A worker’s comp settlement can either be a simple process or a difficult battle in court, and injuries and accidents in workplaces are common nowadays. A recent statistic from the Bureau of Labor revealed that three million non-fatal injuries and accidents happened in workplaces in 2018.
Every business employer must have worker’s compensation insurance to protect all of its workers from the financial stress sustaining injuries at work brings. The worker’s compensation insurance also protects business owners from employee lawsuits when they get injured at work. “How does workers comp settlement work” is what this review is here to address.
The worker’s compensation insurance protects worker’s from;
- Lost wages
- Medical bills relating to the injury
- Disability benefits
It is simple to file a worker’s comp claim, but settling one isn’t as easy as it sounds. The worker’s comp process becomes smooth when the employer and employee have a perfect understanding of the insurance coverage. Everybody has an important role to play regarding worker’s comp settlement. For a worker’s comp claim to work, the injured worker must quickly report an injury or accident to his employer immediately it happens. Failure to report an injury might lead to loss of worker’s comp benefits, and there are deadlines in every state regarding when to file a worker’s comp claim.
How Does Workers Comp Settlement Work
Most states require injured workers to report an injury to their employer within thirty days, and every employer should follow the steps listed below after receiving a complaint from an injured employee;
- Ensure The Employee Receives Medical Attention – Immediately you learn that your employee gets injured on the job, make sure he or she receives medical attention right away.
- Carry Out An Investigation – It is the employer’s duty to record everything that happened and possible safety measures. Taking a record of everything that led to the accident might include taking pictures and taking down some statements from eye-witnesses.
- Proceed To File A Claim – The employer is expected to file a worker’s comp claim with his insurance company. Still, the rules might differ because you might be required to present some documentation to the worker’s compensation state board.
After filing a claim, the claim might be approved or denied by the worker’s comp insurance company. They will investigate to determine how and where the injury occurred. Accident reports and medical files will be reviewed by the insurance company too.
Why A Claim Gets Denied
Insurance companies deny claims when the injuries reported by the employee;
- Are self-inflicted injuries
- Occurred because of an employee’s work commute
- It happened because employees were fighting or playing
- Occurred because the employee was under the influence of drugs, alcohol, violating company rules, or committing a crime
The injured worker can hire an attorney if he decides to appeal the claim denial, and the appeal process would lead to an administrative hearing. Our readers might be concerned about what happens when a claim gets approved, and it would interest you to know that after your claim gets approved, the insurance company or your employer pays for all of your medical expenses. The injured employee would not be able to work, and he will get an amount that would cover lost weekly wages.
As long as an injured worker receives treatment for the injury sustained on the job, the insurance company will keep paying the medical bills. When the injured worker returns to work, the insurance company will stop paying the temporary disability benefits. In some companies, employers provide their injured workers with some back-to-work programs that would help them get back to work easily. Fortunately, the back-to-work programs come with huge benefits too.
Before reaching a settlement, an employee and his attorney would figure out how much the compensation should be, and this compensation will cover future and present medical bills. After finalizing the right amount, the employee and the attorney will begin negotiations with the employer and his insurance company until a final settlement amount is reached.