The terms of workers? compensation insurance indicate that the employer must send all injured employees to a medical facility after an accident. The exceptions of these terms are injuries in which a first aid kit could provide adequate treatment. However, any condition that could affect the employee’s ability to work requires evaluation.
What Is Covered?
Workers? compensation provides coverage for injuries and work-related diseases. The insurance pays for medical treatment for these conditions. It also pays the employee a percentage of their wages. However, if the condition is permanent, the insurance policy provides a settlement.
A workers? compensation settlement reflects the employee’s future earnings. This value is calculated according to the employee’s earning potential throughout their lives. It is also based on the hourly wage in which the employee earned prior to the accident.
Which Are the Exceptions?
There are certain conditions that allow exceptions in these policies. If the employee’s injuries were self-inflicted, they don’t qualify under workers? compensation. Employees who were injured over the course of committing a crime at the workplace won’t acquire coverage.
A violation of company policy also disqualifies the worker for these benefits. For example, if the employee failed to follow policies defining appropriate shoes or clothing, they won’t receive benefits. In these instances, they are at fault for their own injuries.
Defining the Workplace
Under workers? compensation insurance, the workplace is defined as any area in which the worker is instructed to perform work duties. This could include remote locations as well as the business location. Any location in which the worker performs these duties is identified as a lawful workplace.
If an injury occurs in any of these areas, the employer is liable for medical costs and lost wages. The employer must file a claim for the injury. However, this doesn’t guarantee benefits for the employee.
Employees who were denied workers? compensation benefits should report the denial to an attorney. All employees who are denied benefits have a right to file an appeal. To begin an appeal, they must provide proof that they have a qualifying injury.
