What Is Workers' Compensation Insurance?

In California, all workers must be covered under workers’ compensation insurance. This can include employees who are apprentices, and even employees who are unlawfully employed. Under California Labor Code Section 3700, if a business has one or more employees, then they must provide this form of insurance.

Workers’ compensation insurance is a type of liability insurance in which an employer assumes all liability for any and all work-related injuries. An employer will provide this insurance in case any unforeseen incidents occur within the workplace. This will help to cover for the affected workers’ medical bills and possibly for some lost wages that may have resulted from the injury or illness. Also, it may also cover certain physical therapies, medications, surgeries, and more depending on your type of insurance. Under a workers’ compensation insurance, you will receive select benefits depending on your situation. These benefits will be determined by what necessitated by your injury or illness as well as your ability to work. Depending on what benefits you may be eligible to receive, workers’ compensation may assist in finding a new job if you cannot continue working at your former workplace. Also, in cases of death, workers’ compensation may provide financial compensation to the employee’s family and close dependents.

Not all workers’ compensation insurance is the same. The types and the number of benefits you will receive should you have an injury that will depend on what type of insurance your company provides. Also, it should be known that workers’ compensation is a ‘no-fault’ system. This simply means that the employer may not take any legal liability for the injury and that employees who have become injured may not sue their employer. Accidents may occur while on the job and workers’ compensation is meant to provide a safety net to those employers who have sustained an injury or illness. In specific circumstances and in certain situations in which your employer does not have workers’ compensation insurance, they may become legally liable as well as financially liable for your injury or illness.

Under workers’ compensation insurance, if you have sustained an injury or illness while on the job, then you may be made to go to certain doctors and health care providers that are within your employers’ network. Similar to health insurance, workers’ compensation insurance may have a specific list of doctors and health care providers that will take the insurance. Your employer should provide you with the proper information regarding health care providers and doctors.

When it comes to workers’ compensation insurance, your employer has certain responsibilities to uphold. Once again, as specified under the California Labor Code Section 3700, all employers must have workers’ compensation insurance and it must be provided for all employees. If they fail to provide the proper insurance, then they may be liable should any future incidents occur in the workplace.

When you begin working for your employer, they should inform you about the company’s workers’ compensation insurance. Usually, when you have been hired, your employer will provide you with the proper information involving workers’ compensation benefits and the insurance plan. This information may be provided in the form of a pamphlet or employee handbook. This will give information about the company’s insurance plan as well as the employee’s rights when it comes to workers’ compensation. Also, there should be accessible information regarding workers’ compensation at all times. This should provide any information pertaining to coverage and what health care providers you should go to for any work-related injuries or illnesses.

Workers’ compensation insurance should be one of the costs of doing business. This means that your employers should be paying for the insurance as a part of their responsibilities. They may not ask you, or any other employee, to help pay for any cost or premium associated with the insurance.

If your employer does not have workers’ compensation insurance, it is considered to be a criminal offense in California. As a misdemeanor, this crime is punishable by imprisonment in jail for up to one (1) year and/or a maximum $10,000 fine. There may even be additional penalties against the employer depending on the details of the situation. Even if your employer does not have workers’ compensation insurance, they still must pay for any and all medical bills associated with the work-related injury or illness.

If you have gained an injury or illness while on the job and your employer does not have workers’ compensation insurance, you may be able to sue them. This complaint may still be filed alongside a workers’ compensation claim. If your employer does not carry the proper insurance or has violated your rights in some form, you may contact the Department of Labor Standards Enforcement to report the incident and file a complaint. Workers’ compensation is a guaranteed right in California, and all employers must not violate this right.

Workers’ compensation insurance aims to provide assistance in situations where you experience an accident in the workplace. It is a safety net for workers who have become injured or suddenly unable to do their job. Simply put, workers’ compensation insurance should provide coverage for any and all injuries or illnesses that have resulted from doing your job. Workers’ compensation insurance can commonly cover areas such as:

• Medical costs related to work-related injuries and illnesses
• Lost wages
• Ongoing care related to work-related injuries and illnesses
• Funeral costs
• Death benefits

Remember, each company may have different workers’ compensation insurance, and the amount and types of benefits included can vary. It is important to get this information from your employer as they should provide it when you are initially hired.

One of the most important aspects of workers’ compensation insurance is that it can cover medical costs and expenses related to a work injury or illness. Not only may this include a visit to a doctor’s office, but may also include emergency visits, medications, surgeries, and other forms of medical assistance that may be necessary to treat your injury or illness.

Example:

• Jack was helping another employee store material in a warehouse. While assisting, one of the shelves gives way and the pallets of material fall onto Jack. This leads to a broken leg. Quickly, he is taken by the ambulance to the hospital for treatment.

In the unfortunate situation described above, Jack is covered by his company’s workers compensation insurance. This includes the emergency ambulance, the hospital expenses, the medication necessary to treat the injury, and any future doctor visits and treatments. Of course, everyone can face different situations and have different injuries and illnesses that may be a result of their job. The insurance company will figure out what is necessary for your situation based upon your claim.

Workers’ compensation will usually cover a wide range of injuries and illnesses that may stem from your work. This can include physical injuries like broken limbs, cuts, burns from chemicals, and even vehicle accidents if you are required to drive as a duty of your job. Also, this form of insurance may also cover conditions or injuries caused by repeated motions, prolonged exposure to certain chemicals and materials, and more that may affect the state of your health as a worker. In this case, the insurance should cover for necessary treatments as well. This can include physical therapy and more. Also, if your condition or illness needs ongoing treatments, workers’ compensation insurance should be able to cover it as long as it is a result of the work-related injury or illness.

If you have been injured outside of the workplace, you may still be covered under workers’ compensation insurance if you were fulfilling a task as a part of your job. For example, if you get into a car accident, you may still be covered if you were driving as a part of your job’s duties. Also, if you were completing a task outside of the workplace at the behest of your employer and you are injured, then you may still be covered under workers’ compensation. In these situations, all of the injuries outside of the workplace arose out of completing the duties of your job; thus, they are still covered.

Workers’ compensation insurance may also cover any lost wages that may have occurred while you were off the job due to your injury or illness. When it comes to lost wages, workers’ compensation may usually compensate for a partial amount of lost wages. However, it will be determined by the insurance company how much you should receive. Also, depending on the types of benefits you receive under workers’ compensation, the amount you receive and the length of time in which you will receive it will differ based upon your case. Mainly, this comes down to the seriousness of the injury or illness as it will help in determining how much work you will miss. In most cases, compensation for lost wages will be received until you are able to return to work. However, there are some exceptions to this case.

In cases in which a work incident has led to the death of an employee, this will still be covered under workers’ compensation insurance. In this type of situation, when an employee passes due to a work-related injury or illness, their family or dependents will receive compensation. The amount received may vary depending on the insurance itself and the situation. However, it may be enough to cover any funeral costs and to compensate for lost wages due to the incident. Also, your family and/or dependents may receive a specified amount of money depending on the situation on the insurance policy held by the employer. Again, when it comes to this type of coverage, it is crucial to speak with your employer about the details and receive the proper information from them.

Workers’ compensation insurance will cover most work-related injuries and illnesses. However, there are some situations in which you may not be covered under this insurance. First of all, if the injury or illness occurred outside of the workplace and was not a result of fulfilling your job’s duties, you may not be covered. Other common instances you may face denial include, but are not limited to:

• You were intoxicated during the incident;
• You were on illegal drugs;
• The injury was self-inflicted;
• The injury was sustained while committing a crime; and,
• The injury arose from conduct that violates company policy.

When a workplace accident has occurred, your employer will be notified and look over the details of the situation. If they feel there was any sort of wrongdoing on the part of the employee, they may seek to investigate the accident. Also, when you send in a workers’ compensation claim to the proper insurance company, a claims administrator will overlook the claim. They will determine if your claim will be approved or denied. In some cases, they may even seek to investigate the claim to determine their final decision.

During this investigatory period, they may look for signs of intoxication or drug use. If they determine these elements were involved during the incident or a partial cause of the injury, then your claim may be denied. These types of cases are not covered under any sort of workers’ compensation insurance. Intoxication and drug use in the workplace may even be in violation of company policy which is another reason that can be used for denial of coverage.

Also, if you have sustained an injury in the workplace while committing a crime, then you will not be covered. This can be any sort of criminal behavior such as theft, assault, and more. Once again, this may also violate company policy. Simply put, if this is the case, your claim will be denied.

Lastly, if your injury was self-inflicted, you will not be covered under workers’ compensation insurance. Some employees may be tempted to purposely injure themselves so as to receive paid time off of work. However, this is seen as a form of insurance fraud. If it is determined that you have purposely injured yourself in order to receive workers’ compensation, you will be denied coverage.

When it comes to workers’ compensation, there are certain types of benefits you may receive as a result of a work-related injury or illness. However, the benefits you receive may vary depending on the insurance your company holds and on the specifics of your injury or illness. Common benefit types include:

• Coverage for medical expenses
• Temporary disability benefits
• Permanent disability benefits
• Supplemental job displacement benefits
• Death benefits

As stated before, the basic job of workers’ compensation insurance is covering the expenses and bills related to medical attention necessitated by your injury or illness. This includes emergency services, hospital/doctor bills, medications, surgeries, and any ongoing form of treatment.

Temporary disability benefits (TD) provides payments to workers who have suffered from an injury or illness that prevents them from returning to work right away. With this type of benefit, you will receive coverage for medical expenses as well as compensation for lost wages that may occur while you are recovering. As its name suggests, it is temporary and it will only last as long as you are unable to return to work.

Permanent disability benefits (PD) will provide payments to any worker who has sustained an injury or illness that permanently prevents them from returning to work. Once again, this will cover any necessary medical expenses and will compensate for lost wages. In some cases, you may be able to return to work with while continuing to receive permanent disability benefits. However, in most cases, your work will be limited so as to ensure your health. The benefits will be adjusted depending on the amount you will make with reduced hours, less physically demanding tasks and more.

Supplemental job displacement benefits will provide workers will assistance if they cannot go back to their former job as a result of the injury or illness. Usually, if you have not recovered enough to return to your old job, then you will receive this benefit. With this type of benefits, a worker will receive vouchers that will help pay for any sort of training or proper skill learning that is necessary in order to find a new occupation.

Lastly, as stated before, if an employee has died due to a workplace incident or illness, then their family will receive some sort of compensation. This may include coverage for funeral costs and expenses. Also, depending on your employer’s insurance, your dependents will receive a certain amount of compensation for the loss.

Once again, the type of workers’ compensation insurance you may be covered under may be different than others. It is important to receive correct and accurate information regarding workers’ compensation and its benefits from your employer. When you are initially hired, your employer should provide you with all of the necessary details about the insurance and its benefits in some form.

If you have been injured on the job, or if you have developed an illness because of your job, then you should be covered under workers’ compensation insurance. This type of insurance should be carried by all employers in the state of California. It is important that they carry it since it is a safety net should any unfortunate incident occur in the workplace. With workers’ compensation insurance, medical costs and expenses related to the workplace injury will be covered. Also, you may even receive different types of benefits depending on your situation.

At Workers Compensation Attorney Law Firm, we are experienced with workers’ compensation laws and workers’ rights. We can help you understand your rights as a worker and inform you of your right to be awarded workers’ compensation. We believe it is important you are informed about workers’ compensation and what this type of insurance entails for you. If you feel that you have wrongfully been denied or not given a chance to receive workers’ compensation, we can help. Being injured on the job can be stressful and frightening, especially since it will affect your wages and your ability to work. If in any step of the workers’ compensation process you find that you need assistance or legal help, we are here for you. Contact our Los Angeles workers compensation lawyer at 310-956-4277. We are prepared to assist with any matter relating to workers’ compensation. We are waiting to hear from you. Do not hesitate to contact us today.