FAQs
Are all on-the-job injuries covered by workers’ compensation?
Workers’ compensation covers most, but not all, on-the-job injuries. The system is intended to offer benefits to injured workers, also if this injury is caused by the employer’s or employee’s inattentiveness.
But of course, some restrictions do apply. Coverage will most likely be denied in cases where:
- The employee is intoxicated or using illegal drugs
- The injury is self-inflicted
- The injury is suffered while the employee is committing a serious crime
- The injury is suffered while the employee is not on the job
- The injury is suffered while the employee’s behaviour violates the policy of the company
Does worker’s compensation only cover the medical bills?
Workers’ compensation pays the medical and hospital expenses that are needed when identifying and treating your injury. Furthermore, it also provides you with disability payments while being incapable of working – This is usually around two thirds of one’s regular wage. The worker’s compensation may also pay for retraining, rehabilitation, as well as other benefits.
Who actually pays for workers’ compensation?
The benefits of the workers’ compensation are paid by the employers of the state. The system of workers’ compensation differs from state to state, but typically, employers pay for workers’ compensation in one of three ways:
- Premiums to a state-run insurance program
- Payments to an insurance company
- Directly to the workers
If you are in the position of receiving workers’ compensation, the company from which you receive the benefits may not always be your employer. Instead it can be an insurance company, your state government or a third party hired by your employer.
Who decides my entitlement to receive the workers’ compensation benefits?
It is your employer, if they are self-insured, or their worker’s compensation insurance carrier that decides your entitlement to receive the benefits of the workers’ compensation. They will investigate your claim and then determine whether or not you’re eligible.
What happens if there is a dispute?
In cases of a dispute between the injured employee and the employer over the entitlement to benefits from the workers’ compensation, the employee may file either a formal ‘Claim Petition’ or an ‘Application for an Informal Hearing’ with the Division of Workers’ Compensation.
Upon filing this, the case will then be allocated to a judge and a district office depending on the residence of the injured.
