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Currently Browsing: Workers’ Compensation

Work-related Injuries or Illness and the Benefit of Workers’ Compensation Insurance

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Before employers in the US were mandated by the government to carry a workers’ compensation program in behalf of their employees, the latter had to resort to legal proceedings whenever they sustain work-related injuries. Suing their employers was for the sole purpose of recovering lost wages and future earnings, as well as getting the compensation that will enable them to pay for medical expenses. Majority of the employees, however, did not only lose the case, but the case also damaged their relationship with their employer. To win cases, employers always resorted to the following arguments:

  • Assumption of risk – it stated that the injury was an accepted danger normally connected with the job;
  • The fellow worker rule – that it was a fellow worker’s negligence that caused the injury;
  • Contributory negligence – the injury was due to the negligence of the worker himself/herself

If ever there were occasions when an employee won the case, the compensation would either be delayed or it would be much lesser than the amount stipulated by the law. Thus, the establishment of the workers’ compensation law in 1908 (which initially covered federal employees) started an insurance program that would greatly benefit both employer and employee. Majority of the states began adopting their own version of the program between 1911 and 1920; this insurance program, the oldest in the US, was then mandated on most managers or business owners.

The workers’ compensation insurance benefit is aimed at providing financial assistance to employees who sustain work-related illnesses or injuries. The benefits will cover lost wages, medical, disability [temporary total disability (TTD), temporary partial disability (TPD), healing period, permanent partial disability (PPD), permanent total disability (PTD)], vocational rehabilitation and death.

Though the same benefits may be enjoyed by employees regardless of the state they’re in, there are also differences such as coverage and statute of limitation. In Iowa, for instance, an employee whose work is principally based in Iowa or who is hired in Iowa is entitled to all the benefits even if the injury was sustained somewhere else; this is one relevant information mentioned on one of the web pages of LaMarca & Landry, P.C., a law office based in the same state. The page also mentions that the employee ought to inform his / her employer of the injury within 90 days after it was sustained.

Though the workers’ compensation program provides workers with guaranteed benefits (the amount of compensation employees ought to receive cannot be lower even if the injury is due to their own fault) and removes the burden of time- consuming and costly proceedings, there are times when an application gets denied due either to the worker’s failure to fill out the forms correctly and completely or file the application on time. If denied of the compensation benefit or if the amount you receive is lesser than what you believe it ought to be, it would be good if you will seek the assistance of a workers’ compensation attorney, as this will make the processing of application much clearer and faster for you.

Workers’ Compensation Insurance: What It is and How to Apply for It

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Job sites are common venues where individuals sustain personal injuries and, of the many different sites of work, the ones where the highest number of injuries are sustained are construction sites.

The top four causes of severe injuries and untimely death at construction sites are falls, being struck by construction vehicles or equipment, being caught-in-between / pinned between equipment and a solid object and electrocution, which can cause burns, explosions and fire.

Due to the financial losses and costly medical expenses an employee can suffer from in the event of an accident, a workers’ compensation insurance becomes truly beneficial. Also known as the workman’s compensation insurance or employers’ liability insurance, this benefit is mandated by the state on firms that regularly employ at least three employees, on those operating as limited liability companies and partnerships, sole proprietorships or corporation (firms with only one employee, but whose work requires exposure to radiation, ought to have the coverage too).

Workers’ compensation is an insurance program intended to provide financial benefits/assistance to employees suffering from job-related illnesses or injuries. It offers wage replacement (usually one-half to two-thirds of their regular wage, but which is tax free) and medical, disability, rehabilitation or death benefits to employees regardless of the cause of the injury or who was at fault for such injury. In exchange for this benefit, employees are to waive their right to sue to their employer for damages.

There are workers, however, who are not covered by this compensation benefit; some of them are certain railroad employees, some sellers of agricultural products and farm laborers, domestic servants, casual employees, independent contractors and company owners. Commuting to and from work are not covered by the insurance, as stipulated in the Coming and Going rule; running errands for the employer, transporting goods and traveling as required by the job, though, are.

The essential steps that will lead to availing the benefit include:

  • The independent medical examination (IME), which is performed by a doctor authorized by the insurance company whose examination of, and report about, your injury will help determine the amount of compensation you’ll be offered;
  • Notifying your employer within 30 days after your injury was sustained or when your illness began (some states allow a two-year statute of limitation) is actually the first step in filing for a claim. Your employer will supply you with the claims forms required, otherwise, you can get them from your state’s Division of Workers’ Compensation.
  • Filling out all forms and supplying all required information, such as: your name, address, the date and time when injury was sustained, the place where the injury was sustained, full description of your injury, your Social Security Number, your employer’s name and address, the date your employer was informed of the injury, the date you received your claim form, your salary, the dates you were not able to work, plus other vital information.

Getting a claim denied, though, has been a common woe to many applicants; but such denials, as identified in the website of Schuler, Halvorson, Weisser, Zoeller & Overbeck, P.A., are simply caused by failure to fully and correctly fill out the forms, failure to submit the forms within the statute of limitation, exaggerating a claim or filling out the wrong forms altogether. To be able to complete all required forms correctly and submit everything on time, make sure you seek legal assistance whose help can save you all the confusion, delays or, worse, denial of your claim.

Workman’s Comp is a No-Fault Insurance

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Workman’s comp is designed to provide an employee with a safety net in case an accident or illness that can be traced back to work-related activities results in loss of income. The employer is obliged by federal law to pay for this insurance in anticipation of untoward events so that the injured or disabled worker will continue to receive at least part of the wages that a worker would normally receive.

Some occupations are more prone to injuries than others but all employers must provide coverage. Some employers may choose to self-insure if they fulfill the requirements. Self-insuring is when employers take it upon themselves to cover reasonable costs and benefits to an injured or disabled employee personally. The good news is when there are no workman’s comp claims, no money will go out, and the employer saves on premiums. The bad news is when a big claim is made on the company resources, then the employer may easily pay out more money than would have been necessary to cover the entire staff. The wisdom of self-insuring will depend largely on how likely an accident or illness will be work-related.

This is because workman’s comp is a no-fault insurance, meaning it does not matter if the employee, or anyone else for that matter, is in any way to blame for the accident or illness. Workman’s comp kicks in as soon as there is evidence that the injury or illness is work related. Injured employees can use this insurance to cover the costs of their recovery and help them sustain themselves during the period where they are not able to work.

Those receiving workers’ compensation, however, are barred from filing a civil case against the employer even if the injury is due to negligence or recklessness of the employer or his or her managers. This is the main reason that workman’s comp is a good deal for both parties involved, and why there are so many laws surrounding access to it.

If you are having difficulty proving that your injury or illness is work-related, you could be done out of your workman’s comp benefits if you are not careful. Contact an experienced and knowledgeable worker’s compensation lawyer to help straighten it out for you. A lawyer can help you file your claim or can appeal a claim that was denied unfairly. There are many reasons claims are denied, some of them as minor as filling in a form incorrectly. Attorneys can help people pinpoint the reason their claims were denied and help the process go more smoothly the next time.

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