The Workers Compensation system is available to provide injured workers with a reasonable payment of lost wages and the necessary medical treatment to rehabilitate the employee back into their job. Here are 5 misconceptions about Workers Compensation that you as an employer need to know. The info provided can vary depending upon the state that you have coverage in.
Here are 5 of the Most Common Misconceptions about Workers Compensation Policies
- A Workers Compensation Claim Guarantees Payment Workers Compensation is not guaranteed to cover every injury on the job. Workers that are injured on the job must go through a claim process before they are awarded payment. Most states require that employers report every injury that happens on the job. The insurance adjuster will determine whether the criteria of the injury will be awarded payment. Communication between you the insurance carrier, adjuster and injured workers will help clear up any misconceptions about what type of injury will be compensable.
- Workers Compensation Payouts are High Workers Compensation insurance does not pay for pain and suffering. The system is designed to pay a percentage of lost wages, medical treatment and rehabilitation in order to return the employee back into the workforce. Lost wages are determined through an employee’s gross pay. The payment is typically a percentage of what the employee was making and the state determines a maximum amount that the employee can receive per week. In most states, an employee that chooses to accept Workers Compensation is also giving up their right to sue for pain and suffering damages in court.
- Accepting Reasonable Employment Halts Benefits Reasonable employment is a way for injured workers to gain back lost wages. If an injured worker accepts reasonable employment they will be able to recover lost wages in addition to the percentage that the insurer pays. If a light-duty job is offered but declined, it is likely that they will no longer receive Workers Compensation benefits. It is in a workers best interests to accept reasonable employment as it will subsidize lost income in addition to the insurance payments.
- Fraudulent Claims are Common The majority of Workers Compensation claims are legitimate not fraudulent. As a whole, the Workers Comp system receives very little claims that are deemed fraudulent and it must meet strict criteria before it is deemed fraud within a legal court. More common problems are injured workers not following through with medical restrictions, appointments and physical therapy. However if you feel that a claim was made that is not legitimate, it is important that you discuss this with your insurance adjuster before choosing to pursue a legal battle.
- Legal Disputes are Common The majority of Workers Comp claims are legitimate injuries where an injured worker will need medical leave and treatment in order to return to work. The typical claim results in treatment not court cases. Some claims go to court because of the severity of the injury. These cases are usually resolved within 3 months. Longer court battles are the result of a disabling, severe or uncommon injury.
Fraudulent cases are in the news media often however most Workers Comp claims are legitimate whereby the injured employee can seek medical treatment, rehabilitation and get back to work. Most legal disputes are resolved quickly without a long and drawn out court battle. Workers Comp does not include payment for pain and suffering. Workers Compensation insurance pays reasonable and necessary medical treatment.
* The above terms and opinions are to be used for descriptive and reference purposes only. Please review your individual policy for full definitions, exclusions and endorsements. Should you have any questions, please contact your Broker or Agent.