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Vital Information About Worker’s Compensation Claims

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Worker’s compensation insurance is required for all employers who hire more than one worker to complete tasks within the workplace. It doesn’t matter whether the workers are related to the owner. The coverage applies when the workers are injured while performing job duties. OSHA violations in the workplace are reported, and the company could face penalties for these violations.

Was the Worker Eligible for Coverage?

All workers who are injured on the job are eligible for coverage for their initial medical assessment after the accident. However, any additional coverage is provided after the claim’s adjuster determines if the worker is eligible. If they are eligible, the insurance pays the full cost of their medical expenses, and the worker will receive monetary benefits until they recover from their injuries and can return to work.

Did the Worker Play a Role in Their Accident?

The details of the accident determine if the worker played a role in causing their own accident. For example, if the worker was under the influence of drugs or alcohol, didn’t wear PPE, or wasn’t following protocol for their job, they may be accused of playing a role in causing the accident. If the worker failed a drug or alcohol assessment, they are not eligible for any benefits under worker’s compensation coverage. A Workers compensation lawyer can explain how comparative fault is introduced in worker’s compensation claims and show workers how to avoid these allegations.

Where Did the Accident Happen?

The location of the accident determines if it happened in the workplace. For example, the traditional workplace is the business location, and the workers must be in the building or in the parking lot to qualify. However, the business type determines where the workplace could be. If it is a construction company, workers go to clients’ locations and complete services. If they are injured within the worksite, the injury qualifies as a workplace injury. The same rulings apply to independent contractors if the employer sent the contractors to a specific location to perform services.

Did the HR Manager Send the Worker to the ER?

The human resources manager is required to send all injured workers to the ER or an urgent care facility after an injury. If they didn’t send the worker for an assessment, the employer may incur a liability by failing to comply with worker’s compensation regulations. A medical report must be sent to the insurer within ten days of the reported injury.

Why Did the Claims Adjuster Deny the Claim?

The exact reason the claim was denied presents some legal grounds for a worker to sue their employer. For example, if the worker was eligible and denied benefits, the worker may have a viable claim to collect compensation through a lawsuit.

Worker’s compensation laws protect workers who are injured on the job and provide them with assistance if their employer doesn’t provide proper benefits. The laws require a medical assessment for all workers who are injured on the job. Workers can learn more about the claims by contacting an attorney right now.