Workers Compensation Claim
What is workers compensation?
Worker compensation system is a system that exists in all the states of United States to protect workers for any injury received while working or even illness caused as a result of the working conditions or environment. It is system by virtue of which the injured or sick worker continues to receive monetary benefits. The monetary benefit so received includes expenses incurred by the worker for his medical care and certain component of his wages to sustain his livelihood. Who is an employee and who is covered in the workers compensation are clearly defined in workers compensation law.
Who bears the cost of workers compensation insurance?
The insurance premium for workers compensation is paid by the employers. The employer has the choice to recover whole or part of this premium form the workers.
Which body regulates workers compensation claim?
All the cases pertaining to workers compensation are processed by the workers compensation board. It is a state agency which whether the worker is eligible for workers claim and if so, what is the amount to be paid. Importantly, it is this agency which determines the amount of benefits and/or medical care amount. The other word by which this board is name in a few states is the Industrial Commission.
What is the time period within which the worker has to inform the employer?
Once a worker receives an injury on workplace or has a medical ailment on account of working conditions or environment of workplace, he should immediately notify and inform the employer about the same. However, this intimation to the employer has to be made within six months of the injury date. In certain exceptional cases, this period may be extended to three years.
Notifying the employer goes a long way which determines whether the workers claim is compensable. Failure on part of the worker or delaying this information to the employer may render the worker's claim illegitimate.
What is the time period within which the insurer makes a decision on worker's claim?
The insurer has to start making provisional payments to the worker within 7 days of being informed verbally or by way of a claim form. The insurer has to decide with in a period of 12 weeks as to how long these provisional payments shall continue. The final decision on the workers compensation has to be made within a period of 21 days of claim form submission or expiry of provisional payments to the workers.
What happened in cases of permanent impairment?
When the injury sustained by the worker is so severe that is results in permanent impairment, a fixed lump sum amount is paid in addition to weekly benefits. However, the insurer has to mandatorily ensure that worker has received legal advice prior to accepting a lump sum payment in case of permanent impairment.
The worker compensation policy has the interest of the US worker at its heart. Numerous workers have already benefitted by the merits of this policy. The claim compensation procedure is slightly complex and governed by important aspects which have been summarized in this article.