Workers’ compensation is an important part of employment benefits. But what is workers’ compensation exactly, and how does it work? In general, workers’ compensation is an insurance-based program that provides medical and salary-replacement benefits to an employee who suffers an on-the-job injury.
Understanding how the system works is vital, especially if you need to file a claim for an on-the-job injury or occupational illness. If you’ve filed a claim and need assistance getting the benefits you deserve, please contact Petro Cohen to speak with a knowledgeable workers’ compensation lawyer in New Jersey. We have years of experience in workers’ compensation matters and can answer any questions you may have.
What is Workers’ Compensation?
Workers’ compensation protects injured employees who suffer from job-related injuries or illnesses. The caveat is that you generally give up the right to sue your employer in exchange for these guaranteed benefits. That means you typically cannot file a personal injury lawsuit for negligence against your company. There are some very limited exceptions to this, which a skilled attorney can help with.
Workers’ compensation usually covers your medical expenses, rehabilitation costs, and a portion of your salary in case of a workplace accident or occupational disease. This system is designed to protect you from financial strain when you cannot work due to a workplace accident or occupational disease.
How Does Workers’ Compensation Work?
Workers’ compensation operates as a no-fault system, meaning you can receive benefits regardless of who caused the job-related injury or illness. You are not barred from receiving workers’ compensation benefits even if you inadvertently injure yourself.
When you sustain a work-related injury, you must report it to your supervisor and designated workers’ compensation person. Once a claim is filed, the workers’ compensation carrier evaluates your claim. The adjuster determines eligibility before referring you to an approved medical provider. If your injury is severe, you might be rushed to the hospital before filing a claim.
Determining Eligibility for Workers’ Compensation Eligibility for workers’ compensation depends on a few key factors. First, you must be an employee. Independent contractors and volunteers usually do not qualify, although there are exceptions to this which a qualified workers’ compensation attorney can explain.
Second, your injury or illness must be work-related, occurring in the course and scope of your employment. Not all injuries are covered. For example, injuries sustained during your regular commute to work typically are not covered, whereas being asked to run a work-related errand for the boss might be covered.
What to Know About Filing a Workers’ Compensation Claim Filing a workers’ compensation claim starts with reporting your injury as soon as possible. Do not delay reporting your injuries, as it can affect your eligibility for benefits. Your employer will have the information and forms required to file a claim. They should also be able to help guide you through the initial steps.
Be cautious of a supervisor or HR person who tries to discourage you from filing a claim or reporting the incident. These individuals look at the company’s bottom line, not your health and well-being. Their goal might be to keep insurance premiums low or underreport on-the-job injuries to make the company look better.
Also, it is important to remember that workers’ compensation adjusters are on the employer’s side. There’s pressure to minimize payouts and reduce or eliminate benefits whenever possible. Even though it is a no-fault system, you should always be cautious about what you say to the claims rep.
Possible Workers’ Compensation Benefits
Workers’ compensation provides several types of benefits to employees who suffer work-related injuries or illnesses. The most common benefits include:
· Coverage for necessary medical treatments, surgeries, medications, and rehabilitation related to your work injury;
· Compensation for lost wages due to your inability to work as a result of your work- related injury;
· Compensation payable to you if, after your completion of compensable medical treatment, you have a measurable loss of physical function proven by “demonstrable objective medical evidence.” This benefit can be payable to you even if you are able to return to work and have made an excellent recovery and;
· In the unfortunate event of a work-related death, dependents or family members may receive compensation to cover funeral expenses and financial support.
Specific benefits and compensation amounts vary depending on your injury severity and the laws of the state where you live and work.
Workers’ Compensation Laws
State law governs workers’ compensation, which can vary significantly from one state to another. However, certain principles are common nationwide. For states where workers’ compensation is mandatory, there are specific rules about coverage limits and the types of employees who must be covered.
Workers’ comp is also applicable in protecting you from retaliation or discrimination for filing a claim. Furthermore, these laws also outline the procedures for dispute resolution, including your right to appeal a denied claim.