FREQUENTLY ASKED QUESTIONS REGARDING WORKERS COMPENSATION INSURANCE.

Q. Exactly what is covered under a workers’ compensation insurance policy?

A. The workers’ compensation insurance policy consists of two separate coverage’s: workers’ compensation and employers liability. The workers’ compensation coverage refers to injury or disease to the employee caused by employment. The insurance company will pay benefits to the employee specified under the law. Employers liability coverage safeguards the employer for employee work-related bodily injury that is not compensable according to workers’ compensation coverage.

Q. What are workers’ compensation benefits?

A. Depending on the conditions of the accident and/or the injury, employees may be eligible to one or more of the following benefits: Medical Care: All medical treatment necessary to cure or relieve the effects of a work-related injury or illness will be paid either by the employer or the insurance company providing coverage. This consists of physician services, hospitalization, physical restoration, dental care, prescriptions, X-rays, laboratory services, and all other necessary/reasonable treatment ordered by the treating doctor(s). Temporary Disability (TD): Paid should a doctor verifies that an injured employee cannot work because of a work-related illness or injury. TD benefits will not be covered the first 3 days of work missed unless the employee is off more than fourteen days or hospitalized. The amount of TD compensation is determined by law and is two-thirds of the employee’s wages. Payments must be made every two weeks, provided the employee is eligible. TD benefits cease when the employee returns to work or the treating physician releases the worker for work or states that the injury has reached a point of maximum improvement.

Permanent Disability (PD) Paid if an injury or illness results in a permanent impairment that reduces the injured workers ability to compete in the open labor market. The total amount the worker will receive depends on the extent of the disability. Other factors that will be considered when establishing PD include the date of injury, the age when injured, and profession. PD benefit amounts are set by law. PD benefits are paid out every two weeks until the benefit is completely paid or when the employee settles the case and obtains a lump sum Vocational Rehabilitation (VR) Paid if it is not likely a employee will be able to return to the normal job prior to his/her injury and the employer fails to provide other work. Vocational Rehabilitation Maintenance Allowance benefits (VRMA) are paid while the worker is participating in vocational rehabilitation. VRMA is paid every two weeks for as long as the worker is eligible. The Division of Workers’ Compensation, Rehabilitation Unit, has to approve the rehabilitation plan. The right to treatment is voluntary; injured employees may accept or reject this benefit.

Transportation Reimbursement Paid by the insurance carrier or employer for the reasonable cost of transportation sustained while receiving medical care and rehabilitation. The injured worker will be entitled to mileage from their residence to place of treatment, examination or rehabilitation and back. Death Benefits Paid to qualified surviving dependents of a worker who dies from a work-related illness or injury. These benefits are paid generally at the same weekly rate as the maximum TD benefit in effect at the time of injury/illness. The maximum benefit will vary depending on the number of total and/or partial dependents.