Workers' compensation is a state-mandated insurance program that employers are required to carry. It is designed to provide benefits, medical care, and lost wages for employees who are injured or become ill as a direct result of their job.
Benefits include medical treatment, lost wages while recovering, disability payments, and rehabilitation services to help employees return to work.
Key Benefit Guidelines
- 30-Day Injury Reporting: Employees must report their injury within 30 days of the accident to protect their claim rights.
- Waiting Period: Benefit payments do not start until the employee has been absent from work for seven consecutive calendar days. Employees may use accrued sick leave if they miss seven days or fewer.
- Indemnity Payments: Indemnity benefits begin on the eighth day of missed work at the rate determined by state law. In Louisiana, workers' compensation generally pays 66⅔% (two-thirds) of your average weekly wage if you are temporarily or permanently unable to work.
- Retroactive Pay: If the disability continues for six weeks or longer from the date of the original injury or illness, the employee will receive retroactive pay for the first seven days of injury or illness that were previously unpaid.
Workers' compensation laws and regulations vary from state to state; employees should ensure they understand the specific rules in their location.
Instances Where Workers’ Compensation May Not Apply
Claims may be denied or excluded under the following circumstances:
- Injuries occurring as a direct result of an employee's voluntary intoxication or drug use.
- Willful self-inflicted injuries.
- Injuries resulting from fights or engaging in horseplay at work.
- Injuries sustained while commuting to or from work.
- Injuries sustained while participating in company-sponsored or off-duty recreational activities.
- Injuries resulting from actions that violate company policy.
- Injuries sustained while engaging in unlawful activities.