Workers Compensation Coverage

In most jurisdictions, workers' compensation functions much like a private insurance system. With a few exceptions, most employers are required to carry workers' compensation coverage with a private insurer. After an employee is injured or sustains an illness related to on-the-job activities, he or she files an accident report and provides other types of documentation to the employer, who then in turn submits it to the insurer. After a careful review process, the insurer determines whether the claim is valid and makes a decision as to how much and what types of benefits will be disbursed. If the insurer opts to deny the claim, the injured worker usually has the right to file an appeal with the state's workers' compensation agency. If you have been injured on the job and you find out that your employer does not have the required workers' compensation coverage or holds a policy with inadequate coverage, you may have the right to sue in civil court.

Fast Facts

  • In some states, the initial reports of the treating physician are presumed to be correct and true, underscoring the importance of seeking the advice of your own physician.

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