Workers' Compensation Benefits
Common elements. Here are some common elements shared by the state workers' compensation laws:
| Benefits are provided for accidental job-related injury
An employee is entitled to statutory benefits from you when the individual suffers a "personal injury by accident arising out of and in the course of employment." |
| Benefits include wage-loss, medical, and death benefits
Wage-loss benefits usually cover about one-half to two-thirds of the employee's average weekly wage. |
| Covered "employees" are defined by law
"Employees" generally does not include independent contractors. |
| Fault is generally not an issue
Neither the employee's own negligence in causing the accident nor your complete lack of fault are factors in deciding whether the worker gets benefits. |
| Employees retain the right to sue negligent third parties
If a third party's negligence helped cause the accident, the employee can still sue the third party; any proceeds from the suit should be first applied to reimburse you for benefits paid to the employee. |
| The system is administered by a state agency
The responsibility for administering the system is placed in the hands of a state agency. |
| Most employers are required to participate
Except in Texas and New Jersey, which have voluntary systems. |
You should remember that workers' compensation benefits are payable only for work-related injuries. Benefits are not available for self-inflicted injuries or for those caused by intoxication or substance abuse. The payable benefits include:
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Income replacement for partial or total disability of a temporary or permanent nature |
| • | Medical and rehabilitation costs |
| • | Survivor benefits in the case of a fatal illness or injury |
In addition, coverage is provided for certain occupational diseases that are set out in the state laws.