A Short Guide To Help You Understand The Workers’ Compensation Claims Process
Approximately three out of ten workers suffer a workplace injury every year, according to the Bureau of Labor Statistics. The latest data reveals that in 2020, 4,764 fatal work injuries were recorded.
Some common injuries while working are muscle strains, slipping, tripping, falling, walking into walls, falling from vehicles, explosions, and exposure to toxic chemicals.
Whatever the reason for the injury, you should have workers’ compensation insurance to cover the financial costs of treatment, medical expenses, rehabilitation, and related expenses.
But before buying a policy, you should know about the whole process. For example, how are claims filed, the employer’s role, and which areas are covered by the policy?
Having an idea about the whole process will make things easier for you, especially if you have just opened a business and are looking for information on workers’ compensation insurance.
Importance of having an insurance
A policy is essential if you are a small business owner because the treatment-related costs might sometimes be beyond your capacity to handle. Insurance also covers legal costs like attorneys, court proceedings, etc., if someone decides to file a case against you after receiving an injury.
Having coverage for your employees raises their morale, increases productivity, and reduces the attrition rate, all of which will contribute to the growth of your business.
What areas does the policy cover?
Some of the areas which the policy covers are medical expenses, lost wages, ongoing care, repetitive injury, and funeral expenses.
Medical expenses
It covers the medical expenses of the employees injured or fell ill at the workplace. It includes emergency room visits, surgery, and prescriptions.
Lost wages
It compensates the workers for the loss of income because of the days missed at work from the injury.
Ongoing care
It includes doctors’ visits, physical therapy, and other parts of ongoing treatment.
Funeral expenses
These cover all the expenses involved in organizing a funeral, which the insurer provides to the deceased worker’s family, along with other benefits.
Repetitive injury
Workers’ compensation covers injuries caused due to work involving repetitive motion. These include bursitis, carpal tunnel syndrome, and tendonitis affecting the knees, elbows, and wrists.
How does the claims process work?
Seeking medical treatment is necessary
The employer should ensure that the injured worker receives the necessary medical treatment as quickly as possible. Even if they feel fine, you should insist on visiting a doctor at the earliest.
Reporting form
The claims process begins with the employer providing the worker with a reporting form, in which they mention the crucial details of the incident, like the nature of the injury, its location, and the medical treatment required for the injury (which the doctor would suggest after examination).
Filing the claim
After the employee returns the filled form, the employer files a claim with the insurance provider and the State Workers’ Compensation Board. Most states make it mandatory for the employer to take the initiative of filing the claims.
Evaluation by the provider
When the insurer receives the claim and necessary medical documents, they begin evaluating it, and after evaluation, inform the company if they have approved it or not.
However, if the claim is denied, the employee can decide to contest the decision through legal representation. In approved claims, the insurers provide the sum through a settlement agreement or a lump sum.
How to choose an insurer?
It is better to buy workers’ compensation insurance from companies familiar with small businesses requirements.
Some things you could look for in a provider are affordable rates, a month-to-month payment system, and transparent policies that you can easily understand. Reading customer testimonials also gives some idea about the reputation they enjoy with other businesses.
Understanding the process of the workers’ insurance claims, including the areas it covers, is crucial before buying one for your employees. A coverage policy will save you from lawsuits and boost the employees’ morale, creating a win-win situation for both.
