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Understanding the Relationship Between Work Injuries and Workers’ Comp

Understanding the Relationship Between Work Injuries and Workers’ Comp

Workers’ compensation insurance (also called workman’s comp) is a type of business insurance meant to protect both employees and the employer. Essentially, it provides payments to employees who suffer work-related injuries or develop occupational illnesses. In exchange for coverage, employees waive their right to sue their employer for negligence or any other actions related to the injury or illness. An exception to this is if it can be proven that the employer intentionally did something to injure the employee.

The U.S. Department of Labor’s Office of Workers’ Compensation Programs (OWCP) provides compensation programs for federal employees as well as longshore and harbor workers. They also offer a black lung program for coal mine workers and an occupational illness program for energy workers.

Outside of these federal programs, workers’ compensation benefits are generally determined by state law. Each state requires employers to carry some level of insurance, but the amount of coverage offered, and how long it’s good for, may vary. The size of the business and the roles of employees will largely determine which businesses need workman’s comp and how much they need to offer. Generally speaking, there are several benefits you can expect to receive depending on the severity of your injury or illness. Here are the most notable.

Medical Benefits


Naturally, paying your medical expenses is one of the most important benefits of workman’s comp offers. This can include emergency room visits, surgeries, and medical prescriptions. Your benefits will also include ongoing care costs, such as physical therapy, though these may be limited to a certain number of covered visits.

It’s common for workers to hurt themselves while carrying heavy loads or after a slip and fall incident. If you find yourself needing the services of a medical professional who provides neck and back treatment in North Brunswick, NJ, you should be able to make several visits for medical care. They offer treatments for spine conditions that can result in chronic back pain such as herniated discs, sciatica, slipped discs, and more. If you need chiropractic care for back pain, neck pain, or shoulder pain, that should be covered as well as medication for pain management.

Of course, not all injuries are caused by a single incident. You can also be covered for repetitive strain injuries, such as carpal tunnel if you can demonstrate it was caused by work-related tasks. Depending on your state, you may have to find a doctor within your employer’s network, and you may or may not be able to get a second opinion on your treatment plan.

Wage Replacement


If you’ve suffered an injury or occupational illness that renders you unable to return to work, you will be covered for a percentage of your lost wages. The amount covered may depend on your state, but you’re free to use it to cover any living expenses.

For example, if you went through an Automotive and Diesel Technology program to prepare for ASE certification and earned a job working with other diesel mechanics, the last thing you’d need would be for an injury to take you out of work. Unfortunately, work-related accidents are common in the automotive and transportation industry, even for workers with years of experience.

Some of the most common injuries are sprains, muscle strains, cuts, and contusions. Out of these injuries, nearly half result in at least one lost workday, and a quarter of them result in a full week lost. Generally speaking, wage replacement will cover two-thirds of a worker’s wages, but many states only cover up to a specific amount that they won’t go over.



You’ll also be covered if you suffer a temporary or permanent disability resulting from a work injury or illness. This shouldn’t be confused with disability insurance, which is something you purchase yourself. Personal disability insurance covers you if you’re injured away from work and are unable to return to your job. Workers’ compensation disability benefits are only for those injured at work.

If a broken leg keeps you temporarily away from work, then your workers’ compensation disability benefits will help pay your medical bills and replace lost wages until your condition becomes stable. If you suffer a permanent disability, such as loss of limb, you can receive benefits for the rest of your life, which will be determined by the nature of the injury.

Filing Claims


In order to receive any benefits, you’ll have to file a claim with your employer’s insurance company. This is largely similar to filing a health insurance claim with one big exception: you need to inform your employer as soon as possible. Preferably, you can inform them before you even receive medical treatment, but if the injury is too severe, have someone notify your employer as soon as you can. This lets your employer get the necessary paperwork to you as soon as possible, which is important since you’ll have a limited amount of time to file.

Getting medical attention immediately is also crucial because it helps prove that your injuries all came from the work incident, and your medical records will be used to determine your benefits. Your doctor will mail their medical report to your employer’s insurance company, and you’ll need to file all the proper paperwork. If all goes well, your claim will be approved, and you’ll start receiving your benefits.

When You Need Legal Help


Of course, insurance companies don’t make money by providing benefits. You may find that your claim is delayed or outright denied for a variety of reasons. If you believe this is being done unjustly, you’ll need an attorney who’s experienced with workers’ compensation law on your side. Try working with WIN Injury Network to find medical, financial, and legal professionals to help with your situation.

You can generally meet with an attorney for a free consultation to explain your case and possibly get some legal advice. Before this, however, you’ll want to gather as many materials as possible. Your medical records will be vital, as well as any evidence you have of the injury scene or conditions that caused your injury/illness. Even if you take photos after the fact, they can add more context to the situation. All of this is important because injury lawyers typically work on contingency fees, meaning they’ll only take a percentage of the payout if you win your case. You’ll need to convince them that your case is a good one for them to be willing to risk it.

Once you have experienced professionals on your side, you’ll need to keep your lawyer’s office and your doctor updated on any developments. The pace of your recovery can impact your settlement, and your attorney needs to know immediately if anyone tries to contact you about your case. Simply refer them to your lawyer since anything you share may be used against you.

The majority of cases end up settling outside of court, but you may need to take your case in front of a judge to get the justice you deserve. This may wreak havoc on your nerves, but if your attorney believes you can demonstrate that the insurance company is in the wrong, then it’s worth doing. Dress as professionally as you can to make a good impression in court, and let your lawyer fight for your rights.

Generally speaking, workers’ compensation benefits should come through for you if you demonstrate that your injury or illness is work-related, but don’t be afraid to fight if you’re being treated unfairly.

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