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Workers compensation frequently asked questions

What government agency administers workers compensation?

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Each state administers its own program, and the federal government protects those not covered by state laws. Certain maritime employees are covered under the Longshore and Harbor Workers' Compensation Act which is administered by the U.S. Department of Labor. The federal government administers workers' compensation for all of its employees.

How long can I get benefits?

If your work injury is severe, you may receive benefits for the rest of your life. But that is less likely today because medical advances are helping to get people back to work.

How is workers comp different from health insurance?

Benefits under workers comp are only paid if you are injured on the job or develop an occupational disease.

What kind of benefits can I receive?

Workers comp insurance covers medical care, dismemberment, disability, and death (with each state defining a benefit level that employers must meet). Essentially, the medical benefits are the same as those you would get with health insurance. Unlike health insurance, however, you can also be compensated for lost wages for as long as you are considered partially or totally disabled.

Additionally, the doctor who treats you under workers' comp laws must assess what percentage of disability you have and when you may be fit to work again.

Will I be compensated for pain and suffering?

All states have their own laws for workers' compensation. Few states include payment for "pain and suffering". Check with your state insurance department and find out the specific guidelines to recover for "pain and suffering" under workers' comp, and how to file a claim.

How do I file a claim?

You should report an injury to your employer as soon as it happens. Your employer — not you — needs to file the claim. It’s a good idea to write down the details of your accident and keep it in your records.

In general, your employer will file a claim with its insurance carrier, which in turn files with the state. Or, if your company is self-insured, it will file the claim directly with the state.

If you are concerned about the status of your workers' comp claim, you should check with your employer before you seek out your state's workers' compensation agency.

What do I do if I believe I'm wrongly denied benefits?

In some cases, you may have to resort to litigation if you have been wrongly denied workers' comp benefits. But there are other ways to handle the dispute. Some states have an ombudsman who explains workers' rights, and the services of the ombudsman may be enough to resolve the claim. For example, if an employer has told an employee that he or she has to go to a doctor chosen by the employer, when in fact state law entitles him to use a doctor of his choosing, an ombudsman will inform him of that right. Other states use mediators to resolve disputes.

To find an ombudsman, contact the workers' compensation agency in your state.

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