Coverage and eligibility
Workers’ compensation benefits are designed to provide financial assistance to employees who are injured or become ill due to their work. The coverage and eligibility criteria of workers’ compensation vary from state to state, but generally, the benefits cover all employees regardless of fault.
In most cases, even if the employee was at fault for the injury, they still qualify for workers’ compensation benefits. To be eligible for workers’ compensation benefits, you must be an employee of the company that carries a workers’ compensation insurance policy.
Independent contractors are not covered by this type of insurance. Additionally, certain categories of employees such as domestic staff and farmworkers may not be covered by some states’ laws.
Medical expenses coverage
Workers’ compensation covers medical expenses related to an injury or illness caused by work. This includes hospitalization, medication costs, rehabilitation programs such as physical therapy or occupational therapy. However, there is a catch — medical treatment must be reasonable and necessary.
It’s important to note that employers choose healthcare providers for their workers’ comp plans in many states. In some cases you can request another provider if unsatisfied with your care or treatment plan.
Wage replacement benefits
Wage replacement benefits are designed to compensate employees who cannot work due to work-related injuries or illnesses. Most states offer two types of wage replacement benefits: temporary total disability (TTD) and permanent partial disability (PPD). TTD provides financial assistance when an employee can’t work because they’re injured on-the-job; PPD is provided when a worker suffers a permanent impairment which doesn’t completely prevent them from working but might limit earning potential.
The amount paid out under TTD varies by state but typically is two-thirds of the worker’s average earnings up until the date they were unable to continue working. PPD benefits are calculated based on the worker’s level of impairment and the state’s predetermined schedule for such injuries.