How do Workers Compensation Benefits Work?

If you are injured on the job, or develop an occupational illness (such as carpal tunnel from years of typing or data entry) you may be eligible to receive workers compensation benefits.

Background

In order to understand how workers compensation benefits work, it is important to understand two things about workers compensation:

  1. Workers compensation reduces the employees ability to sue their employer if they suffer an injury while performing their job.
  2. On the flip side, under workers compensation laws the employer gives up the right to reduce benefits to an employee if the injury was caused by the employee or a co-worker.

The goal of workers compensation laws is the balance out the needs of the employer and the employee. The employee has access to more immediate benefits when injured at workk and the employer is not subjected to a barrage of lawsuits from injured employees.

Benefits

Workers compensation benefits are administered at the state level and do vary by state, so it is important to be aware of the benefits you are entitled to in your state. Your employer should have information readily available to you regarding workers compensation, and how to file a claim. You can also get information from your state workers compensation board.

The benefits that are available to you will generall fall into four categories:

  • Medical
  • Some tax-free income replacement
  • Vocational rehabilitation, if necessary
  • Death benefits for surviving family members

Making a Claim

If you are injured at work, a claim should be filed as close to immediately as possible. Your employer will ask you to fill out some paperwork, but the actual claim is submitted by your employer to their workers compensation insurance company or directly to the state workers compensation board if the company is self insured.

As long as your injury was work related and not purposely self-inflicted, or happened while you were committing a crime or violating company policy you should be able to have a reasonable expectation of your claim being accepted.

Waiting Period

Most states have a waiting period of 7 days before your benefits can begin, but many will compensate you back to the date of your injury if you are injured for longer than a specified amount of days:

  • In New York State, there is a 7 day waiting period but if you are still out of work after 14 days you will be paid for the first 7 days as well.
  • In Louisiana, there is also a 7 day waiting period but you won't be paid for those 7 days unless you are out of work for more than 42 days.

Income Replacement

Income replacement benefits from workers compensation are usually a fraction of your normal earnings, but the income is tax free. Using New York as an example again, your weekly payment is calculated as two thirds of your average weekly salary over the previous year multiplied by the percentage of how disabled you are determined to be.

Get Legal Help

Although workers compensation laws were originally designed to see that more workers received rightful benefits and there was less litigation needed, the process between employee, employer and insurance company is fairly adversarial. The best way you can make sure you are receiving the maximum benefits you are entitled to is to hire an attorney who specializes in workers compensation laws in your state to represent your interests and protect your rights.

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