What Is Cobra Insurance and How Does It Work

How Does Worker's Compensation Insurance Work?

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A workplace injury or illness can place a lot of financial and emotional stress on both you and your family. The workers' compensation system was introduced to provide fair and timely compensation for injured workers. Even if you feel your situation appears relatively simple and straightforward, there may be benefits available that neither you or your employer are aware of.

What Is Workers' Compensation?

Workers' compensation is insurance against workplace injuries or illnesses. Insurance coverage and payment of premiums is the responsibility of the employer. Employers cannot deduct from employees' wages to cover these costs.

Workers' compensation covers any medical costs incurred after an injury or illness and may also include compensation for lost wages. Should an accident or injury result in the death of the employee, the family receives benefits.

While there are specific federal schemes, most workers' compensation takes place on a state basis.

What Does Workers' Compensation Actually Cover?

If you are injured in the workplace, your minimum entitlements include:

• Covering the cost of all medical bills directly related to the workplace injury
• Payment of temporary disability benefits for any injury that prevents you from working for longer than three days
• In the case of longer-term total or partial impairment, permanent disability benefits may be awarded
• Retraining benefit if your injury will permanently prevent you from returning to your previous position or duties
• Access to further benefits in certain circumstances, including payment to a surviving family member in the event of death

What Should I Do If I Am Injured or Become Ill at Work?

You must notify your employer as soon as possible after the injury occurs or the illness develops. Your Human Resources Department can direct you to a board-approved medical practitioner for treatment if required.

If your employer doesn't provide the claim form, a medical practitioner can do so. Fully complete the Employee section of the form, making sure to sign and date the form.

Return the completed form to your employer. The sooner you return the form, the sooner any entitled benefits can commence. If you are unable or unwilling to deliver the form in person, you can send it by registered post.

If you do not receive a claim form, contact your state Workers' Compensation Board, which will advise you on the next steps to take.

Remember, you are entitled to seek legal advice at any stage of the process. If seeking legal advice, consider the advice of a workers' compensation specialist.

What Happens Next?

Your employer will submit the completed form to their insurance company for assessment. If the injury or illness is temporary or relatively minor in nature and your employer admits it occurred in the workplace, this may be the end of it. If your employer does not accept responsibility or their insurance company denies the claim, problems may arise. If your claim is denied, you are entitled to appeal the decision.

Will I Have to Go to Court?

Many workers' compensation claims are settled without going to court. You may even feel confident to represent yourself in court. However, if you have chosen legal representation, your lawyer might negotiate a settlement out of court. They will gather all evidence required, negotiate with the employer's insurance company and draft a settlement agreement. If you are unable to reach a mutually agreed settlement, the lawyer will then prepare all information for trial.

Your Rights

Workers' compensation is there to protect employees from financial hardship during a stressful time. You do not need to accept 'no' as an answer. Knowing your rights will help you through this:

• You are entitled to file a claim for any injury or illness sustained while working
• You are entitled to receive medical treatment
• You may seek legal advice at any stage of the process
• You cannot be denied a return to work on clearance from the treating medical practitioner
• You can not be discriminated against because of your injury or illness
• You are entitled to fair compensation for medical expenses and lost wages
• You are entitled to appeal any decision made

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