Charles Spinelli Speaks On How Worker’s Compensation Benefits Both Employees and Employers 

The objective of the workers’ compensation insurance program is to provide certain benefits to workers who get injured or become ill as a consequence of their job. The government-mandated rule is enacted to ensure injured or disabled workers resulting by occupation have faster access to necessary medical intervention and fetch compensation covering a portion of the lost wages due to their inability to join the work till their recovery. According to Charles Spinelli that almost all employers are obligated to have comp insurance to ensure coverage of payment for medical costs as well as partial salary replacement caused by occupational injuries and illnesses. 

Benefits of Workers’ Compensation 

• Salary Replacement

Typically, an employee who is under worker’s compensation is paid a salary replacement less than the individual’s full salary. To a maximum extent, the pay may be 2/3rd of the gross salary. At both federal and state level the cash benefits offered is not taxable.

• Healthcare Cost Reimbursement

All compensation plans provide coverage of medical costs for injuries related as a direct consequence of the occupation. Charles Spinelli explains it with an example – while a worker involved in construction can claim compensation for being injured due to falling from a scaffold, but, not for an injury sustained while traveling to the work site. 

• Survivor’s Benefits

In the event of a worker dies caused by a work-related accident, workers’ compensation insurance is obligated to make payments to dependents of the worker.  

Contextually, it should be noted that agreeing to accept workers’ compensation as decided by the insurer, waives the right of workers to sue their employers due to negligence. In doing so, workers also give up their further scope for bargaining while employers agree to the extent of insurers as well as their liability to the incident. 

What Is The Process Of Workers’ Compensation Claim?

After a work-related injury or occupational illness, there is a time limit to report the incident as well as filing a claim. Failure to act accordingly could lead to refusal of benefits against workers’ compensation insurance.

This is why, employers need to educate their employees to report an injury right away once it happens at work. Once it is taken into the notice of the company, the employer or a manager will be responsible to report the same and submit a claim to the insurer of their workers’ compensation. The claim form should be furnished with details like the date, name of the employee, time, place, and documentation regarding the incident. Before documenting, having statements of witnesses if any, and including their statements in the claim form is the best practice to avoid discrepancies in declarations during the investigation process done by the insurer.

The employer should also be responsible for

• Providing full assistance to the injured worker to get immediate medical intervention.
• Identify the cause of the accident and take necessary measures to prevent such accidents from happening again.
• If the employee is found unable to carry such a job, the employer can assign a different job for the injured once he/she re-join the workplace.

When Worker’s Compensation is Not Entertained  

Although workers’ compensation insurance offers a wide range of protection, the insurer typically does not cover injuries and illness even if such incidence occurs in the workplace.

• The illness or injury was not related to the occupation. For example, an injury caused during a recreational activity at the workplace. The illness was an outcome of any pre-existing condition
• The employer was not informed about the injury when it took place. Consequently, that causes a delay in the submission of the claim that voids the right of the claimant
• The injury was caused while fighting with co-workers at the work site.
• The workers got injured due to being intoxicated or drunk

In a nutshell, the program is beneficial for both employers and employees. Having worker’s compensation insurance reduces the risk of employers being sued by the victim. On the contrary, it provides medical care and financial protection to employees who get injured or ill at work. Employers without insurance could be fined or get criminal punishment like imprisonment.

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