What Are Workers’ Compensation Benefits

What Are Workers’ Compensation Benefits & Do You Qualify?

You’re here because you or someone you love got hurt on the job — and it may impact your ability to work for life. Workers’ compensation benefits exist to provide the care you need when going back to work is not an option. Answering the question “What are workers’ compensation benefits?” is easier said than done. Every state has small differences in how you apply, qualify and pay amounts. But despite the differences, most workers’ compensation programs offer similar core benefits.

What Are Workers’ Compensation Benefits? Understanding the 3 Different Categories

To answer the question, “What are workers’ compensation benefits?” You must first realize they fall under three unique categories:

  1. Lost Wages. These are temporary workers’ comp payments the insurer pays while you heal from your illness or injury.
  2. Medical Expenses. This includes any emergency or ongoing medical treatment you receive after your accident.
  3. Survivors’ Benefits. If an employee dies from a workplace illness or injury, surviving family members may qualify for these payments.

What Are Workers’ Compensation Benefits Like for Those Who Need Time Off to Recover?

There are 4 subcategories of disability/impairment benefits that fall under the “lost wages” category. These include:

  • Temporary Total Disability (TTD) – You can receive TTD benefits from when your total disability starts until you’re back at work. Once you medically recover and can work again, this payment stops.
  • Temporary Partial Disability (TPD) – You can receive TPD payments only while partially disabled. If, for example, you are able to return to work on a part-time basis, but cannot work full time due to your disability or continuing rehabilitation, you will receive a TPD payment. This will be a portion of the full amount of your weekly gross earnings.
  • Permanent Partial Impairment (PPI) – PPI is a payment you get in addition to temporary disability benefits. Your doctor may determine you’re able to work again. However, you may have some permanent physical loss (such as amputation or loss of use of a body part). This payment is based on the percentage of loss determined by your doctor. Then, your disability payment rate depends on your estimated amount of lost wages. Your employer’s insurer may make this payment in a lump sum or in increments, depending on your state’s laws.
  • Permanent Total Disability (PTD) – You can get PTD benefits if your injury disables you so much that you can no longer earn your regular income level. PTD is determined based upon the nature of the injury, the degree of physical impairment, age, education, work history, and the injured worker’s ability to be retrained and the availability of suitable work in the geographic area of the worker’s residence. PTD benefits are paid until death.

What Are Workers’ Compensation Benefits Like for Families of Deceased Employees?

In the case of a work-related death, the insurer will pay for a portion of funeral expenses and a payment to the employee’s surviving spouse and dependents. The amount of these payments varies depending on your state of residence. In addition to these payments, weekly payments will also be made to the employee’s dependents at the PTD rate for a certain amount of time depending on the status of the survivor.

  • Medical Benefits – Your employer’s insurer must pay eligible medical bills related to your injury or illness. Insurers usually pay for all medical care until you fully recover and start working again.
  • Reemployment Benefits – You may get this benefit incrementally or in a lump sum payment. You can use these benefits for training in a new occupation or as a “job dislocation” compensatory payment. In other words, if you need to learn new skills or move to find a new job, that’s what this money pays for.

What Benefits Exist for Those with Minor Injuries?

If you have a very minor injury, you should still seek medical attention immediately after your accident. This ensures you don’t miss anything that could cause lasting harm down the road (like a concussion, for example). You may treat minor injuries with a workplace first aid kit, of course. But if you do seek medical attention at the closest clinic, your employer’s insurance should cover that bill.

Who Decides if I Qualify?

In most cases, the insurance provider will evaluate your initial claim and decide if you qualify. Some states review initial workers’ compensation claims through their respective workers’ compensation review boards and make a determination.

Not all states review initial workers’ compensation claims. Many only require the workers’ compensation review board to engage in disputed claims. If a claim has been denied by an insurance company, and the injured worker disputes this decision or files an appeal, it is usually the workers’ compensation review board that mediates and ultimately makes a determination regarding the case.

If you are filing an initial workers’ compensation claim or if you have a claim that has been denied, a workers’ comp attorney can help you. These attorneys always offer free, no-obligation consultations and give confidential advice for your situation. It’s the fastest, easiest way to know where you stand.

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