Workers' compensation insurance costs
Workers’ compensation insurance is required for most businesses with employees. This type of insurance ensures that the company’s employees will receive proper medical care and financial assistance in the event of a work-related injury or illness.
Unlike other types of insurance, the beneficiary of a workers’ comp payment is usually not the insurance policyholder. The business owner, not the employee, is the one who pays the premiums, but the employee is the one who receives the benefits from the insurance company.
Employees should receive workers’ comp payments for:
- Medical or hospital bills
- Rehabilitation costs
- Prescription expenses
- Career retraining (in some cases)
- Partial missed wages
In the event of a fatality, an employee’s family may receive death benefits, which can help cover the costs of a funeral and burial for the deceased employee.
It is important to note that most work compensation policies will only provide workers’ comp payments if the injury or illness is considered a “covered” event. There are usually certain conditions that dictate what types of injuries and illnesses are considered covered. An insurance policy might include conditions such as being clocked in or being on company property or at a designated work site. Injuries that occur while the employee is on a lunch break, for example, might not be considered “covered.” Furthermore, illnesses that arise as a result of non-work activities would not be considered “covered.” Injuries that occur while an employee is failing to operate within the confines of company rules or policies could also disqualify them from receiving benefits.
What is Workers' Comp
Workers’ comp payments to employees
Perhaps the most important factor in receiving prompt workers’ comp payments is the timing of the claim filed. The injured or ill employee should notify their employer about their situation immediately. The employer should then file an incident report, which will be sent to the insurance company along with other documents needed to file a claim.
Sometimes employees delay notifying their supervisor about an accident at work, and this can lead to a delay or even a rejection of benefits. It is critical to notify the proper authorities right after an injury or illness occurs.
The employee should also do their best to gather as much documentation as possible. Anything that can support their workers’ comp claim will be helpful in getting their claim processed as quickly as possible. Documentation might include:
- Timesheets
- Video feeds or photographs
- Equipment maintenance logs
- Witness testimony
The distribution of workers’ comp payments to employees may also vary depending on the state the insurance company is located in. In Oklahoma, for example, workers’ compensation companies are required to directly reimburse the employee within 30 days after receipt of the claim.
The other factor to consider when receiving workers’ comp payments is the doctor or hospital administering the medical service. Typically, workers’ compensation insurance companies have their own networks of doctors, similar to health insurance plans. The employee should try to see an in-network doctor in order to be reimbursed quickly and without hassle. If the employee wants to see a different doctor, it’s best to put the request in writing and correspond with the insurance provider in a timely manner and before treatment to ensure adequate coverage can be provided.
Workers’ comp disability payments
Disability payments, however, are slightly different. There are four types of disability:
- Temporary partial disability
- Temporary total disability
- Permanent partial disability
- Permanent total disability
Each of these types of disability comes with a different reimbursement formula and schedule. For example, an Oklahoma employee on temporary total disability—that is, an employee who temporarily cannot work at all—can receive workers’ compensation disability payments after three days of the initial injury period, for up to 156 weeks (or three years). In contrast, an employee with a permanent total disability—unable to work at all, permanently—can receive workers’ compensation disability payments for up to 15 years, or until their Social Security benefits begin.
There is a lot of variety among different types of injuries and illnesses in terms of the frequency of workers’ comp payments made to employees. In order to receive prompt payments, the most important thing is to file claims paperwork promptly and provide substantial documentation for the injury or illness. This will help ensure prompt payment from the insurance company.
Why CompSource Mutual
CompSource Mutual has provided Oklahoma businesses with workers’ compensation for more than 85 years. We’re proud to help protect Oklahoma workers because we serve the communities where we live. When you partner with us, you partner with neighbors. Our team offers top-notch expertise to the businesses that support the Sooner State’s economy. Get the coverage and insight that you need from our experienced team. Request a quote.
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What is an impairment rating?
When an employee sustains an injury that results in permanent impairment, the employee must be assessed by a physician and given an impairment rating. This rating is a number that expresses the total level of impairment that the employee experiences. The employee may then receive an impairment rating payout based on the level of total or partial disability that they have sustained.
Can an employee receive workers' comp payments for carpal tunnel syndrome?
Receiving carpal tunnel workers’ comp is possible, but effective documentation is required. Carpal tunnel syndrome is a condition that can be brought on by many things, including typing at a keyboard or playing tennis. It is difficult to determine whether an employee’s carpal tunnel syndrome was specifically brought on by work-related duties, or whether it occurred as a result of outside-of-work activities, like playing sports or video games.
Can an employee receive a workers' comp payment right after being injured?
Not necessarily. The employer must first file the claim with the insurance company. If it is a “clean claim”—that is, there are no issues with the documentation or the circumstances of the injury—then the payment may go through within 30 days. This may change depending on the type of injury and when the claim was filed.
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OKLAHOMA CITY, OK
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