Sustaining an injury at work or within the scope of your employment may make you ask, “What is workers’ compensation, and how does it work?” Workers’ compensation, often shortened to workers’ comp, provides compensation to workers who get injured or fall ill from work-related injuries. This insurance is state-mandated, though the benefits awarded vary from state to state. Employers in Ohio and Kentucky are expected to have workers’ compensation insurance, from which workers’ compensation claims are paid.
Do you have a work-related injury or illness and want to pursue workers’ comp benefits? Young, Reverman & Bolotin can maximize your financial recovery by offering quality representation. Call 513-400-0000 to book a free consultation with one of our experienced workers’ compensation lawyers.
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What Is Workers’ Compensation?
Workers’ compensation provides benefits to employees who get injured, develop disabilities, or fall ill because of workplace accidents or conditions. Every employer with more than one employee is required to take out workers’ compensation coverage.
Workers’ compensation is useful in two main ways. First, it protects employees who are hurt or unable to resume work. The benefits they receive cater for treatment and living expenses before they get back on their feet. Second, it protects employers from lawsuits by workers who suffer injuries or fall ill from workplace accidents.
A workplace injury can life-altering. Besides enduring the pain and discomfort of your injuries, you will have mounting healthcare bills. A workplace injury can be so severe that you can no longer work to earn a living permanently or temporarily. In worst-case scenarios, you can lose a loved one from work-related accidents.
Workers’ comp insurance is designed to address such circumstances by offering benefits to the affected workers. So, What are the four types of workers’ compensation benefits? They include medical benefits, disability benefits, partial lost wages, and death benefits.
Medical Benefits
These benefits cover medical treatment for injuries suffered at work. They also pay for psychological counseling for conditions like PTSD that result from a workplace incident. Ongoing care costs, like multiple surgeries and physical therapy, may also be included in your medical benefits.
Lost Wages and Disability
Some injuries can keep you away from work as you get treatment and recuperate. Workers’ compensation can replace a portion of your lost wages until you return to work.
Employees can suffer permanent total disability, permanent partial disability, or temporary total disability following a workplace injury. You will be entitled to benefits if you find yourself in such a situation.
Kentucky worker’s compensation laws provide a tier system for determining disability benefits. For total permanent disability, you will collect payments until you reach your Social Security Retirement Age.
Death Benefits
You may qualify to receive death benefits if you lose a loved one due to a job-related injury or illness.
Injuries and Illness that Are Eligible for Coverage Under Workers’ Comp
Injuries or illnesses arising in the workplace or in the course of employment qualify for workers’ comb benefits. They include:
Physical Injuries
In 2022, Ohio recorded 102,300 nonfatal job-related injuries and illnesses in the public and private sectors. In the same year, Kentucky reported 40,600 nonfatal job-related injuries and illnesses in the private sector.
Physical injuries that occur at work or when you are doing your work duties are eligible for coverage under workers’ comp. They include sprains, broken bones, and herniated disc injuries from falls, slips, and inadequate lifting equipment. They also include head trauma, traumatic brain injuries, and back and spinal cord damage arising from vehicular accidents and trauma from heavy equipment failure.
Occupational Illnesses
Work-related illnesses can stem from exposure to harmful chemicals, allergens, and toxins. A prime example is Coal Workers Pneumoconiosis (CWP). CWP, or black lung disease, is caused by inhaling graphite, coal, or synthetic carbon over an extended period. You can also develop an occupational illness because of working in older buildings that contain banned substances like asbestos. Asbestos exposure can cause lung cancer, asbestosis, and mesothelioma.
Workers’ comp does not cover injuries and illnesses caused by health complications outside the scope of employment or the natural aging process. Psychological issues are eligible for coverage only if they stem from a physical injury.
How Does Workers’ Compensation Work in Kentucky?
Kentucky workers’ compensation laws require an injured employee to report a workplace accident within three days of its occurrence. For illness, report as soon as you begin experiencing symptoms. Upon filing your First Report of Injury, you have two years from the incident date to pursue your claim.
For injuries you are getting treatment for, the benefit will be up to two-thirds of your average weekly wage. These payments are known as the Temporary Total Disability Payments.
Additionally, Kentucky has a multi-tiered system for determining the duration an injured worker can receive benefits. Under this system, you are entitled to benefits for up to 425 weeks if you have a permanent partial disability (PPD) rating of 50% and below. If your PPD rating is more than 50%, you will be entitled to benefits for up to 525 weeks.
Once a final rating determination is made, your workers’ compensation lawyer can negotiate with your employer and the employer’s insurer to have your benefits paid in a lump sum.
Misconceptions About Workers’ Compensation
Most misconceptions regarding workers’ compensation are often around the coverage. So, who or what does workers’ compensation not cover?
Every employer in Kentucky and Ohio with one employee must have workers’ comp insurance. This requirement, however, does not mean every employee in Kentucky and Ohio is eligible for coverage. Some exemptions apply, including:
- Domestic workers working in a home with less than two employees
- Maintenance workers whose employment doesn’t exceed 20 consecutive workdays
- Members of religious organizations and charity workers
- Agricultural workers
Reporting an Injury Might Cause Employer Retaliation
Many employees fear that reporting a workplace injury and pursuing compensation can lead to employer retaliation. Workers’ comp law bars employers from retaliating against an employee seeking compensation.
Your employer cannot reduce your hours, terminate employment, or decrease your pay because you reported a workplace injury or filed a workers’ compensation claim. Involve your workers’ compensation lawyer if you suspect your employer is retaliating against you. Your lawyer will investigate your claims and guide you on how to hold the employer liable for unlawful retaliation.
The Company Dictates Which Doctor to See
Many injured workers wrongly believe they are tied to a doctor their company endorses.
When you get injured at work or a work site and there is a company doctor, it makes sense to consult that doctor. Some companies will even try to tell you which doctor to see. There is no problem with this, and it helps with the requirement to inform your employer of an injury.
However, you don’t need company permission to see a different doctor or specialist. Under Kentucky law, you can choose your doctor, pharmacist, and other medical personnel.
Some employers have a managed care plan. While they can require you to use the plan, they must let you pick a provider off the provided list.
How Much Workers’ Compensation Should I Expect?
No two workers’ compensation claims are the same. Several factors are considered when determining the workers’ compensation settlement amount.
Your wage history is an important consideration in the calculation process. The figure used will be the average weekly wage you have earned over the past 52 weeks before your injury. Other considerations include a medical estimation of the level of impairment should you not fully recover, any ongoing or recurring medical expenses, your level of education, and the severity of your injuries.
Your workers’ comp claim should also account for the costs of retraining if you need to gain skills in a different role if you can’t go back to your previous position.
One thing you can be sure of when filing an insurance claim is that the insurer will try to pay as little as possible. After an injury, mounting bills and loss of income can pressure you to jump at the first offer. This is not always the best direction to take.
At Young, Reverman & Bolotin, we know how workers’ compensation works and mistakes that can compromise your claim. As such, we will advise you on what to do and what not to do when on workers’ comp. We will also throw all our weight behind getting the best possible settlement for you. Contact us at 513-400-0000 for a free initial consultation.
