Workers' compensation is, according to the government of New York State, a form of insurance which provides benefits to workers who get injured or sick while on the job. Note that the ailment must come as a direct result of the job in order to qualify. Typically, workers' compensation insurance is paid by the employer and there is no cost to the employee. Benefits of the insurance can include cash reimbursement and payment of medical expenses. In some cases, the employer or insurance carrier can dispute a claim and a ruling must be made by a judge in the favor of one party or the other.
Workers' compensation laws vary slightly by state, so it's a good idea to check on the specifics that apply to you. Minnesota and Michigan require all employers to have the insurance without exception, while Rhode Island makes exceptions for independent contractors, according to the National Federation of Independent Business.
Example: A slip-and-fall injury
As reported by the National Safety Council, injuries caused by slipping and falling on the same level cost American employers $8.6 billion dollars each year, with those costs skyrocketing to about $70 billion when added to the complete medical costs. Injuries like these can, in part, be prevented by augmenting safety training and wearing the proper equipment. Many of these injuries could be prevented by wearing a slip-resistant shoe, for instance. Check out this article for more information and statistics about fall-related accidents.
Steps to file a claim
First, you should seek medical treatment for any serious injury or illness – in this example, the injury is a fall-related accident, so the injured employee should definitely see a doctor to assess the extent of the injury. This is also important because the doctor can make a record of everything he saw. For the sake of this example, let's say the doctor recommended taking 30 days off of work to recover.
"The more documentation you can provide, the better."
The claim itself should be filed as soon as possible. The exact time period allowed between injury and the report will differ by state, but in general it is less than a month. Filing the claim means reporting the injury to your employer and the insurance company. Once that's done, you will typically have to fill out a form concerning the injury and the results thereof. The claim is usually filed by the employer, though some states require you to file a separate form on your own.
Once the claim goes to the insurance company, it or your employer could attempt to deny the claim. There are many reasons why they might do this, but in most cases it's best if you are able to present the insurance company with documentation about the injury and about the care you received for it. The more documentation you can provide, the better. Additionally, you should consider documenting any witnesses who saw the accident.
After the claim is accepted, you'll be told how to submit your documents for reimbursement. In this example, the slip-and-fall injury only kept you out of work for 30 days, so the extent of the coverage would most likely be limited to the medical bills. In other instances, where an injury caused long-term or permanent inability to perform your job, workers' compensation could pay for some of your living expenses.
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