If a workers injury arose out of and occurred within the course of his employment, he/she is likely entitled to workers compensation benefits.
If you don’t know about “what are the benefits of workers compensation” then this guide is for you, keep reading!
4 Types Of Workers Compensation Benefits
Generally, there are 4 types of workers comp benefits are as follows:
- Temporary disability benefits
- Permanent disability benefits
- Medical benefits
- Death benefits
*Also Check: How To Get Workers Compensation Insurance in New York
1. Temporary Disability Benefits
Temporary disability benefits compensate an injured worker for the wages he loses during the healing of the work-related injury.
Temporary benefits continue until he either reaches a limit imposed by state law or maximum medical improvement.
Maximum medical improvement occurs when the employees condition plateaus and he is believed to be as close to his pre injury condition as he will ever become.
Temporary disability benefits can be either partial or total.
An injured worker will receive temporary disability benefits if the injury makes him unable to do work of any kind.
Most USA jurisdictions provide weekly benefits of two thirds the workers average weekly wage prior to the injury.
However, state laws often cap temporary total disability benefits at a certain percentage of the average weekly wage in that state.
For example, Iowa Vermont and New Hampshire historically allow benefits as high as 150% of the state average weekly wage. However, New York capped weekly benefits at 50% of the state average weekly wage.
State law may also limit the duration of benefits,
For example, South Carolina limits temporary total disability benefits to 500 weeks.
A worker will receive temporary partial disability benefits if the work injury leaves him only partially unable to work, for instance he may still be able to work part-time or light duty.
Alternatively, the employer may be able to provide a different temporary job for the injured worker until he reaches maximum medical improvement.
As with temporary total disability benefits the amount of temporary partial disability benefits that an injured worker can receive may vary state by state.
For instance, South Carolina caps temporary partial disability benefits at 340 weeks.
2. Permanent Disability Benefits
Permanent disability benefits compensate an injured worker for the permanent loss of earning capacity resulting from the work-related injury.
It is generally awarded after the injured worker attains maximum medical improvement.
As with temporary benefits, permanent disability benefits can be partial or total.
Permanent total disability benefits are awarded when a worker is permanently and totally disabled from working.
He/She is not expected to return to work of any kind, whether a worker is entitled to permanent total disability may depend upon not only his injury but upon factors such as his level of education, level of work skills, and age.
Just like temporary benefits most states of USA provide permanent total disability benefits of 2/3 the workers average weekly wages at the time of the accident.
Most American states also allow permanent total disability benefits to continue for either the period of disability or the workers life.
Some states limit permanent total disability however, for instance South Carolina caps permanent total disability benefits at 500 weeks except where the worker has specific injuries including paraplegia, quadriplegia, or brain damage.
Other states may have similar provisions.
Permanent partial disability benefits are intended to compensate a worker for his permanent partial limitation on earning capacity due to the work injury, this means the worker is expected to return to work after maximum medical improvement earning lower wages than he earned before the work-related injury.
Most states in USA have a dual approach system for calculating permanent partial disability benefits.
One scheduled and second non scheduled scheduled.
Scheduled Permanent Partial Disability benefits are calculated using a specific number of weeks of benefits that state law assigns or schedules for the injury of a particular body part.
For example, if New York law assigns 312 weeks for the arm then if a worker loses his arm he is entitled to three hundred and twelve weeks of permanent partial disability benefits. If the worker loses fifty percent use of his arm he is entitled to 156 weeks of benefits.
For example, as stated above states usually provide weekly benefits at the rate of 2/3 the workers average weekly wage before the accident therefore, if a workers average weekly wage before the accident was 500 dollars then he would be entitled to two thirds of $500 i.e. $333.33 cents each week. If that worker lost his arm or lost one hundred percent use of his arm he would be entitled to 312 weekly payments of permanent partial disability benefits in the amount of $333.33 cents.
Since state law assigned 312 weeks of benefits to the arm if the same worker instead lost just fifty percent use of his arm he would be entitled to 50% of the total number of weeks assigned to the arm, he would be entitled to one hundred and fifty six weekly payments of PPD benefits in the amount of $333.33 cents.
Statutory schedules cannot list all possible types of injuries however therefore states use various systems of calculation for non scheduled injuries including the impairment approach, which basis benefits on the seriousness of the injury.
Instead some states use the loss of earning capacity approach which considers the seriousness of the injury as well as the effect that education, work experience, and age have on earning capacity.
Other states such as New York have used the wage loss approach, which provides permanent partial disability benefits based upon the workers actual wage loss, California law considers the workers physical impairment age and occupation, but does not consider the workers diminished future earning capacity.
*Also Check: questions to ask your workers compensation lawyer
3. Medical Benefits
Injured workers are generally entitled to medical treatment that is reasonably required to cure or relieve the symptoms of the work-related injury, such treatment and expenses may include doctor visits, medications, surgeries, hospitalizations, physical therapy, nursing services, and equipment.
The injured worker is not responsible for deductibles or coinsurance payments.
Additionally, the worker can receive medical benefits for as long as they are medically needed, the benefits are not limited to a specific number of weeks as with disability benefits.
The injured worker is generally obligated to accept medical treatment that is deemed necessary by his treating physician, if the claimant refuses treatment, the employer may have the right to suspend weekly disability benefits until the claimant complies, unless the Court finds that the claimants refusal of treatment was justified.
State laws vary regarding who chooses the treating physician,
For instance, in South Carolina the employer usually chooses, but in New York the employer is usually not allowed to choose.
An employee may also be entitled to travel expenses associated with medical treatment including mileage, lodging, and food.
4. Death Benefits
An injured workers family may be entitled to benefits if the worker dies as a result of the work injury, either immediately or while the work-related disability continues.
Generally, limited burial expenses are allowed as well as disability benefits. however, the amount of benefits to which surviving family members are entitled varies state by state.
For example, in South Carolina surviving dependents are entitled to compensation benefits to the same extent as the deceased worker would have been, had he survived.
In contrast the extent of death benefits under California law depends upon the number, and age of the workers dependents.
Video: What Are The Benefits Of Workers Compensation?
Final Thoughts
Once entitlement to benefits is established an injured worker can rest assured that he will receive some type of compensation to assist him with temporary wage replacement and medical expenses.
However, the types and extent of benefits to which he is entitled may be confusing and can vary greatly, depending upon the jurisdiction.
I hope, now you have clear idea about “what are the benefits of workers compensation“
What’s your thoughts on this guide please et us know in comment section below.
FAQs
What is workers compensation?
Workers’ compensation is a form of insurance that provides in lieu of wages and health benefits to employees who have been injured in the course of employment in exchange for a mandatory waiver of the employee’s right to sue their employer. for damage caused by negligence.
What are the workers compensation rates?
An injured worker is entitled to compensation equal to two-thirds of New York State’s average weekly wage (AWW) for the 52-week period prior to the date of the accident.
*References: https://www.dol.gov/general/topic/workcomp