On the job work injury claims have remained at a relatively stable level over the past several years, according to published reports. From 2002 to 2009, injury claims have stayed in the 240,000 to 250,000 range. The rate of claims was about twice as high for males as for females, with the highest number of claims coming from the age group 35 to 54. The occupation with the highest claims was “Agriculture, forestry and fishery workers. Most claims were to cover medical costs, as weekly work accident compensation only covers about 7 % of the claims.
By law, workmen’s comp is a no-fault insurance, this means that employers must cover occupational injury or illness even if the employee is at fault. Employees do not have to prove employer is at fault to collect benefits. However, some states will deny claims for injuries that are not “accidental.”
All state’s workmen’s compensation laws cover employee medical expenses (due to work-related injury and illness), a portion of lost wages (due to temporary or permanent disability), basic rehabilitative services, and spousal death benefits. The extent these benefits for work injury claims are offered varies from state to state.
Most workmens comp state laws require insurance companies to provide “full medical benefits” for work injury claims. In other words, most state laws do not set time or compensation limits on workmen’s comp medical coverage.
All workmens compensation laws require insurers to pay a portion of lost wages for a work-related injury. Regardless of disability, Insurance companies are generally required to pay no less than 66 2/3 of a claimant’s lost wages up to a set dollar maximum for the duration of their disability or a set number of weeks.
There are some lower rates in a few states. Each state law requires disability claims to be defined as “temporary” or “permanent.” Additionally, they must be classified as “partial” or “total.” These classifications determine the claimant’s weekly indemnity or disability payment for lost wages.
You can also be covered by additional insurance that an employer may provide to cover short term disability for illness unrelated to work (usually less than 6 months), as well as long term disability that could continue for several years. Many employers proved the short term coverage free to the employees and the long term coverage is an option for the employee to purchase. The cost of the insurance varies by the salary level and occupation of the worker. An example of coverage would be AFLAC, which is typically provided by a company as a benefit that can be purchased by the employees.
If illness or work injury claims are permanent, you may qualify for Social Security disability insurance after a qualifying period for lost wages and for Medicare coverage for medical and drug coverage.
Another form of insurance that is a good idea to have in case you get injured or become very ill and can’t work is mortgage insurance, which could cover one of the biggest monthly expense you may have. All of these forms of “disability insurance” typically coordinate with each other, but in some cases they pay individually regardless of other insurance coverage you may have.
Beyond disability insurance the last form of insurance you really must have if you have a family is life insurance. The amount you purchase should be enough to replace your income in case you die so your family will be protected. The two types of insurance are term and whole life. Term life is cheaper and the amount of life insurance can be much higher, but there is no value building with each premium payment. On the other hand, with whole life insurance you build cash value that is returned to you at the end of the coverage period and you still are entitled to the insurance coverage. Age and your current medical condition play major roles in determining what the cost of the insurance will be to cover work injury claims.
This article is written by Daniel J. Killi, who has been in the Human Resources field for over 30 years and has worked for Fortune 500 Companies such as the Hershey Company and Pepsico. Dan has been a member of the Society of Human Resources Management (SHRM) and has a Masters of Science degree from the University of Utah in Human Resources.
