Almost everyone has heard of workers’ compensation, but a lot of misunderstanding remains. For example, you probably know that workers’ compensation can protect businesses, but did you know that it’s actually designed to protect workers?
Want to learn more, but having trouble finding information on patients workers’ compensation, instead of what businesses need to know?
Here are the basics of workers’ compensation as it applies to patients.
No-Fault Benefits
Workers’ compensation is an insurance system that pays medical bills and lost wages to those who are injured at work, or who experience a work-related disease or illness. Did you know that claims are paid, regardless of who is to blame for the accident?
Patients workers’ compensation covers employees by providing care without the need to prove their case before receiving benefits. It ensures you get the care you need, when you need it, without the stress or fear of worrying about who will be found at fault.
Occupational Medicine Clinicians
If you’re injured on the job, you will most likely visit an occupational medicine clinician. That’s because they are familiar with patients workers’ compensation, and they are familiar with the system in general. They have the experience and skills to communicate with patients, employers, and insurance companies.
They also have extensive experience treating the most common work-related injuries and illnesses, so they know what it takes to provide you with the care you need to transition back to work as smoothly as possible.
What Workers’ Compensation Does and Doesn’t Cover
Some of the most common claims that workers’ compensation covers for patients include:
- Overexertion, like when a muscle is pulled beyond its normal point of motion, or it is overused
- Slips, trips, and falls, like when the floor is wet or a mat isn’t secured to the ground
- Falls from a height, like from a ladder or a rooftop
- Sprains and strains when trying to correct a fall
- Struck by an object, like when something falls from a shelf
Patients workers’ compensation doesn’t cover everything, though. Some things that aren’t covered include:
- Injuries that are caused by drugs or alcohol
- Self-inflicted injuries
- Injuries that are due to a fight started by the employee
- Injuries that result from violating company policy
- Felony-related injuries
- Any injuries that are caused off the job
- Any injuries that are claimed after an employee is fired
- Injuries suffered by independent contractors
Filing a Workers’ Compensation Claim
Every state is different when it comes to workers’ compensation, so it’s vital to talk to your employer about the right way to file a claim where you live. You may only have a few days to seek medical attention, while in other states, you may have a few years.
Because benefits are awarded regardless of fault, it’s also a good idea in general to talk about your injury with your employer. They can help you fill out paperwork and make sure you see the right occupational medicine clinician.
They may also be able to tell you which insurance carrier they work with. That way, if you have questions about patients workers’ compensation that your employer doesn’t seem to know the answer to, or they’re so busy they keep forgetting to get back to you, you can try contacting the insurer directly.
At DJM Insurance, we work with contractors, employers, and employees to find the best insurance, but we continue providing outstanding service long after you sign up for a policy. Contact us today to learn more about how workers’ compensation works, as well as how we can customize a policy that protects your business and its employees.