Employee Claims Under Workers’ Compensation

Most countries have a workers compensation policy to protect employees injured on the job.

In America, the worker’s compensation insurance requirements and benefits are complex as the law differs per state.

In some US states, employers are still not required to have it at all – i.e. it’s not compulsory. Texas, as of 2018, has not made this insurance a must-have. However, most companies have it to attract employees, and it does offer benefits for employers and employees.

Employer

In the states where the workers’ compensation is compulsory, there is ‘limited liability’ for the Employer up to the amount in the workers’ compensation statutory framework. However, there are exceptions to this rule too, i.e. in the state of New Jersey, there is no upper limit of employer liability, whereas, in Pennsylvania, the employer has no liability at all.

Typically in Pennsylvania, it’s the subcontractors or manufacturers of a product involved in the injury in the line of fire for liability instead of the employer. Therefore it’s prudent to always get professional advice on insurance policies about your business.

Employee

Are you an employee? Or are you a freelancer or subcontractor? As an employee, your employer’s policy covers a wide range of injuries, and it’s worth mentioning worker’s compensation is not interested in playing the blame game its focus is to cover the employee when injured. Check you are an employee and that you are covered on your employer’s policy as an employee.

PPD Award

What is a PPD Award? According to Walthew Law Firm, a PPD (permanent partial disability) award is paid in cases where the employee is injury renders them physically impaired with no remedy. The award is essentially compensation for the injury that can not be repaired. There is a specific process to go through, including a physician providing a rating that may also need to be further assessed by an independent medical examiner.

Workers’ Compensation Policies Coverage

Did you know most injuries occur in travel to and from work? So do you think you’d be covered with workers’ compensation insurance? In most cases you’re not covered, so your recourse is filing a personal injury claim. There are exceptions, however, for example, if you’re working late at work or you’re required to travel to various locations as part of your job then suffering an injury on a journey may be covered.

What can be claimed?

Medical coverage

Costs for lab tests, treatments, medications, hospital stays, and follow-up appointments and medical procedures directly related to the injury are all covered.

Disability

You will receive compensation for lost income if you suffered a disability and are unable to go back to work either temporarily or permanently. Mentioned earlier see PPD Award.

Vocational rehabilitation

The policy also covers the costs of learning a new skill for workers who cannot continue with their current job due to an injury they sustained on the job.

Death benefits

If the worker succumbs to their injuries, their spouse and children can file a workers’ compensation claim. The policy covers medical costs incurred between the time of the injury and the time of death, funeral costs, lost income, etc.

Workers Compensation Vs Personal Injury Claims

Workers’ compensation claims are almost identical to personal injury claims when it comes to the filing process, but that’s where the similarities end.

Personal injury claims are more far-reaching with no limit to the damages claimed, including pain and suffering.

Workers Compensation only covers what’s in its policy and typically not included is pain or suffering as a result of the injury.

However, as mentioned earlier, policies vary, so get professional advice on interpreting the terms and conditions which are typically written for lawyers, not laypeople.