regarded as the first day of your disability. If your employer pays you for the entire shift, the next day is considered to be the first day of your disability.

Answer: You should not receive any medical bill for medical care that is reasonable and necessary in connection with your work-related injury. However, should you receive medical care that is not approved by your workers compensation insurance company, you may be responsible for that bill.

Answer: Although it varies from state to state, the weekly wage loss amount that you receive usually amounts to around two-thirds of your regular salary. The amount of money that you get from workers compensation will depend on how long it takes for you to recover from your work-related injury and when you are able to return to work.