workmans’ comp Frequently Asked Questions
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Insurance and compensation deals can be pretty complicated for consumers who are new to these policies. Every insurance policy including workers’ compensation coverage requires a detailed explanation about different aspects. Coverage will be mainly based on the case and situation of the individual. Apart from the coverage technicalities, here are 20 common questions that are frequently asked by the consumers:
1. Do the workers need to be at the workplace to claim coverage?
It is not compulsory for the coverage holder to be at the workplace to claim coverage. The damage or the loss will be compensated for every work-related situation, whether the accident happened at work or in any other setting.
2. Does workers’ compensation cover all the employees?
Every state has certain rules to define the employees that are not covered under workers’ compensation. The responsibility of the employer varies depending upon the total workforce and what type of work they are doing.
3. Is long terms health issue covered under workers’ compensation?
The health compensation does not need to be about injuries only. Any health issue that may occur during your job period is covered under worker’s compensation. Chronic diseases like heart diseases are also covered.
4. Can any doctor treat me under workers’ compensation?
It is a common practice that employees are treated by the company’s doctor or any physician who is paid by your employer. The recommendations of the doctor will decide the compensation.
5. Can I sue my employer over workers’ compensation?
Yes, employees can sue the employer if the injury is caused due to the negligence of the employer. If you want to proceed with this option, make sure to hire a competitive local attorney for the case.
6. How do I file for workers’ comp?
The employee can report the injury to the employer right after the accident. Both oral and written reports are acceptable and you also need to file the report for the workers’ compensation commission. You also need to attach proof of service with your case.
7. What if my employer does not have workers’ comp insurance?
According to the law, all employers and businesses must have workers’ compensation insurance. If any employer does not have the said insurance, you can report the employer to the authorities or the relevant commission.
8. Can I file for workers’ compensation if I fell on the floor?
Generally, insurance companies try to avoid paying for slip and fall injuries. There are several factors included in deciding the nature of the accident. The best approach is to file your case with full documents. If you feel being tricked by the insurance company, consider hiring an insurance attorney who can help you get the said benefits.
9. Is the day of the accident is included in determining if the employee more than one day?
The day of the accident is generally included in the day count when the employee missed the work. If the accident happened after halftime, that day will also be counted in the total days of missing the work.
10. Is the time required for the appointment with the doctor considered as lost time?
No, the lost time is based on the days when the employee was physically injured and could not work on the project. The day or consultation with the doctor is not included in the lost days.
11. What if I am too injured to sign the case file for workers’ compensation?
It is important for the employer to get the signature of the employee on the report. If the employee is too injured to make it happen, the spouse and any other blood relation can sign the report on the employee’s behalf.
12. Why cannot I see my personal physician after injury at work?
The workers’ compensation act ensures that all type of medical billing is handled by the employer. If you decide to see your personal doctor, the employer will not pay under workers’ compensation. It is a must for the employee to get medical attention from the doctor appointed by the employer.
13. How will I receive workers’ compensation?
If you are seriously injured and cannot come to work for more than eight weeks, you will be eligible for Temporary Disability Benefits. The compensation for that period will be paid in form of weekly payments until you are recovered to join the work.
14. How much money will I receive under workers’ compensation?
The exact amount you might receive depends upon the state maximum. Usually, injured employees are paid 70% of the weekly pay.
15. Can I return to my old job after recovery?
The availability of the exact job position matters for your placement. The employer is not bound to fire the replacement employee and if any other job position is available, you might be assigned that task.
16. Can I apply for unemployment if my claim is rejected by workers’ compensation insurance?
If your claim is rejected by the insurance company, you cannot apply for unemployment. In such situations, employees can file for Temporary Disability Benefits. As you are not actively looking for a job due to injury, you cannot apply for unemployment.
17. Can I get workers’ compensation if the accident was my fault?
If you are injured at the workplace, you can always file for the workers’ comp and it does not matter who was responsible for the accident or injury. All of your medical bills are covered under workers’ compensation if you met an accident during work.
18. Do I need to pay my attorney before filing the case?
It is a common practice that workers’ compensation attorneys will get paid after receiving the compensation. Usually, the attorney is awarded 20% of the total amount recovered from the insurance.
19. What to do if my checks are always late?
There is no reason for the insurance policy to hold your checks and if you face such a problem, you can sue the insurance company for a 10% penalty.
20. What I should do if the amount on the check is wrong?
This might happen due to many reasons. Instead of dealing with such issues on your own, consider hiring an experienced lawyer for this job.