When to File Your Workers’ Compensation Claim

When to File Your Workers’ Compensation Claim

An employee’s injury or sickness qualifies for workers’ compensation benefits if it happens on the job or within the scope of employment. This covers occupational illnesses or diseases caused by exposure to hazardous chemicals or other dangers while on the job. To file your East Brunswick worker’s compensation claim, all of the following conditions must be met:

  1. You have an active workers’ compensation policy.
  2. The injured worker is a qualified employee of your business.
  3. Your employee became injured while at work or became unwell due to work circumstances.

An overview of workers’ compensation

Workers’ compensation is a type of employer insurance coverage that benefits employees who are injured or become disabled due to their job. Workers’ compensation benefits may include partial salary replacement when the employee cannot work. Also, benefits might include healthcare and occupational therapy reimbursement.

Additionally, private insurers fund most workers’ compensation schemes through premiums paid by individual businesses. Each state has a Workers’ Compensation Board regulating the program and mediating disputes.

Common benefits of workers’ compensation

Workers’ compensation requirements differ from state to state. For instance, some states exclude small businesses from the obligation for coverage while others have specific needs for various industries.

  1. Salary replacement

A worker’s compensation salary replacement is often less than the employee’s entire salary. The most generous programs pay around two-thirds of the individual’s gross earnings. Workers’ compensation benefits are usually not taxed at the state or federal levels, covering a significant portion of lost income. Taxes may be due to individuals who receive benefits from the Social Security Disability or Supplemental Security Income programs.

  1. Healthcare cost reimbursement and survivor benefits
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Most worker’s compensation plans provide coverage of medical expenses only related to injuries that directly result from employment. For instance, a construction employee could claim compensation for an injury sustained in a fall from scaffolding; however, not for an injury incurred while driving to the working site.

In other circumstances, workers can get the equivalent of sick pay while on medical leave. If an employee dies due to a work-related accident, workers’ compensation makes payments to the worker’s dependents.

How to apply for your workers’ compensation

The procedures for filing a claim for workers’ compensation differ by state. In general, a worker who has been injured or unwell in the workplace should:

  • Make a detailed record of the accident or sickness, including pictures and the names of any witnesses.
  • Inform your employer about the injuries or sickness. The employer should handle everything else, including filing your claim with the insurance.

You can check with the employer’s insurance carrier to see if a claim was submitted. You can also file an appeal with your state’s workers’ compensation board if the claim is denied.

Most states require employers to offer workers’ compensation claims to at least some of their employees. The states write the regulations, so there are numerous exceptions and exemptions. Contractors and freelancers are rarely covered, and many states exclude particular occupations from the mandate or limit the scope of the benefits.

Regardless of your business type, workers’ compensation is an excellent way to protect your business and your employees. Call Mid Atlantic Orthopedic Associates, LLP, or book your appointment today to determine ideal personalized treatment plans to help you recover from your injury and get back to work quickly and safely.

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