How Workers’ Compensation Payments are calculated

When people go to work every day, the last thing they can expect is to get injured in the course of duty. But unfortunately, there are certain things that can’t be controlled.

It is common for employees to get injured – to a point that they have to stay home until they recover.

That’s the reason why almost all employers in the United States are required to have an insurance cover to protect their employees against such happenings.

Workers’ compensation insurance is designed to ensure that an injured employee continues to earn a salary as well as cover medical bills – in case of a work injury.

The employer caters to the bills and continues to pay the worker so that they are not sued by the employee for negligence.

Calculating workers’ compensation benefits

When it comes to calculating workers’ compensation benefits, there are ways in which the calculations are done. They include the following:

  • Temporary total disability
  • Temporary partial disability
  • Permanent partial disability

Temporary total disability

Temporary total disability is usually paid during the recovery time of an employee. An employee is paid two-thirds of the total amount of salary he or she used to earn at the times of an injury. The employee is not required to go to work during this period.

Temporary partial disability

For temporary partial disability, a worker is paid while recovering and at the same time able to attend work and perform light tasks. In this kind of scenario, the employee receives a certain percentage of his or her salary as well as a percentage of the compensation benefits.

For instance, if an employee is receiving 60 percent of his or her salary, then the compensation benefit will be 40 percent. If she is getting 50 percent of the wages, then she will also get 50 percent of her comp benefits.

In other words, the total wage an employee should receive in case of a temporary total disability should add up to 100 percent.

Employees should always ensure that they furnish the comp carrier with their wage details as soon as possible to ensure that they receive the correct amount of benefits. Failure to provide correct details about your salary will make it hard for the insurance company to calculate the compensation benefits.

Permanent partial disability

The last type of comp benefit is known as a permanent partial disability. It is a type of disability payment where the victim or employee is compensated after recovering from the injury. The amount of compensation may vary from one state to another.

An employee is entitled to receive a certain amount of money every week. The payment usually depends on the injured part of the body.

After the figures have been determined, they are calculated using a common comp formula and multiplied by the number of weeks an employee is entitled to the benefits.

Medical bills

As soon as your employer has been made aware of the injury and a workers’ compensation and a claim has been launched, the insurance company is supposed to cater to any bills associated with the injury.

This may include a doctor’s consultation fee, physical therapy, medical bills, and medical prescriptions.

Some states require insurance companies to pay a certain amount of medical expenses. For example, California demands that the insurer pays a total of $10,000 irrespective of whether the claim is accepted or rejected.

Some injuries will require an employee to seek permission from the insurance company before commencing treatment. This is for the insurer to prove that the treatment is medically necessary. It is however important to report the injury within 30 days – to facilitate prompt medication.

How long do workers’ comp benefits last?

Although employees can receive weekly compensation benefits for as long as they want before returning to work, there are limits as to how long one can get the benefits when it comes to employees suffering from long-term injuries.

Different states have limits in terms of time for receiving benefits. For example, Maine caps the limit for receiving benefits at 520 weeks while California has a limit of 104 weeks.