After an employee is injured at work some companies attempt to minimize or outright ignore it if they think they can get away with it. Sometimes they can if the injured worker sits idle. However, whether the injured worker receives proper benefits is not up to the company. State law controls help available to those injured while working. For injuries that occur outside of work, but that put people in a position of not being able to work, all the same, a disability insurance policy can help people pay their bills and not be too financially affected by their injury.
Workers Compensation Benefits
Workers comp laws in each state spell out required benefits. Basic benefits pay a wage replacement plus reimbursement for medical bills. Wage replacement payments, paid at what is called the compensation rate are calculated at a percentage of an average weekly wage before the injury. The compensation rate can be paid as temporary total disability when the injured worker cannot work. During this temporary period of total disability the employee receives the full compensation rate. Or, the benefit can be paid as a partial disability, if a work capacity is found.
Workers Compensation Process
Where a ‘first report of injury’ is not filed and where the insurer fails to pay benefits after submission of proper medical documentation, then a claim must be filed through the state division administering workers compensation law. In Massachusetts this is the Department of Industrial Accidents. In New Hampshire, it’s the Labor Department, Workers Comp Division. These are the two states in which I am licensed. But, each state has its own workers compensation agency and procedure.
Basic workers compensation benefits include the compensation rate and the medicals. Later benefits can compensate for loss of function, scarring, permanency and in some, but not all cases a lump sum settlement. There is generally no pain and suffering in workers compensation.
No Pain and Suffering Compensation, Unless …
Sometimes, injured workers have the potential to recover pain and suffering. But, only in what’s called a third party case, where a party other than the employee or employer caused the injury. The simplest example is a delivery truck driver injured in a traffic accident.
The delivery company’s workers compensation insurance company pays workers compensation benefits. But, if the accident was caused by the negligence of another motor vehicle operator, then that operator and their insurer are liable in this third party case.
Here is more information on that subject: Third Party Lawsuits.
This general summary of a complex area of the law is not legal advice in any individual claim. My office handles workers compensation in Massachusetts and New Hampshire. Procedural rules and legal issues vary state-to-state. But general compensation concepts discussed in this blog are relatively universal across the U.S.