In 2019, workers' compensation insurance premiums amounted to over $48,343,292, as reported by the Insurance Information Institute. Unfortunately, this figure is only a part of the bigger picture, as over 888,220 people were injured on the job, and these are just the numbers of compensated workers.
Whether you have experienced a workplace injury or not, it is essential to educate yourself on workers' compensation. This includes understanding what workers' compensation is, the situations that qualify for workers' compensation claims, and how to file a claim if necessary.
Workers' compensation is an insurance policy specifically designed to cover employee injuries on the job. All employers have a legal obligation to purchase and provide coverage for workers' compensation insurance for employees.
However, problems can arise when insurance companies refuse to pay for full medical expenses or when employers fail to respond appropriately despite being aware of the injury.
What is a Workers’ Compensation Case?
A Workers’ Compensation Case is opened when an employer of an insurance company fails to pay appropriate premiums to the injured employee.
Cases are generally pursued with the goal of fair compensation in the form of wages, benefits, and medical expenses. The employee typically files a claim internally to their employer to notify them about the dispute.
If the employer does not follow up in a given time frame (usually 14-30 days), employees will either have their claim automatically validated by the state OR the employers will need to pay a fine. After filing workers’ compensation claims, insurance companies should follow up with case details in 4-8 weeks.
Overall, claims are filed through your employer to their insurance coverage company. However, in certain circumstances claims can be directed towards employers. Employer-related claims are filed when employers intentionally harm employees. If you are in this situation it’s crucial that you contact legal professionals to help you pursue your case.
What Does the Workers’ Compensation Process Look Like?
Generally, a workers’ compensation case process can resemble the following:
- You bring your injury or illness to the attention of your employers.
- Your Employer provides you with the necessary paperwork for insurance claims
- Employer files the claim and…
- Sends reports to insurance companies
- Files reports for state workers’ compensation boards
- Notifies you about rights and workers’ compensation benefits
- Gives your information about when to come back to work
- The insurance company approves or denies the claim.
- You return to work after recovery and compensation payouts.
What Are the Different Types of Workers’ Compensation Injuries
There are several different situations where employee injuries may take place.
A few of the most common injuries include…
- Motor vehicle accidents
- Slip and falls
- Head/back/neck injuries
- Mental or psychological injuries
- Amputation or permanent loss of bodily function
- Machinery or equipment injury
There are also certain jobs that are especially prone to injuries. In 2018 occupations with the highest volume of workers’ compensation injury claims included…
- Laborers (manufacturing, construction, etc.)-68,470
- Nursing Assistants-33,430
- Maintenance workers-29,370
- Stocking and order fulfillment-25,570
- Delivery services-26,760
Are Workers’ Compensation Payments Taxable?
There are some tax implications to consider for workers' compensation claim payouts. Generally, compensations may be taxable, but there are two significant exceptions.
The first exception is employees who are already receiving Social Security Disability Insurance (SSDI) benefits. SSDI is a government program that provides income to individuals with long-lasting disabilities.
The second exception is Supplemental Security Income (SSI), which includes people who do not qualify for SSDI due to insufficient work credits. If you are not receiving SSDI or SSI benefits, your workers' compensation payouts will not be taxable.
How to File a Workers’ Compensation Claim
To file a workers' compensation claim, the first step is to fill out the necessary claims form from the Department of Industrial Relations. Your employer should provide you with this form within one day of being notified of your injury.
Once you have submitted the claim, your employer will assist you with filling out the rest of the paperwork.
If you want the best chance at a successful workers’ compensation claim or you feel your employer has intentionally caused your injury Contact Us at Levin and Nalbandyan.