What is Workers Comp and How to File a Claim?
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Workers’ compensation benefits are paid out to employees for various types of work-related medical conditions or injuries. It is paid out by the Workplace Safety & Insurance Board (WSIB). So what is covered in workers comp insurance and what can you do if your employer doesn’t allow you to file for it?
What Does Workers’ Comp Cover?
A workers comp claim can be made if the employee has been injured in an accident. The injury must be a bodily injury caused due to an unusual or unexpected event. If the injury doesn’t fall into this category, it may be referred to be covered under basic health insurance.
If you have developed some occupational diseases which are related to your work, it can also be claimed under workers’ compensation. Such illnesses are caused due to the circumstances surrounding the functions of the worker. Some types of eye, skin and lung disease can be caused because of long-term exposure to certain substances at the workplace. These are considered as occupational diseases and don’t require an accident to be covered under workers comp.
Conditions for Acceptance
If a workers’ compensation claim must be accepted, it must arise out of your employment. It may also be required to be related to your work. For example, if you work in an environment with water and slippery surfaces, a slip and fall injury can be considered to be arising out of your unemployment.
Besides, it is also required that the injury be caused during the “course of employment.” This refers to the time, location and the circumstances around the injury. So the injury must have occurred during the time of your job. It must also have taken place at the workplace or another location that was designated by the employer. When the location is different from the business premises of the employer, the injury must have occurred while delivering your duties.
Only if all the conditions are fully satisfied can a workers comp claim be entertained by the insurance company. Many times the insurance carrier may conduct an investigation. You can file your claim with the Workers’ Compensation Commission to get an estimate about the type of benefits and the amount that you may be entitled to. This could be different from what the insurance carrier may conclude.
Taking Legal Action
You may take legal action against your employer for any intentional or irresponsible action that may have led to your injury. If you take such a course, your workers comp insurance rights will have to be waived off. Your compensation will then depend on what the court may award you in damages.
Besides, the employer is required by law to file your workers comp claim. If your employer objects to doing so, you can report them to your local workers’ comp office. You can find lots of legal assistance in this regard. There are some companies that help both employees and employers deal with complications arising out of filing and settlement of workers’ compensation insurance claims.
Employers Resource helps every business at all stages with growth and development. Find out more! Call us today at (800) 559-2350.
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