Worker’s Comp 101: What It Does and Doesn’t Cover

When you’re working in a high-risk job, it’s inevitable that you’ll get injured at some point. Whether it’s a sprained wrist from lifting something too heavy or an injured back from working for hours on end, these accidents will eventually happen. 

Fortunately, as an employee, you have worker’s compensation insurance to help ease the financial strain of these injuries. This insurance provides benefits for employees who are injured while working and unable to perform their usual duties. 

However, the details might be so confusing that you may not know what it covers and what it doesn’t. 

In this article, we will talk about what workers’ comp is and what it covers. Keep reading to find out more!

What Is Workers Compensation?

Worker’s compensation is a form of insurance that covers medical expenses and lost wages for employees injured while on the job. This type of insurance coverage is required in almost every state, and employers are typically required to purchase it. 

Worker’s compensation is different from health insurance in a few ways. First, it covers injuries that occur on the job only — not off the job. Also, it covers only work-related injuries or illnesses that keep you from working. Finally, workers’ comp is a no-fault system, which means that employees aren’t at fault for having an injury and therefore don’t have to prove negligence.

Which Injuries Are Covered by Worker’s Compensation?

Worker’s compensation covers any injury that occurs while on the job and keeps you from working for a certain amount of time. The policy pays for medical bills and lost wages from the time of injury to when you’re able to return to work at full capacity. It also covers specific job-related injuries and illnesses, including: 

• Sprains and strains – These are common workplace injuries that occur when muscles and ligaments become overstretched or torn. 
• Burns – Burns happen frequently in the workplace, usually due to a chemical or electrical hazard. 
• Injuries from falling objects – If an object falls and hits you while you’re at work, you may be eligible for worker’s comp. 
• Carpal tunnel syndrome – This is a painful wrist injury caused by repetitive motions, such as typing. 
• Diseases – In some states, worker’s comp covers some work-related illnesses, such as allergies and diabetes. 
• Chronic conditions – Workers comp may cover conditions that have arisen from regular work activities, such as repetitive stress injuries or depression.

Which Injuries Are NOT Covered By Workers’ Comp?

Unfortunately, not all injuries that occur at work are covered by worker’s compensation. The following injuries and illnesses are not covered: 

• Pre-existing conditions – If you have a heart condition or diabetes, for example, you wouldn’t be covered if your condition worsened at work. 
• Criminal acts – If you’re assaulted on the job, you’re not covered if your injuries are a result of the assault. 
• Conditions you cause – If you’re injured while drunk at work, you’re not covered by worker’s comp. 
• Personal illnesses – If you get sick at work and it’s due to your environment, you may be covered. But if you get sick because you work too much, you’re not covered.  

The Final Words

Whether you’re a blue collar worker or you work in an office, there’s a chance you’ll get injured at some point in your career. Fortunately, worker’s compensation insurance is available to help employees who are injured on the job. That said, the way worker’s compensation works depends on the state you live in and the type of job you have. 

In most states, the insurance carrier is responsible for paying the doctor directly, and the employee is responsible for filing the claim with their employer. Other states, however, use a hybrid system, in which the employer pays a portion of the claim and the insurance company pays the rest.