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Workers Comp 101: Things You Need To Know

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Feb 18, 2015

Workers' compensation is a form of medical insurance that most employers are required to purchase to cover employee medical bills and loss of income in the event of an injury on the job.

Notorious for its loopholes and complications, workers’ comp can be incredibly confusing and complicated to deal with. Below are a few tips to help make the process a little less painful.

How it Works

Workers’ comp premiums (or amount to be paid) are equated by multiplying the industry rate by the amount of payroll per job function. The industry rate varies by state and can be found by visiting Florida’s workers’ comp website – in Florida, all companies are required to charge the same rate meaning the cost of workers’ comp does not vary from company to company. Each state also determines the maximum amount of pay loss per week and, typically, these benefits are significantly less than what the worker’s salary was prior to the accident. Usually every workplace has their own specific workers' comp policies and protocol for a medical emergency.

What it Covers

Though the specific coverage of workers’ comp varies by state, benefits will typically include the following: an up-to-date payment system, access to a disability case manager, availability of management nurses, certified life care planning nurses, consults on vocational rehabilitation, physician consulting services, contracts with medical network providers, prescription drug programs and applicable legal staff.

What it Doesn’t Cover

All injuries or sicknesses that occur in the workplace are not necessarily covered by workers comp. For example, in the case of injuries inflicted by horseplay or as a result of intoxication, a workers' comp company does not automatically pay. Furthermore, workers’ comp coverage might also be denied if the injury is self-inflicted, if the injury was suffered while committing a serious crime, if the injury occurs while the worker is not at work, or if company policy was violated when the injury occurred.

Steps to Take

Once an injury occurs on the job the HR department, or apropriate supervisor, should be notified immediately and a proper injury report submitted. Once at the doctor it's very important to relay every detail about the incident and ensure the medical record includes the important information. 

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