Workers’ compensation insurance, or Workman’s Comp, offers benefits to employees who suffer from a work-related injury or illness. When an employee gets sick or receives an injury on the job, workers’ compensation insurance covers his/her medical expenses and rehabilitation costs.
The insurance also provides partial lost wages if the employee is forced to miss work due to the injury. Many policies offer death benefits if an employee loses his/her life while performing a job-related task. The Workers’ Compensation insurance provides benefits to employers as well. Businesses can cover their legal expenses when an employee decides to sue their company for any occupational illness, injury, or accident.
Since Oakland is one of our country’s economic hubs, the city has its share of work-related injury cases. If you want to file a workers’ compensation case in Oakland or any part of California, Latimer Law is one of California’s best law firms.
Let’s delve deeper to learn more about Workers’ Compensation.
What Does Workers’ Comp Cover?
Here are the expenses that the Worker’s Compensation Insurance covers if an employee suffers from a work-related illness or injury.
Ongoing care expenses
The insurance does not provide any coverage if employees get sick or hurt outside your company’s official premises. Furthermore, no benefits are available for intoxicated employees who intentionally get into an accident or hurt themselves.
The insurance covers an employee’s medical expenses related to a work-related illness or injury, including prescriptions, necessary surgeries, and emergency room visits. For instance, if your plumber cuts his hand at a customer’s home, the workers’ compensation insurance will cover his hospital bill.
In some cases, work-related illnesses/injuries are so severe that employees need multiple treatments. For instance, if someone hurts his wrist or twists an ankle while lifting heavy boxes at work, the insurance will cover all ongoing care costs, including physical therapy.
In some cases, injuries do not result from a single traumatic incident. Over time, your employees may develop many types of repetitive injuries, such as carpal tunnel syndrome. For instance, your company will have to pay the receptionists who developed the syndrome after decades of typing with poor ergonomics.
Workers’ comp will make up for a part of your employee’s lost income in case they need some time off after suffering from a work-related illness or injury. For instance, you run a restaurant business, and one of your chefs receives a burn injury. If the chef needs some time-off, you can use the Workers’ compensation insurance for replacing some of his lost wages until he fully recovers.
In some work settings, workers suffer from exposure to harmful chemicals that lead to an illness. In worst cases, the exposure can result in the death of an employee. When your employee gets sick due to a work-related condition or incident, you can use this insurance to cover immediate and ongoing care costs.
An unfortunate work injury can also lead to a temporary or permanent disability in your employees. Employers can use the insurance for covering treatment and some of their lost wages to help disabled employees.
The insurance also provides coverage for funeral costs. If an employee loses his life because of a work-related accident, this insurance will cover all funeral costs and provide death benefits to any beneficiaries.
Our expert and seasoned attorneys will help you settle your dispute/case so you can pay your medical bills and make up for lost wages. According to the California Workers’ Compensation Law, all employers must offer insurance coverage to their employees for dealing with work-related illness and injury.
Are You Required to Buy Worker’s Compensation Insurance?
Many business owners with employees must purchase this type of coverage. However, this insurance’s requirements vary according to the nature and location of the business or employees.
For example, freelancers and sole proprietors may not require this coverage legally. Nevertheless, the insurance is good to have even if you work for yourself and don’t have any employees. Ensure you get in touch with experienced and qualified insurance agents to know how the Workers’ Compensation Insurance can benefit you in the long run. Your agent should be aware of how the insurance functions in your state.
In a few states, there are no coverage requirements for:
Family members under a certain age
Business partners or owners
Real estate agents
How the Claim Works
Employees who develop an occupational illness or receive a workplace injury must remember to report immediately. Time is an essential factor because reporting periods vary for each state. The employee may not receive any benefits if he/she fails to report before the specified deadline.
Once the employee reports the illness or injury, both the employee and the employer should take these steps.
Visiting a Qualified Healthcare Professional
Sick or injured employees must seek medical help immediately because any delays will jeopardize their benefits and health. After the visit, the doctor issues a medical report for filing the injury claim.
Paperwork for the Claim
The next step is to start the claiming process. Employers provide all the forms and information related to the claim process and the contact information for their insurance provider.
Filing the claim
The employee files a claim with the employer’s insurance company, keeping in mind the reporting deadlines. The claim should include any medical reports, forms, and state-mandated paperwork.
After the approval from the insurance company, the employee starts receiving Worker’s Compensation payments. These funds cover the medical expenses, two-thirds of their wages (if they need time off for recovery), and rehabilitation costs.
Return to work
In most cases, injured or disabled employees return to work on a reduced schedule, as per their treating physician’s advice. Organizations must take steps to accommodate all such employees, so they have a smooth back-to-work transition. Employers may also adjust their workplace or provide any necessary safety training to guarantee that the same injury doesn’t occur again.
Workers’ Compensation Settlements
Generally, employees who get injured, sick, or acquire a disability because of a work-related accident settle with their employer and do not file a claim. The voluntary agreement between the employee and his/her employer can close out the case. The employee can return to work after finalizing a lump-sum payment instead of accepting the insurance company’s compensation.
Workers’ Compensation in Oakland and all other parts of California can provide a host of benefits to injured employees. Generally, insurers try every trick in the book to deny the compensation you deserve. We will file your Workers’ Compensation case and put your life back to help you deal with the pain and trauma of a work-related injury.
Every employer is responsible for providing information on how Workers’ Compensation works to all current and new employees. For over two decades, James E. Latimer and his team have been protecting the rights of accident victims and their families. If you want to know more about how to file a personal injury claim or a workers’ compensation case in Oakland, contact us today. We will not charge you if your case does not receive a settlement.