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nico2me   , 57

from Spring


What You Need To Know About Workers Compensation Benefits

The major workers’ compensation benefits include payment for medical care, lost wages, and physical rehabilitation and in some regrettable instances, death benefits. 

Workers comp definition is the payment made to a worker to cater to medical bills or in compensation for lost wages. Workers compensation could also come in the form of physical rehabilitation or death benefits to beneficiaries or relatives of the worker.


Workers compensation benefits

Lost wages are paid under workers’ compensation benefits when the worker experiences either permanent or temporary disability. Basically, the worker is getting paid for the wages lost as a result of not being able to work. In the event of a permanent disability, a worker’s compensation benefits claim can give a lump sum payment, depending on the victim’s current wages and expected life expectancy.

Like most states in the U.S., Texas workers compensation laws include provisions that allow an injured employee to enter a rehab program. This is beneficial to both parties – employee and employer, as it gives the injured worker a chance to re-enter the workforce shortly after the rehab treatment is completed. In some cases, workers re-enter the workforce even during the treatment.

In most cases, the workers’ compensation insurance carrier decides on whether or not the workman’s comp pay will be made to the employee. The insurance carrier is also charged with the responsibility of approving any rehabilitation or lump sum payment.

In a situation where the insurance carrier fails to approve the workman’s compensation claim for any reason, the employee or claimant has the right to appeal the decision. This is usually done before an industrial commission or a worker’s compensation board.

How soon should a claim be made?

The injured worker or victim, in this case, is required to file a workers compensation claim within twelve months from the time of the injury. Either the employee or his or her relative can file the claim. It is advised that the claim is filed as soon as possible. This is to avoid being suspected of a fraud as a long wait before filing a claim brings suspicion. Therefore, workers compensation should be filed as soon as possible.

Another point to note is the notification of the employer or company of the injury. It is required that the injured employee notifies his or her employer within thirty days of the accident or sustaining the injury. The time period usually varies depending on the state. However, a file must be made within thirty days. The failure to notify the employer could result in the injured employee forfeiting his or her benefits and any claim to them. It is important to note that notifying the employer is different from making benefits claim, as both actions are separate and should be done separately.

When notifying the employer of a workers compensation injury, it is required that someone in a managerial position is in the know of the situation and what led to the injury. It is not enough to tell a coworker as such a person might have little or no power over the situation. In circumstances where the injured employee is unable to reach the employer as a result of being admitted to the hospital, exceptions as regards meeting the deadline might be granted. However, this is not guaranteed. Therefore, injured employees are advised to try as much as possible to notify their employers within 30 days of sustaining the injury.

Once the employer is aware of the injury, a report can be submitted to the state’s worker's compensation board or industrial commission as the case may be. The employer can also take it a step further by notifying the worker's comp insurance carrier. This is the only time the insurance company can start to pay the medical bills and a portion of the employee’s weekly wages which could be as much as 66%.

An appeal to the industrial commission or the state's workers’ comp board can be made if the claims of the employee are rejected by the insurance carrier. The appeal and arbitration can go on if the carrier continues to reject the claim. However, it is usually advised that the employee hire a workers compensation attorney that can provide professional help to avoid having prolonged cases and ensure that the employee gets what he or she is owed.