Workampers & Workers Compensation

Do Employers have to cover Workampers under their Workers Compensation? Should I asked if I’ll be covered? Well, the answers are “maybe” and “yes” — in that order.

Except as noted below, Workers Compensation is the law, and there’s no way around it: Employers must provide workers compensation for their employees.

Workers compensation pays for medical expenses from on-the-job accidents and work-related illnesses. However, you should check with the applicable state’s labor department for its definition of an “employee.” It can include a full-time, 40-hour-per-week person, as well as someone who works three hours a week every week, and it may not include all categories of employees in some states (such as those who do not work for wages, but receive a site in exchange for their labor).

An employer’s Workers Compensation policy may pay medical benefits, disability income benefits, rehabilitation benefits, and death benefits. It may also use a managed care program in which employees who are hurt on the job or become ill must see a doctor in the insurance company’s network.

Because Workers Comp insurance can be costly for small businesses, laws enacted in the late 1980s allow the use of “preferred providers” to curb medical care costs, a faster back-to-work process, increased emphasis on fraud detection, and better price competition among Workers Comp insurers. Each state has its own Workers Comp requirements that employers must comply with, including a menu of illnesses and injuries that qualify as a Workers Comp claim. It also mandates the level of benefits that must be provided to employees. These rules will typically address the amount of medical coverage that must be provided for each employee and the percentage of the employees’ salary that must be paid.

Workers Comp policies will typically provide basic coverage for accident and illness, as well as coverage for legal fees for lawsuits filed by employees for job-related injuries. Some states also mandate a death benefit and financial support to dependents. As you can see, the considerations involved are complex and vary by state. We would recommend everybody ask every employer as they change jobs. The adage “Better safe than sorry.” was never more apropos.

[NOTE: Texas is the only state that still allows private employers to choose whether or not to maintain workers’ compensation insurance. Employers who choose not to maintain coverage must notify the Commission and their employees that they do not intend to maintain workers’ compensation insurance.]

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