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Workers' Compensation Benefits: Good But Often Problematic

Employees injured because of a work situation may be entitled to insurance coverage. Workers' compensation is offered to almost all employees. However, workers may encounter problems with the insurer from time to time. The below provides some insight into both the good and problematic things about workers' compensation coverage. Read on so you will know what to expect, both good and problematic, from the workers' compensation insurer.

Good Aspects of Workers' Compensation

  • It is affordable. In fact, it's free for workers. The employer pays the premiums on the employee's behalf.
  • It begins right away. Many types of insurance require a waiting period. For instance, some employees must wait a few months before they can be covered by healthcare insurance. However, workers are covered from day one with workers' compensation insurance. 
  • It pays all medical expenses. If the doctor in charge of the employees' care deems a procedure necessary, it is fully covered. No copays, no deductibles, and no out-of-pocket obligations. 
  • Disability payments may help. If a worker must remain home to recuperate from an injury or illness, workers' comp pays the worker a disability payment. The amount varies and is never meant to be a salary replacement, however.

Problematic Aspects of Workers' Compensation

  • Claims are sometimes denied. The workers' compensation insurer may deny the claim unjustly. For workers, that means they should not be surprised when a claim is denied but should follow up and take action. Learn more about the denial and rectify the issues. If you are unable to get your claim reinstated, speak to a workers' compensation lawyer. 
  • Fraudulent claims affect everyone. Workers' compensation can provide an opportunity to cheat the insurance system for some. That can translate to extra scrutiny for legitimate claims. For example, some workers are surveilled after they file a claim. They may be followed and recorded as they go to doctor's appointments and more. The perception of fraud may also mean workers need more proof of an accident. If you are told that you need more corroboration for an accident, find some witnesses and locate camera footage of your accident, if possible. 
  • You are not paid your usual salary. Workers' compensation payments are not enough to replace a salary and that puts workers in a bad place financially. However, don't allow that situation to force you back to work too soon. Only return to work if you are healed and cleared by your doctor. 

Speak to a worker's compensation attorney to learn more.


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