The Purpose And Effect Of Workers Compensation

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Worker's compensation is a type of insurance that provides restitution for medical care for employees that are injured while in the place of employment, in exchange for the forfeit of the employee's right to sue the employer under the umbrella of negligence. Plans fluctuate according to different state court districts, though they can be made for weekly payments instead of wages as a type of disability insurance, compensation for past and future economic losses, the payment or reimbursement of the medical expenses as a type of health insurance, and benefits payable to the depends of workers who were killed as a type of life insurance.

The purpose of worker's compensation law is to provide employees who are injured on the job with insurance coverage that will compensate them for lost wages, medical care, and if necessary, vocational rehabilitation. This was designed to be a strict liability system, meaning that it is not necessary to prove who was at fault in order to obtain benefits.

Prior to the implementation of worker's compensation laws, an injured or sick employee had to hire an attorney and prove in court that the employer had in some way caused the accident or created the exposure. Now, in return for payment of benefits provided under the worker's compensation law, the employee agrees to not sue the employer for negligence that resulted in the injury. There are exceptions to this, however, such as if the employer is in a violation of OSHA (Occupational Safety and Health Administration) regulations, or when an employer fails to remedy a known hazard.

Under worker's compensation laws, both employer and employee have responsibilities. An employer must provide insurance coverage or maintain a self-insurance fund, and post information specified by the state in a prominent place so that all employees have access to it. An employee has an obligation to read the posted information and to report an injury or occupationally related illness within the allotted time. Non-compliance by either party can have costly consequences.

Most worker's compensation laws also provide employers and co-workers with a specific level of protection, by putting a cap on the amount an employee can receive from an employer. This level of protection is also accomplished by prohibiting the ability of the employee to sue their co-workers. Worker's compensation acts as a no-fault system wherein an injured worker's own negligence, or that of the employers is not put at the fore front, but rather the employee is simply covered for those injuries sustained at the work site.

There are some circumstances when an employee is not covered for an injury that occurs on an employer's premises. Claims for injuries that occur when an employee is under the influence of alcohol or drugs, when in the course of committing a crime, or when self-inflicted, have significant grounds for rejection. Most state laws have provisions to protect the employer in these situations.

The employer has an obligation to select a physician or medical facility to evaluate and treat an injured employee. If an employee has an objection to a particular doctor, he or she has the right to file a protest and request a different provider or a second opinion. The request may or may not be approved, depending on the individual state's guidelines for such occasions. The evaluating physician's report will have a considerable impact on the outcome of the claim. From the physician's report, a claim will be classified as partial or total disability, and identified as to whether the limitations are expected to be permanent or temporary. These classifications then help to identify the level of payment a claimant may receive.

While some injured employees believe their injury is worth much more than an employer might offer to cover as a worker's compensation benefit, most states have laws that are specific about limits of liability. Employers are not obligated to make payments beyond those limits. This is another measure that is intended to help prevent injury claims from burdening the court system as well as the individual and employer.


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