top of page
  • Writer's pictureTom Fowler

Types of Workers Comp Claims | Everything You Need to Know

The different kinds of workers' compensation claims will be discussed in this article. These workers' compensation claims are divided into different groups based on how serious the worker's injury was. Additionally, the duration and amount of the compensation are based on the severity of the work-related injury.


However, before that is discussed, it is important for employees and employers to understand a few key phrases. Should a person carry workers compensation insurance? If so, which type? This page will help people see the workers’ compensation landscape more clearly.


What Is a Workers' Compensation Claim?

What Is a Workers' Compensation Claim?


A person on an employer's payroll is referred to as a worker. The benefits that the aforementioned injured worker will get in exchange for his liabilities are called workers' compensation.


Now, what liabilities does this include?


In this context, the term "liabilities" refers to the worker's monetary losses and health problems. This usually includes items like the compensation for the days the worker didn't show up to work, the cost of their attorney's fees, and the costs they incurred to pay their medical bills.


What Is the Workers’ Compensation Law?


There are specific safety regulations for each workplace. They are also there to ensure that no one is harmed in the first place. Humans will always make mistakes, and since they don't live in a perfect world, someone will incur an injury. Even when it is not their fault, accidents can happen to people in an unsafe work environment.


Prior to the development of the workers' compensation system, a worker's injury on site would complicate matters for both them and their employer. In addition to the pain of his disability, they would also have to deal with the loss of time, money, and sometimes their capacity to work.


As for the employer, they would also be in a very dangerous position because they are now open to legal action and may face a lawsuit from one of their employees.


Fortunately, ever since the workers' compensation statute went into effect, if a worker ever gets into an accident at work, both the person and the company can walk away with a relative win.


Workers’ Compensation Benefits & Insurance: Explained


Workers’ compensation insurance works just like any other insurance policy. A person must first buy insurance in order to be able to claim his benefits.


The insurance that an employer must obtain in order to cover workers' compensation claims is known as workers' comp insurance. Most companies try to get away with it because they must continue to pay for the insurance even when there is no injury. If you run into issues with your company, it is always smart to contact a Des Moines workman's compensation lawyer.


Furthermore, the state government has been in charge of overseeing the need to buy workers' compensation insurance, and various insurance providers and employers have contributed to the reserves for workers' compensation claims.


One thing employers should keep in mind is the various frauds and scams related to workers' compensation claims.


Seven Types of Workers’ Compensation Claims


Workers' compensation claims can be broadly divided into three categories based on the severity of the injury: medical, disability, and death. In fact, they are more precisely classified into seven categories of which four are subclasses of disability.


However, it is not a set rule and varies depending on the state. Essentially, in some states, the sorting is carried out according to wages. In Louisiana, there are three different forms of workers' compensation claims: average weekly wage, temporary total disability (TTD), and supplemental earning benefits (SEB).


The most common types of workers' comp claims, in California, are for medical treatments, short-term disability, long-term disability, additional job displacement, and death payments.


Considering all the states, these are the types of workers’ compensation claims available:


Medical-Only


The easiest to submit and the quickest to process are these kinds of workers’ compensation claims. This claim usually relates to workplace injuries that are minor and treated quickly and successfully. Depending on the severity of the injury and the kind of service offered, injured workers may return to work the following day or the same day.


Temporary Partial Disability


One of the more common types of injuries covered by workers' compensation is a temporary partial disability. In this case, the injured worker experiences severe partial loss and is unable to do their usual duties during that time. They can request time off from work or the company can give them some light-duty work.


Their medical expenses and missed payments will be covered by the proceeds of the workers' compensation claim.


Temporary Total Disability


The worker falls under the TTD (Temporary Total Disability) category if their injury prevents them from working at all for a while. The diagnosis will indicate a full recovery in this instance, but the worker is totally disabled during the healing process.


In addition to their replacement wages, this workers' comp claim will pay for the costs of their medical treatment, rehabilitation, and specialized visits such as those to a doctor or chiropractor.

However, in some cases, injured workers return to work before they reach maximum medical improvement, often with restricted duties and lower or differential pay.


Permanent Partial Disability


All workers who have suffered an accident that prevents them from performing their usual duties for the rest of their lives are covered under the PPD (Permanent Partial Disability) claim and receive workers' compensation benefits.


The majority of the time, these people are let go by their employers, and if they are, they are offered a position that is more suited to their permanent disability.


Because of the decrease in their earning potential, people continue to get disability benefits even after losing their jobs. It goes without saying that their medical expenses and lost wages will be paid for - these are known as disability benefits.


Permanent Total Disability


When a worker has an accident that prevents them from fulfilling their regular activities and it is determined that they will never fully recover, the worker will lose their ability to earn money. Also, the worker won't be able to get compensation under a PTD (Permanent Total Disability) claim in terms of the permanent total disability benefits.


Vocational Rehabilitation


An employee's ongoing care may be covered by workers' compensation benefits. This includes ongoing physical therapy or job training to help them pick up new skills so they can return to work in a different role. Even the cost of new training and certifications may be covered by workers' compensation in terms of vocational rehabilitation.


If you cannot return to your previous employment because of your injuries, you can include vocational rehabilitation benefits in your workers' compensation claim.


A transferable skills analysis might also be given to a disabled employee. This assists in helping them find new jobs in which they can develop new skills and work around their disability. An employee will often have a vocational counselor assigned to them to carry out the evaluation. These vocational rehabilitation counselors can help staff find extra guidance or training.


Death and Funeral Services


In the tragic event that an employee passes away as a result of a work-related illness or injury, workers' compensation may be able to provide death benefits to their beneficiaries and family. They can use these benefits to offset funeral and burial expenses and lost wages.


The majority of coverage plans contain a cap on these costs, which varies from state to state. If an employee's insurance company determines that their expenses are excessive or unnecessary, the insurance company may refuse to pay.


Workers' compensation death benefits typically go to immediate relatives or dependents who lived with a deceased employee, such as their:

  • Elderly parents

  • Children

  • Spouse

Some states don’t allow children over 18 to receive death benefits, but there may be an exception for children with disabilities.


Lost Income


Workers' compensation benefits can help employees make up some of their lost wages if they must take time off of work to recover from a work-related illness or injury.


If an employee dies, their family could benefit from the missed income. The amount their beneficiaries receive depends on state regulations.


General Liability vs. Workers’ Compensation Insurance


Workers' compensation insurance is different from general liability insurance. Essentially, general liability allows employers to fight against claims that their company damaged property or caused bodily injury. General liability, for instance, may contribute to the cost of a customer's medical bills if they are injured at a place of business.


What Do the Two Policies Have in Common?


Bodily injury is protected by general liability insurance as well as workers' compensation. Most small firms are often required by law to have workers' compensation insurance. Even though general liability insurance isn't usually required by law, having it can still be a good idea.


Without insurance, an employer's staff or clients may be forced to pay for their medical care and then sue the company to reclaim their medical costs.


Because of this, general liability and workers' compensation are beneficial to owners, employees, and third parties.


Different types of claims are covered by each insurance. Workers' compensation offers a company's employees wage benefits as well as medical benefits to help in their recovery from a work-related injury. For almost all cases, gathering evidence for a workers compensation injury claim is needed.


If they need to take time from work for recovery, these benefits can replace part of their lost income and help with medical expenses. The costs associated with claims of property damage and physical harm brought against a company are eased by general liability insurance.

It also helps cover costs to settle claims of:

  • Libel

  • Slander

  • Advertising injury

  • Trademark penalties

Choose the Best Workers' Compensation Insurance for Your Business

Choose the Best Workers' Compensation Insurance for Your Business


The laws governing workers' compensation benefits vary from state to state, so people should be mindful of this when buying insurance. Employers working with an insurance provider that is familiar with the laws of each state is important because it can become complicated if an employer runs a business over state lines.


Tom Fowler Law can help a company find the best protection for its unique needs and financial situation, whether it's a huge corporation or a small business.

1 view0 comments

Commentaires


bottom of page