What Does Workers’ Compensation Cover?

Workers’ compensation insurance supplies medical and compensation benefits to individuals who are harmed or become sick at their job. Each state’s government mandates workers’ comp coverage and benefits. 

Workers’ compensation is a social contract between management and labor. Business owners are protected from civil suits from their workers who become injured on the job when they provide workers’ compensation insurance. Keep in mind that each party’s benefits have constraints. 

Workers’ compensation coverage is purchased by businesses and is underwritten by insurance companies or publicly supported state funds. If you are unsure if your work-related injury is covered, speak with a St. Louis Workers’ Compensation Attorney today. 

Workers’ Compensation Coverage

If your employee suffers a work-related injury or illness, workers’ compensation benefits can help cover their:

  • Current and future lost wages
  • Funeral costs
  • Medical care costs
  • Ongoing care costs

Workers’ comp benefits generally are unavailable when employees get hurt or sick outside of work. Benefits generally are also unavailable to intoxicated employees involved in an accident on the job or if employees intentionally hurt themselves.

Workers’ Compensation Insurance Requirements

All states require businesses with employees who are not part owners of said business to purchase workers’ compensation coverage for those employees. This coverage is designed to protect the employee and business in the event of a work-related accident. 

Businesses that fail to provide workers’ compensation coverage could face severe repercussions. These repercussions often include payment for injury claims out of pocket, fines, and possibly imprisonment. Business owners that fail to provide workers’ compensation coverage could also lose the right to conduct business in that state.

Workers’ Compensation Claims

When someone is injured on the job, the first thing an individual must do is visit an employer-approved medical care professional.  A doctor can provide the necessary medical reports to support your claims. Your physician will also lay out a treatment plan that will help you recover as soon as possible. 

Once they have seen a doctor, injured employees can begin the claims filing process. Workers’ compensation claims experts urge you to be sure to include any state-mandated paperwork or forms to avoid claim delays. Once these claims are approved, the recipient will receive their compensation payments and can return to work whenever they are ready.

Workers’ Compensation Coverage Claim Process

Workers’ comp claim processes vary in each state. It is important to note that no matter where you are located, it is important to start the claim process as soon as possible after a work-related illness or injury. Take the following steps to help expedite your claim process:

  • Get immediate medical care.
  • Notify your employee or their representative about the work-related injuries or illnesses you have as soon as possible
  • Wait for word from your employer or their insurer about the acceptance or denial of your benefits. 
  • Discuss your benefits or denial benefits with a workers’ compensation attorney in your local community

Most states have a time limit for when employees can report a workers’ comp injury. This is usually between 30 and 90 days. Do not hesitate to get the compensation you deserve. Start your claim with a professional workers comp attorney today. 

There can also be a time limitation for when employers can report workers’ comp injuries. It is important to understand how the claims process works in your state and the statutes of limitations on coverage. 

Your specific roles, the size of the business, and whether you are full or part-time, seasonal or permanently employed can affect your right to benefits. Requirements vary from state to state, so you must understand what your state requires for workers’ comp coverage.

Some states do not require workers’ compensation coverage for:

  • Farmhands
  • Insurance agents
  • Family members under a certain age
  • Casual workers
  • Business owners and partners
  • Real estate agents
  • Temporary employees
  • Interns

Federal government employees are not covered by state-regulated workers’ compensation insurance because they are covered by federal workers’ comp. An experienced workers’ comp attorney can help you understand which exceptions, if any, apply to your claim. Let them help you get started today if you’re in need. 

Workers’ Compensation Benefits Payments

On-the-job injuries or illnesses can happen at any job or business. When this happens, workers’ compensation insurance can step in and give employees the necessary benefits they need to survive while out of work. 

An injured or ill employee can receive weekly workers’ comp payments to cover their medical bills or lost wages. Workers’ compensation benefits give employees a percentage of their average weekly wage. However, the weekly payment amounts they receive depend on regulations from your state workers’ compensation insurance.

Partial vs. Total Disability

The weekly amount you receive is based on the type of injury or illness. If you are partially disabled, you receive different benefits than someone with a temporary injury. Disabled employees normally get 60% or two-thirds of their average weekly wage. 

Each state also has a maximum weekly rate, and your workers’ comp specialist can help you to understand the rules and benefit amount for your state. If you are wondering how long workers’ comp lasts, that also varies. Commonly, the more severe a work-related injury or illness is, the longer payments last. 

Temporary Disability Benefits

If a medical professional says you are unable to work or can only work with restrictions, you may receive temporary disability benefits to cover a portion of your lost wages. You will not receive these benefits for the first three business days off work unless you cannot work at your regular job for more than 14 days. 

Temporary disability benefits generally continue until:

  • You can return to your regular job duties
  • Your doctor says that you have reached maximum medical improvement (MMI), meaning that your condition is not likely to improve further, or
  • You have received benefits for the relevant maximum time 

If you expect your employee to need future medical treatment beyond regular workers’ comp payments, you may want to talk to a lawyer for legal advice. MO workers’ compensation legal specialists can help you understand Missouri’s benefit laws, advocate on your behalf, and fight any claim denials you may face.

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