What Kind Of Injuries Does Workers Comp Insurance Cover?

While employers are trying to make the workplace environment safer for employees, on-the-job injuries still happen more often than they should.

Over 2.6 million on-the-job injuries and illnesses were reported by employers in 2021. Luckily, workers comp coverage was available in most of those cases.

Workers comp coverage is a popular insurance plan. In most states, it is mandatory to protect workers suffering on-the-job injuries or illnesses.

In the Murray v. UBS Securities LLC case, employees had to take out their employers. The court ruled in their favor. But employers should have a law-abiding workers comp policy in place, to avoid such cases.

It wasn’t very long ago that workers who were injured on the job had to take their employers to court to try to recover financial damages after an on-the-job injury.

Progress, Not Perfection

How long we have come in just a few short years. While most people are familiar with workers comp coverage, some still have questions about the type of injuries that are covered by workers’ compensation. Just about any injury that occurs on the job will be covered in most states, although each state has its own rules regarding worker comp coverage.

Workers comp coverage provides benefits for employees who are injured while on duty. In most places, it does not matter if the injured worker is a part-time or a full-time employee as long as they are not an independent contractor. If employees are injured during the course of performing their job duties, then workers comp coverage pays benefits.

Commonly Covered Injuries

The most common types of workers’ compensation injuries include head, back, and neck injuries due to trips, slips, and falls in the workplace. Poor lighting, slippery surfaces, and inclement weather contribute to these types of workplace injuries.

Deep cuts, or lacerations, are the next type of injury commonly seen by workers comp coverage. Manufacturing and restaurants are the biggest contributors to these types of workers’ compensation claims with moving machinery and sharp knives causing most of the injuries.

Falls and lacerations are not the only other types of injuries covered by workers’ compensation. Job-related automobile accidents, burns, fractures, contusions, and more are covered by workers’ compensation when they occur on the job. If an employee is on the job and conducting themselves properly, then workers comp coverage pays benefits on most types of injuries.

Injuries Not Covered By Worker’s Compensation

In a few instances, your employer won’t cover your on-the-job injuries. You may also face a cut in your injury coverage. But why?

It happens only when you are found under the influence of drugs or alcohol. Or you got tangled into a fight with a colleague. You can’t redeem injury coverage for such issues.

Workers comp coverage covers those who follow the safety protocols. You’re following the safety norms, but still got hurt; you can expect full coverage.

Pre-Existing Conditions And Workers Comp Coverage

Workers comp coverage can get a little gray when it comes to pre-existing conditions because the laws are different in every state.

Often employers cover an injury till it assumes the pre-injury shape. Let’s take the example of back injury.

Imagine you can work but your back still hurts. You have periodic cramps too. Will the worker’s comp scheme still cover you? In this case, yes!

Until you have a trace of back pain, the cover will compensate you. But you have to submit an authentic doctor’s note to testify that you are still injured.

Again, the rules vary in every state. So a case-by-case analysis is better, when it comes to workers comp. Most of the time, a pre-existing condition does not automatically exempt an employee from workers’ compensation benefits.

It is essential to ensure pre-existing conditions and workplace injuries are properly assessed for the correct workers’ compensation benefits to be paid.

Filing Your Workers Comp Claim

There are 5 key steps to file it. For federal employees, the steps may be slightly different:

1. Report the injury

Don’t delay. Let your line manager know about the injury as soon as possible. It is better to inform you about it within 24 hours.

2. Get medical treatment

You need to raise a query for medical treatment. Ideally, there should be a healthcare staff to attend to you, within the work premises.

3. File Your Claim Form

You will get a claim form from your employer. Fill in the necessary details, regarding the injury, date, location, and witnesses.

4. Submitting your claim form

Return your completed claim form to the employer within a dedicated time slot.

5. Keep your copies

Keep a copy of the completed claim form with you. Also, prepare duplicate copies of supporting documents you need to prove your claim.

Process for Federal Employees

If you are wondering about the process, let us discuss it in detail. There are two extra steps that federal employees must follow:

1. Access Your ECOMP

Firstly, go to the ECOMP website. Then register for your account. Finally, file your claim online.

2. Select the right form

You may face different sorts of injuries. Based on the type of injury, you must fill out the CA-1 or CA-2 form.

The first one is for traumatic injuries. The following is for any kind of occupational disease.

Workers’ Compensation Laws by State

The workers comp laws vary by state. These laws mainly decide whether employers need compensation insurance to operate or not. Well, 80% of the states need employers to secure employees with workers comp insurance. Some states rule that companies with 2 or less employees won’t need it.

Lastly, some monopolistic states have slightly different laws. For example, Ohio, Wyoming, and similar states apply different rules. They mandate that companies should buy insurance from the state fund only.

Workers Comp Coverage

The worker’s comp protects employees in the first place. But it also secures employers from lawsuits. Most employers have insurance plans to cover workers comp.

But you need to claim workers comp immediately. It may be anything. Starting from medical expenses due to workplace injuries to lost wages, it covers all.

Workers comp lets you worry no more about litigation. Meanwhile, employees get a fine working environment. As a result, their productivity grows, and the company also grows.

Quick Workers’ Guide

While there are exceptions to every rule, workers comp coverage provides benefits in the case of most injuries. Workers’ compensation insurance covers everything from falls to lacerations, broken bones, and more.

Even automobile accidents, as long as employees are conducting themselves appropriately. And not under the influence of drugs or alcohol during the accident. It is even possible that benefits may be paid when pre-existing conditions were present at the time of the accident.

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