Workers' Compensation Frequently Asked Questions

What is Workers' Compensation?

Workers' Compensation is a law that pays injured workers wage loss and medical benefits related to a work injury.

What does Workers' Compensation cover?

Workers' Compensation covers injuries incurred or medical conditions caused while in the course and scope of your employment.

Are there time limits to report an injury or medical condition?

The employer must be told that there is a work-related injury or condition within 120 days of the injury or the date that the employee learned about the condition.

The employer/insurance carrier has 21 days to accept or deny the claim. If the claim is accepted, Workers' Compensation benefits are payable and an attorney may not be needed.

If the claim is rejected, the injured employee has three years to file a claim. You may need an attorney to assist you with this process.

What type of Workers' Compensation benefits are payable?

• Medical Benefits - Reasonable, necessary, and causally related medical expenses are payable.
• Wage Loss Benefits - Total disability is payable when an injured worker is completely disabled from working or their employer cannot accommodate their doctor's restrictions for their work injury. Partial disability is payable when an injured worker has returned to work but at a loss of wages.
• Specific Loss Benefits - Special benefits for amputations, loss of use of extremities, vision or hearing, as well as facial and neck scars.
• Partial Disability Benefits - When an injured worker returns to work at a lower wage, benefits are paid at the rate of 2/3 the difference between their pre-injury wages and their actual wages upon returning to work.
• Lump sum settlements may be negotiated.

What are potential reasons why I would be denied Workers' Compensation?

Reasons for denial include:

1. Failure to report injury in a timely manner
2. Failure to treat with a Panel health care provider
3. Lack of support from a health care provider relating your problems to a work injury or accident
4. Pre-existing conditions
5. There are numerous other reasons why your claim could be denied

Am I entitled to both Workers' Compensation and Social Security Benefits?

You may be eligible for both workers' compensation and social security disability.

The standards/requirements are different, but you may be able to receive all of your Workers' Compensation and part of your Social Security Disability benefits.

There is an offset under the new Workers' Compensation law for Social Security Retirement benefits.