Workers’ compensation is an insurance that companies use to take care of their employees if some sort of justified injury or death were to occur on the job. Workers’ compensation does not always mean that you need to be on the job site and be injured; you can also be off site, and receive an injury and still get workers’ compensation. There are times when a person may work for a company that works with hazardous materials or where there is poor air quality that may result in an illness/disease. It is important for companies to give this type of insurance because there are so many times when people get injured while on the job. Usually when the worker is injured they have to fill out the claim, they usually have to be injured for 7 days at the least before they are eligible for cash benefits. If the worker is still hurt then the company will start paying the medical expenses. They usually also get paid for those first days when they have been hurt longer than 7 days. Each differs from how much they pay their workers’ expenses. Most companies will pay for the injury as long as it was not done intentionally, but by accident.
Many jobs are dangerous and employers know this, so it is good that coverage is provided. It is very important that the employee lets their employer know about the injury immediately, they only have a certain amount of time to do this. After they have written out a report of the injury the employer must then send it to the compensation office. The employer will provide the injured employee with insurance and the employee must use the physician that is covered from that insurance, if they do not then it usually results in a denial. This is the employee’s responsibility. For most states it is important that the employer purchases insurance to cover their employee’s in case of an accident or injury that has happened on the job. It is the employer’s responsibility because if they do not provide the proper coverage for these accidents they are subject to fines, they also may be prosecuted. There are some special exceptions, like for smaller business; they do not have to have insurance.
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It is the employer’s responsibility to provide emergency coverage if the employees needs it, post the rules of the compensation, they must complete a document of the injury so that they can send it to the compensation office, and they must write all of information about the accident that has caused them to loss time. There are times when employers retaliate against employees because they are upset that they have to pay for the injury, but it is illegal for them to treat their employee any different. If the employee was terminated, they could file a claim and sue the company and they are not allowed to demote or lower their salary because they are upset. If that does happen and they go to court, the employer must convince the judge that they did not make their decisions based on the workers’ compensation. Those are the most important responsibilities of the employer. The physician’s responsibility is to see the injured employee and determine just how hurt they are.
They let the employer know when the employee can return to work. Once this decision has been made the doctor then documents all of the progress from the future visits. The physician must then bill the insurance carrier, and then the insurance pays the practice. The employee should not be charged for any of the services and the employer should not be billed for anymore then what the fee for services allows. The insurance carrier has the responsibility of figuring out whether the employer is liable for the employee’s injury. Once this has been decided the carrier must inform the employer, who then will start paying for the injury.
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If the employee is denied they must then pay for their own injuries which can be paid through their own insurance. The HIPPA Rules only apply to a certain extent because it is one of the few reasons why a person’s personal information can be shared. In federal cases information is restricted. It is important that the employee gives their employer written authorization stating that they can have access; the information can be limited to only what they need. There can be implications when viewing a person’s information because they feel like they have no rights, but the employer must view any past injuries that resulted so that they can make sure that there is no fraud involved.
Reference:
FindLaw, a Thomson Reuters business, (2010).
Workers’ Compensation – Employers’ Responsibilities p.1 Retrieved October 17, 2010 from http://injury.findlaw.com/workers-compensation/workers-compensation-basics-overview/workers-compensation-basics-employer.html
The McGraw-Hill Companies, (2008).
Workers’ Compensation and Disability. Payers ch.13, p. 425-433. Retrieved October 14, 2010 from University of Phoenix
