If you’re injured on the job and need treatment, you might wonder what expenses does workers’ compensation cover? The compensation should help you cope and adjust to your regular work schedule after an incident. In addition, your dependents receive death benefits if you lose your life in the accident. Each policy has its own extent of coverage, but these are the most common areas.
What Medical Care and Treatment Expenses Does Workers’ Compensation Cover?
Workers’ compensation ensures employees get the necessary medical care and treatment after an incident. The policy caters to your medical bills if you prove that the injuries result from a work incident. Some policies require a filed incident report to ascertain how the accident happened and its impact on your professional and personal life.
Once they confirm the nature of the incident, the insurer must pay for any medical care or follow-ups made until complete recovery. For the compensation cover to take effect, take note of these two factors.
Care Due to the Injury
The medical issue you get treated for must be due to the work injury. If there is no relation between the work injury and the type of treatment plan offered, the insurer won’t accept the claims or damages.
You must also prove that the injury occurred on the work premises or in your line of duty. Contact a lawyer to help you present your medical information to tie it to the accident. It gives you a better chance of receiving compensation for your workplace injury.
Reasonable and Necessary to Cure the Injury
The medical care should also be a reasonable and necessary treatment plan per the doctor’s evaluation to get compensation. Your medical documentation details your medical journey diagnosis to full recovery.
What Vocational Rehabilitation Expenses Does Workers’ Compensation Cover?
Vocational rehabilitation involves getting your professional life back on track after your injury. You may need retraining to return to your daily routine. This happens when you’ve had surgeries or correctional treatments that affect your normal mobility or ability to carry out your regular duties.
A Qualified Rehabilitation Consultant (QRC) will help you communicate with your company. You will want a kind, competent, and trustworthy person to be your QRC.
There are three types of rehabilitation expenses that workers’ compensation does cover.
Medical Management
In medical management, your QRC will inform all parties about your medical progress. They act as a liaison between the company, management, and the insurer.
With the constant medical updates, insurers can prepare for the type of rehabilitation you’ll need or start looking for a new job with fewer tasks. If there’s a great possibility that you’ll lose your job and income, the insurer will prepare the wage loss compensation as per the QRC’s recommendations.
Rehabilitation
Rehabilitation gives you the chance to get back to your job. Depending on the type of injury, you’ll need time to rehabilitate your body and mind as you prepare to get back to work. From the physician’s report, the QRC will look at possible job options within your workplace that you can handle.
The QRC takes time to discuss with your employer how you’ll get back to work, the tasks you can handle, and your expected performance. In addition, they must consider your physician’s medical restrictions and if you’ll fit in the company.
If the employer doesn’t find it feasible to accommodate the injured employee once they recover, the QRC can help them with a job search. Once approved by the QRC, the insurer should cover the cost of this process until you get back on your feet.
Retraining
Retraining involves giving the worker a new skill set to fend for themselves. You can go back to school or get formal or informal training. Insurers can only cover these pieces of training or learning for three years. After that, they’ll cover the costs of books, transport, living, and education.
Wage Losses Covered By Workers’ Compensation
Workers’ compensation also caters to wage loss. Sometimes after an injury or accident, you can lose your ability to work or receive income either temporarily or permanently. Get to know these four categories of wage loss below.
Permanent Total Disability
When you can’t work anymore because of the injuries sustained in a work accident, the policy will give you a permanent total disability package. The doctors must ascertain that you can’t handle any duties or jobs, even with other treatment plans. This policy substitutes your income, thus reducing the impact of the injury on your loved ones.
The insurer commits to helping you with the medical commitments based on your signed rates and documentation.
Temporary Total Disability
When you have a temporary total disability, you can’t work or earn an income for a while during your treatment. Your insurers should compensate for your troubles with a steady income for the first 130 weeks from diagnosis, giving you time to work through your treatment plan to full recovery.
You should get a note from the doctor to ascertain your claims, making you eligible for this compensation. The insurer will stop the payments if:
- You recover earlier than the stated period and get back to work
- 90 days elapse after attaining maximum medical improvement
- The 130 weeks elapse
- You can work without restrictions
This package allows you time to fully recover without worrying about providing or earning.
Temporary Partial Disability
With temporary partial disability, you earn significantly less than you made before the injury. However, the insurer compensates you for up to two-thirds of the difference you earned for a maximum of 275 weeks for the period you’ll have the physical restrictions.
Permanent Partial Disability
With permanent partial disability, a physician analyzes the impact of the injury on the body after recovery. They consider how much the injury has affected your body, and from the payout ratings, they will calculate how much you should receive from this category.
Does Workers’ Compensation Include Death Benefits?
Death benefits are a straightforward type of compensation where your dependents get your workers’ benefits as stipulated. Every beneficiary listed receives the benefits, while for minors, there is a structured system where their guardians can take charge of the funds.
There are also additional burial expenses that the workers’ compensation does cover. This helps the dependents to work through the funeral plans without financial strain.
The Importance of Workers’ Compensation
Workers’ compensation should help you get back to work after an injury. Unfortunately, it’s not always easy to muddle through the red tape. Understanding what expenses workers’ compensation does and does not cover isn’t easy, but a reputable attorney can help you, so contact Mottaz & Sisk Injury Law to help you through the process.
