Workers' comp benefits can include medical care, rehabilitation expenses, and disability coverage to compensate you for lost wages. If you've been injured on the job or become ill through your work, you may have already been told that you can receive some or all of these benefits through your employer's workers' compensation insurance. (To find out if you are eligible, see Nolo's article Are You Eligible for Workers' Comp Benefits?)
If you are a dependent family member of someone who was killed on the job, you might be entitled to death benefits through workers' compensation.
This article takes a brief look at each type of workers' compensation benefit -- explaining what it is and who is eligible. Each state has its own spin on these general rules, and the details can be complicated. If you have any questions about your workers' comp benefit eligibility, or if an employer is disputing your right to workers' comp benefits, you should consult with an attorney in your state who has experience dealing with workers' compensation issues. See Nolo's consumer friendly Lawyer Directory for a list of attorneys in your geographic area.
Medical benefits available through workers' compensation include hospital and medical expenses that are necessary to identify and treat your injury or illness. Although the details of what is covered vary in each state, workers' compensation generally covers such things as doctor visits, medication, and surgeries. If you need equipment (such as a wheelchair or special vehicle) to help you deal with your injury, workers' compensation will likely cover that cost as well. In some instances, workers' compensation will also cover services like counseling, pain therapy, and acupuncture.
For the most part, only generally acceptable medical practices will be covered. If you would like to use an experimental or investigative treatment or therapy, you may have trouble getting coverage for those expenses, so you may want to get an attorney's help.
State laws differ on whether you or your employer gets to choose your health care provider, and some states regulate how much the provider may charge for your treatment.
Rehabilitation benefits pay for medical and therapeutic care (such as physical therapy) necessary to help you cope with and recover from your injury or illness. They also cover the care and training necessary for you to regain the skills and abilities you need to return to work.
If your injury or illness prevents you from returning to your former job, rehabilitation benefits might pay for evaluation, retraining, tuition, and other expenses associated with helping you become qualified to work at a different job.
The primary role of disability benefits is to compensate you for wages lost while your injury or illness makes it impossible for you to work. Disabilities fall into one of four categories depending on whether they are total or partial, temporary or permanent.
- A temporary total disability is one that prevents you from working at all, but only for a limited amount of time. In other words, you can't work now, but you will be able to work some day. The vast majority of workers compensation disabilities fall into this category.
- A temporary partial disability is one that prevents you from doing some of the duties of your job for a limited amount of time. In other words, you can do parts of your job now, and someday you may be able to do all of the duties of your job, just as you did before your injury.
- A permanent total disability is one that prevents you from ever returning to work. You don't need to be totally helpless or medically incapacitated to fall into this category, just unable to work at your job or a similar one.
- A permanent partial disability occurs when the damage is permanent, but it only partially impairs your ability to work.
If your injury or illness places you in any one of these categories, you are entitled to some form of disability benefit. The benefit you receive will be based on the amount you were earning prior to your injury -- typically, two-thirds of your wages (although some states set a cap on the amount a worker can receive). You will not have to pay income tax on the benefits, so the amount will be closer to your usual wages than it first appears. Most states will require you to wait a period of time (usually a week) before you can start collecting disability benefits. (For more information on Social Security benefits, see Nolo's article Social Security Disability Benefits.)
Most states' workers' compensation programs provide death benefits to people who were related to the deceased worker (for example, a spouse, child, parent, or sibling) and were financially dependent on that person. Although most states provide funeral and burial expenses as part of this benefit, the main purpose of the benefit is to compensate dependent family members for the loss of financial support. Most states calculate this benefit as a percentage of the deceased worker's earnings. Some states have maximum and minimum amounts; others provide a lump sum.
Sometimes, the relationship between the dependent and the deceased worker can pose difficult legal issues. For example, some states do not allow a partner to receive benefits if the partner and the worker were not legally married. And, although children born during a valid marriage are almost always allowed to receive benefits, only some states allow benefits for stepchildren or children born outside of marriage. Parents of the deceased worker can also receive benefits if they were financially dependent on the worker. Depending on the state, parents might include biological parents, adoptive parents, in-laws, and foster parents.
For More Information
For information on eligibility for workers' comp benefits, see Nolo's article Are You Eligible for Workers' Comp Benefits?, or if you were injured in California, see the book California Workers' Comp, by Attorney Christopher Ball (Nolo).