We get many questions about workers’ compensation benefits and laws, so we put together this quick guide to help you figure it all out.
The first thing you need to know is that workers’ compensation requirements differ from state to state.
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Workers’ comp is an insurance benefit. An employer is required to provide this benefit in the event of an injury while an employee is carrying out their work-related responsibilities. As long as the employee gets injured or becomes sick doing activities that fall under their employment scope as outlined in their contract, that person is eligible for compensation.
However, if an injury occurs due to negligence on the part of the employee or in circumstances contrary to your company policy, then the employer is not liable.
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Find Five Frequently Asked Questions About Workers’ Compensation Benefits
Question 1: As a Small-Business Owner, Do I Need Workers’ Compensation Insurance?
Yes! As soon as you get your first employee, your state might legally require you to get workers’ comp. With limitations, employees are eligible for workers’ compensation regardless of who is at fault in an injury—the employee, employer, co-worker, or client. It doesn’t matter.
You might need general liability insurance for non-employees who suffer injuries on your business’s premises. You might also be required to provide other forms of health insurance coverage for your employees, for incidences outside workers’ comp.
Contact MartinoWest NOW for a FREE consultation on health insurance bundles suitable for your business.
Question 2: What Are Some of the Employee Benefits Under the Workers’ Comp Insurance?
As a general rule, workers’ comp pays benefits even with pre-existing conditions that were worsened due to an injury at work. Workers comp covers all expenses related to an injury, including:
- Medical treatment
- Wage replacement
- Vocational rehabilitation
- Death benefits
Wage replacement benefits include temporary total disability, temporary partial disability, permanent partial disability, and permanent total disability. The amount your employee is eligible to receive is usually two-thirds of their pre-injury wages.
In exchange for the workers’ comp benefits, employees vacate their right to file a personal injury lawsuit against their employer, except if:
- The injury is due to a defect in a product.
- Toxic substances caused the injury or sickness.
- The injury rose from intentional or inhuman actions of the employer.
- A worker or employer intentionally caused the injury.
- The injury occurred while the employee was acting against the requirements outlined in the company policy.
Question 3: Who Pays for Workers’ Compensation?
Employers have a legal responsibility for carrying a workers’ compensation insurance coverage. This excludes Texas, where coverage is left to the employer’s discretion.
Employees don’t bear the responsibility of paying for workers’ compensation. So, it’s not a co-pay type of benefit between the employer and the employee.
Question 4: How Do I File a Workers’ Compensation Claim?
First, always inform your employees that they need to report to their respective supervisors as soon as someone has an injury. Job-related illnesses should be reported as soon as a diagnosis is made, when the cause can be traced back to the job. The supervisor should take note of the date, time, and circumstances of the injury.
In the event of an injury, first ensure that the employee gets emergency medical attention as the circumstance demands. Your state may have requirements or information to give in your claim, but generally, you’ll need the following:
- The company’s insurance policy information. An account or policy number.
- The injured employee’s information. Name, age, address, phone number, Social Security number, etc.
- Incident information. Date, type of injury, body part injured, cause of injury, etc.
As soon as you collect all the necessary information, file your claim with your insurance.
Be sure to confirm the window of reporting as provided by your state, too. New York, for example, requires that claims be filed within 30 days of injury.
Question 5: How Do I Get Workers’ Compensation Insurance?
You can get workers’ compensation insurance by contacting an insurance company or an agent.
Your state regulations determine the nature of the workers’ comp policy you’ll get for your employees. Some of the factors that affect your workers’ comp insurance and cost include:
- State laws
- The industry in which you do business
- Number and type of employees
- Nature of on-the-job risks
You can opt to buy workers’ comp from private insurance companies, work with a PEO (professional employer organization), or go for state-funded programs.
MartinoWest offers PEO bundles with healthcare and workers’ comp customized to your business needs. You can rest assured that your business is protected, and your employees are covered with industry-leading benefits packages. Get an online quote today or contact an agent directly at (855) 924-1597.
Our goal is to offer our clients suitable, competitive solutions. When anything happens to your employees, you can rest easy knowing that our programs give you the coverage and protection you need.