What does workers' comp cover? Top 5 worker comp benefits

What does workers' comp cover?

Accidents can happen anywhere and at any time. The workplace is also prone to sudden mishaps that might badly injure an employee. Due to the dangerous working conditions, the chances of labour getting ill prevail quite often. These unavoidable circumstances initiate the need for the organisations to include worker's comp benefits for the affected employees subjected to such happenings. Worker's comp benefits should cover the expenses connected with occupational illness or injury.

Most of the state laws around the world urge employers to incorporate workers' comp benefits in case of any staff get wounded or sick because of job-related activities. In contrast, the law also provides the right to the companies to contest that compensation claim if they find evidence of fraud. This guide will help you to deeply understand the what does workers' comp cover.

Let's have a look at the prominent five worker comp benefits which are essential to be provided to employees affected by on-job injury or illness.

Medical Treatment Cost Benefit

In the year 2017, there were nearly 2.8 million occupational injuries and disease cases being reported by private industries residing in the US. This means that the workplaces are prone to such fatal happenings. Even in the safest offices, accidents can occur. For instance, an employee's leg might get stuck to an exposed computer cable and as a consequence, he falls down and eventually fractured any body part. Apart from that, in the United States, the chief employer is the industrial sector. Several people work in the heavy industrial units of these USA based manufacturing businesses and are always subjected to accidents due to the tough nature of work.

Figure 1: Work-related illness and injury occurrence rate in the USA private industry (2003-2007).

Source: https://www.bls.gov/news.release/pdf/osh.pdf

In relation to that if a worker gets injured or ill because of job-related activity or task then the employer should provide him with instant medical care. Workman's Comp benefits that a company is liable to offer in such happenings include payment for ambulance rides, bear doctors/hospital expenses, medicine and bandage charges and all the necessary medical costs incurred for the treatment of an injured employee. However, the company must go through the medical treatment compensation criteria set by the USA Department of Labour in the prospect of providing comp benefits to an affected worker.

The USA has a separate worker comp benefits unit that offers welfare with respect to the nature of medical treatment required depending upon following situations:

  • Injury
    • Serious Work-related Injuries
    • Nonfatal Work-related Injuries
  • Illness
    • Serious Work-related Illness
    • Nonfatal Work-related Illness
  • Fatal Injuries

Lost Wages Benefit

Imagine that one of your staff members gets harmed while carrying out occupational chores and as a result is unable to work for some time. In this case how the employee will get the salary to fulfil basic needs? The employer, in such scenarios, will be responsible for providing the salary or at least a significant portion of the missed income to the injured employee till the complete recovery. The wage comp benefits can be in the form of a specific percentage of workers' missed salaries or might be a fixed amount in dollars allocated for this purpose.

USA government has developed laws that urge organisations to recompense at least a share of lost wages of injured/ill labour while they recover. Also, doing so can go in favour of the enterprise as the cost incurred for hiring and training the new person can be alleviated, particularly if the recovery time of the employee is small. On the contrary, in case of major injury or disease, which require an ample amount of time for recovery, can be a frightening aspect for the employer. This can lead to the hefty financial burden (referring to wage compensation) on the organisation and delay in work due to the limited labour force. To avoid such repercussions, the company must buy passable insurance policies that could reduce the chances of monetary burden.

Return to Work (RTW)

Today numerous workers suffer from work-related injuries or health conditions that prevent them from working or coming to office. However, many of them can come back to the office by making certain modifications in their working environment, duties, time schedule, etc. As per the USA Office of Disability Employment policy, enterprises must include a return to work benefits for affected employees that should contain work-from-home or part-time work facilities, or modify their job tasks and requirements. Such kind of initiatives can readily bring back the employees to work as soon as possible.

Southfield-based labour's welfare attorney Richard Warsh has shared his experience that the majority of injured workers return back to their job if work benefits are provided to them. Return-to-work benefits fuel employee motivation towards coming back to work after experiencing an accident or catch a disease due to on-job chores.

On-going Care

At times the work-related injury or illness is so severe that the worker needs on-going care from the employer's end. On-going care normally refers to surgery, expert treatment, therapy to recover from trauma, and any other acute medical care facility needed by the sick or injured worker. In addition, on-going care should be provided to those employees as well that would not be able to return back to the office.

The firms must not need to get scared by this extra money expenditure and should look for the most suitable insurance policy that can be enacted in such situations. This is because many insurance service providers offer policies dedicated for such purposes. Also, USA has workmen reimbursement programs, which assist companies in providing comp benefits to the employees.

On the other hand, the law permits employers to challenge the worker's compensation claim if they consider it doubtful or is overstated. The State of Michigan says that many of the corporations in the past have contested their employee's comp benefits claim. The reason behind giving this right to the employers is that in many instances employee has surpassed the compensation expenses against what they actually require. To help companies from fraudulent reimbursement claims, this rule is set by the government of many nations.

Funeral Costs and Death Benefits

What will happen if an accident occurred in your organisation and leads to the death of an employee? How will the organisation recompense the death of its employee to their immediate dependents? To deal with such worst scenario, the enterprises must include provisions for job-related accidents that stole precious lives. Worker comp benefits or insurance should contain funeral expenses and a sustainable amount of money to the mourning family. This, in turn, will reduce the pain and worry of the family of the departed employee. Moreover, death benefits should be valid for illness caused by work-related activities. Grieving family can hire a lawyer, which can help them to formulate their compensation claim.

If a company provide such kind of benefits then this could help them in retaining employees in the high-risk industrial zones. This is because such benefits will ensure the financial security of the employee's family in case of the occurrence of a deadly incident at the workplace. Thus, to keep staff motivated for working in dangerous industrial units the enterprises must provide death comp benefits to them.

What does workers' comp cover - Conclusion

The worker comp benefits or insurance is a vital requirement for the businesses as it helps them to ensure employee job security and financial assistance. Prominent reimbursement benefits include medical treatment, wage loss compensation, return to work, on-going care, and death benefits. These types of compensation are provided by many countries to their employees. However, the worker comp benefit policies might differ from country-to-country or even at the state level. Thus, it is essential for the workers to know and keenly understand the compensation policies pertaining to their country or state.

ClaimFight.com - Shayyan  - author / writer

Shayyan has completed his master in Law from University of Melbourne along with a year of experience as a law professor in Melbourne. He is very opinionated and believes in the saying that a pen is mightier than a sword. Since his early life, he has served greatly to make the world a better place by writing worthy articles regarding political, legal, and social problems. During his leisure time, he loves to travel and learn about new cultures, languages and societies

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