Types of Workers Compensation

Millions of Americans commute to their jobs daily, expecting a routine workday. However, worker’s compensation benefits provide crucial financial support when work-related injuries or illnesses occur. This system ensures employees have a safety net when faced with work-related health issues.

What is Workers’ Compensation?

Workers’ compensation is a form of insurance that helps with wage replacement and medical expenses for injured workers or those who fall ill due to their jobs [1]. The system protects employees and employers.

It helps employees receive the necessary medical care and financial support and provides employers with some protection against lawsuits from injured employees.

Who is Covered by Workers’ Compensation Insurance?

Most states have workers’ compensation laws that ensure workers’ compensation insurance covers most employees. These benefits include full and part-time employees. Some categories of workers that might be covered include:

• Seasonal and temporary workers
• Regular employees in private businesses
• Federal employees
• State and local government employees

In rare cases, independent contractors or volunteers might be eligible for workers’ compensation, such as:

• Business owners
• Agricultural workers
• Independent contractors
• Domestic workers in private homes
• Casual or occasional workers

Types of Workers’ Compensation Benefits

Workers’ compensation is a much broader term than many people think. Understanding the different types is vital to maximizing your benefits.

Medical Benefits

One of the most common types of workers’ compensation is medical benefits. These help the injured or sick worker get all the necessary medical treatment for their work injury or illness. Medical benefits include:

• Hospital stays
• Emergency room visits
• Surgeries
• Doctors appointments
• Prescription medications
• Medical devices
• Physical therapy
• Travel expenses for medical appointments

These benefits usually apply only to reasonable and necessary medical treatment for work-related injury or illness. Experimental treatments or elective procedures are rarely covered.

Disability Benefits

Disability benefits are essential in workers’ compensation. They’re there to provide wage replacement for workers who can’t work or have reduced earning capacity due to their work-related injury or illness. The four main types of disability benefits are:

• Temporary Total Disability (TTD): For workers who cannot work temporarily and have lost income.
• Temporary Partial Disability (TPD): For workers who can return to work but have limitations and reduced earnings.
• Permanent Partial Disability (PPD): For workers with permanent impairments that impede their ability to work.
• Permanent Total Disability Benefits (PTD): For workers who are permanently unable to work.

Vocational Rehabilitation

Vocational rehabilitation is an important part of workers’ compensation coverage. These wage benefits are designed to help the injured worker who can’t return to their previous job because of the injury or illness. Vocational rehabilitation services can include things like:

• Job analysis and modification
• Skills assessments
• Career counseling
• Retraining or education
• Job search assistance
• Resume writing and interview preparation

Death Benefits

In the tragic event that a work-related injury or illness causes the death of someone, their dependants can receive workers’ compensation benefits. These benefits provide financial support to the dependants. Death benefits usually include:

• Funeral and burial expenses
• Ongoing financial support, typically a percentage of the deceased’s wages

Dependants eligible for death benefits are:

• Minor children
• Spouses
• Adult children who cannot support themselves due to permanent disability (mental or physical)
• Sometimes, other family members who are reliant on the deceased’s income

Other Types of Workers’ Compensation

Other programs and coverage types exist outside the standard workers’ compensation benefits.

Second Injury Funds

Second injury funds are also known as subsequent injury or special disability funds. They encourage employers to hire employees with pre-existing conditions or disabilities and help cover the costs when a worker with a pre-existing condition suffers a new work-related injury or illness.

The purpose of second injury funds are:

• To encourage employers to hire workers with pre-existing conditions by reducing their liability.
• To protect employers from bearing the full cost of a disability partially attributed to a pre-existing condition.

When someone suffers a new work-related accident at work while they have a pre-existing condition, the combination of the new and old injuries might result in greater disability than the old injury alone. These funds will help cover the additional costs without paying for the pre-existing condition, reducing the employer’s financial burden.

Self-Insurance Programs

Many employers purchase workers’ compensation insurance from an insurance company, but some larger employers will self-insure. This program means that they take the financial risk of paying workers’ compensation claims themselves rather than paying premiums to an insurance company.

To be self-insured, companies will need to meet certain financial requirements set by the state to ensure they have enough money to cover workers’ compensation if necessary. They might also have to purchase insurance to cover catastrophic claims. The advantages of self-insurance to large employers are:

• Greater control over claims management
• Potential cost savings on workers’ compensation insurance policy premiums
• Incentive to improve their working conditions to reduce claims

Self-insurance programs have risks. A sophisticated claims management system is needed, and there is the potential for substantial and unexpected employee payouts.

Federal Workers’ Compensation Programs

State laws govern most workers’ compensation programs, but a few federal workers’ compensation programs exist for specific workers. Some federal workers’ compensation programs include:

• Longshore Harbor Workers’ Compensation Act (LHWCA): This program provides compensation benefits to maritime workers, including maritime construction workers and most dock workers [2].
• Federal Employees’ Compensation Act (FECA): This program covers most federal employees injured or ill during their federal employment [3].
• Energy Employees Occupational Illness Compensation Program Act (EEOICPA): This program provides workers’ compensation benefits to Department of Energy employees and contractors who fall ill due to exposure to radiation and other toxins [4].
• Black Lung Benefits Act: This program is for coal miners who have a permanent disability thanks to pneumoconiosis (black lung disease) contracted through their jobs.

Navigating the Workers’ Compensation Claim System

The first step is to understand the different types of workers’ compensation systems. Figuring out how to navigate the claims process can be far more complicated and intimidating. But going through the process and taking the right steps will help ensure you get the compensation you deserve.

Reporting Your Injury

Before you do anything else, you’ll need to report your injury to your employer. You’ll want to do this as soon as possible after the injury happens. If you need immediate medical attention, you can officially report the incident as soon as possible, but the earlier, the better.

Many states have a strict deadline for employees to report their workplace injury to their employer and seek workers’ compensation. This timeline can range from a few days to a few weeks, so it’s important to look into your state laws.

Failing to report the work-related injury or illness within the timeframe can jeopardize your ability to get temporary or permanent disability benefits. When reporting your injury:

• Provide a clear and detailed account of how the injury happened;
• List all the body parts affected by the injury or illness;
• Identify any witnesses who saw the injury happen;
• Follow all your employer’s procedures surrounding workers’ compensation.

Even if an injury initially seems minor, it’s still important to report it so there’s a record. Some severe injuries worsen over time, so having an official record can mean the difference between getting the temporary disability benefits you deserve.

Filing a Claim

After you report the injury to your employer, the next step is to file your compensation claim. Usually, your employer will provide you with all the necessary forms and then file the claim with their insurance company on your behalf. However, you’ll want to make sure that the claim is filed. Some things to remember include:

• Fill out all the forms correctly and completely.
• Keep copies of all the documents related to your workers’ compensation claim.
• Meet all the deadlines for filing and responding to further requests for information.
• Attend all the required medical treatment and follow your doctor’s treatment plan.
• Keep detailed records of all your treatment, symptoms, medical costs, and how the injury has impacted your daily life.

The Role of a Workers’ Compensation Attorney

Many people choose not to hire a workers’ compensation attorney because many of the claims are straightforward, and they don’t see the point. Even with the most straightforward workers’ compensation case, an attorney can be invaluable. An experienced workers’ compensation lawyer can help:

• Ensure you meet all the deadlines and complete all the required paperwork properly.
• Gather and present evidence that supports you getting the maximum for your workers’ compensation benefits.
• Negotiate with insurance companies on your behalf.
• Represent you in settlement negotiations, hearings, or appeals if your claim is denied.
• Advise you on other benefits you might be eligible for, like Social Security Disability (SSD).
• Ensure you receive all the benefits you’re entitled to under the law.

Attorneys are especially vital in complicated workers’ comp cases.

Secure Expert Legal Counsel!

If you’ve been injured on the job, knowing your rights and navigating through workers’ compensation can be overwhelming. Rosenfeld Injury Lawyers have the experience and drive necessary to help you with your workers’ compensation case and get you the compensation you deserve.

We deeply understand workers’ compensation benefits and will work with you to ensure you receive a fair settlement based on your injuries.

Consult a Chicago workers’ comp lawyer today at (888)-424-5757 or fill out our contact form.

All content undergoes thorough legal review by experienced attorneys, including Jonathan Rosenfeld. With 25 years of experience in personal injury law and over 100 years of combined legal expertise within our team, we ensure that every article is legally accurate, compliant, and reflects current legal standards.