About Workers' Compensation

Workers' Compensation Need-to-knows

Workers' compensation, also known as "workers' comp," is a system of insurance that provides benefits to employees who are injured or become ill as a result of their job. The benefits typically include medical expenses, lost wages, and death benefits. The program is designed to protect both employees and employers by providing a streamlined process for addressing workplace injuries and illnesses.

Eligibility

An employee is typically eligible for workers' compensation benefits if they are injured or become ill as a result of their job or job-related activities.

The following injuries and illnesses may make you eligible to receive workers' comp:

• On-the-job accidents (such as slips, falls, or accidents with machinery).
• Occupational illnesses (such as repetitive motion injuries).
• Illness or injury arising out of and in the course of employment (such as disease caused by exposure to hazardous materials).
• Mental illnesses or stress resulting from work conditions.

To be eligible, the employee must report the injury or illness as soon as possible to their employer, and it should be documented. Some states may have a time limit for employees to report their injury or illness and apply for benefits. For example, an employee may have to report an injury within 30 days of the accident, and file a claim within a certain number of days from the date of the injury.

It is worth noting that some state laws may have additional or different requirements, or have different qualifications for the type of benefit.

Ineligibility

There are certain situations where an employee may not qualify for workers' compensation benefits. These can include the following:

• The injury or illness is not work-related. In order to qualify for workers' compensation benefits, the employee must be able to show that their injury or illness is directly related to their job or job-related activities. If the injury or illness is not work-related, the employee will not be eligible for benefits.
• The injury or illness is caused by the employee's own misconduct. If the employee's own intentional actions, such as horseplay or violation of safety rules, caused the injury or illness, they may not be eligible for benefits.
• The injury or illness is caused by the employee being under the influence of alcohol or drugs. If the employee's injury or illness is the result of the employee being under the influence of alcohol or drugs, they may not be eligible for benefits.
• The employee does not meet the jurisdictional requirements. Some state laws have different qualifications for the type of benefit and if the employee does not meet them, they are not eligible.
• The employee does not file a claim within a certain timeframe. Some states have a strict time limit for employees to file a claim for worker's compensation benefits. If the employee misses this deadline, they may not be eligible for benefits.

It's worth noting that the eligibility of an employee for workers' compensation may also depend on the specific facts of the case and the interpretation of state laws by courts. An attorney or government agency may assist in determining whether the employee is eligible.

Registering for Workers' Compensation

How to Register for Workers' Compensation

In the event of a work-related injury or illness, the employee must notify their supervisor immediately. The supervisor will provide the employee with the necessary forms and instructions for registering for workers’ compensation.

• The employee must complete and submit the workers’ compensation registration form within the specified time frame, typically within 30 days of the injury or illness. The form will be available on the company's system or can be requested from the HR department.
• The HR department will review the employee's registration form to ensure that all required information has been provided and that the injury or illness is covered under the workers’ compensation policy.
• If the registration form is complete and the injury or illness is covered, the HR department will submit the form to the workers’ compensation insurance provider.
• The insurance provider will review the registration and may require additional information or documentation from the employee or the company.
• Once the registration is approved, the insurance provider will issue a workers’ compensation claim number and provide the employee with information on the benefits available and how to access them.
• The HR department will maintain records of all workers’ compensation registrations and claims, including the date of injury or illness, the benefits provided, and any updates to the employee's status.
• The HR department will also provide ongoing support and assistance to the employee throughout the workers’ compensation process, including answering any questions and helping the employee access the benefits they are entitled to.

By following this SOP, the workers’ compensation registration process will be completed efficiently and accurately, ensuring that employees receive the support and benefits they need in the event of a work-related injury or illness.