Who Provides Workers’ Compensation Benefits?

Workers’ compensation insurance provides benefits in case an employee is injured on the job. It benefits the worker by paying for medical care and even lost income while they recover from an on-the-job accident. Workers’ compensation also benefits employers by protecting them from lawsuits by the injured worker.

Workers’ compensation insurance covers employees regardless of who was at fault. Workers’ comp, as it is commonly abbreviated, also provides death benefits for the employee’s dependents if the accident is tragic.

Who Buys Workers’ Compensation Insurance?

The employer is responsible for providing workers’ compensation insurance for the business. Employers have the responsibility to take care of their workplace, which includes ensuring that employees are safe. But even in the safest offices, accidents can occur. Healthcare costs for one incident could be exorbitant. Without workers’ comp insurance, the employer could have to cover these costs out-of-pocket. Plus, the state may fine the business for not having appropriate insurance.

What are Each State’s Requirements For Workers’ Compensation Insurance?

State laws determine the workers’ compensation insurance program. In most places, businesses are required to have workers’ comp insurance, regardless of whether they have one employee who is not an owner or 5,000 or more employees.

The amount of workers’ compensation insurance a business is required to have depends on state regulations. States dictate many of the features of workers’ comp insurance, such as how impairments are evaluated and how medical care is provided. State law can also establish how claims are handled and how disputes are resolved. Some states place limits on certain benefits to control costs of insurance.

How Do You Access Workers’ Compensation Benefits?

Generally, you go through your employer’s insurance company to access workers’ comp benefits. If you are injured on the job, you will need to contact your employer to know how to proceed based on the laws of your state and the insurance company’s procedures. Each state has rules that govern the time limits for reporting injuries. It’s recommended to inform your employer as soon as possible after an injury.

You and/or the employer will submit your claim to the insurance company, which may want to investigate your claim before approving or denying it. If the claim is approved, you will receive benefits based on your situation. Typically, if the claim isn’t denied by a certain deadline, it’s automatically approved.

Many workers’ compensation claims are denied. There are many reasons the claim could be denied. Maybe you missed a deadline to file. It could be that the insurance disputes your claim is related to work. You do have the right to appeal the denial, but the process can be complicated. You may want to talk to a workers’ compensation lawyer to get help with your case.

Source: NY Workers Compensation Lawyer, Polsky, Shouldice & Rosen, P.C.

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