What are Workers’ Compensation benefits?
Workers’ compensation pays for three things: (1) time out of work; (2) medical expenses; and, (3) permanent injury (in some cases). There are also death benefits, which are paid when a worker is killed on the job or dies later as a result of a work-related injury or illness.
For time out of work, there is a one-week waiting period. If you are out of work for one week or less, then you will not be paid workers’ compensation benefits. If you are out of work for two weeks, then you will be paid only for the second week. However, if you are out of work more than two weeks, the waiting period is waived and you will be paid from the first day of your disability.
In the workers’ compensation system, “disability” means that you are not working or earning less than you were before the accident because of your injury. The only proof of disability that is accepted by the Workers’ Compensation Board is medical evidence. Medical reports stating that you are disabled must be filed on a regular basis while you are out of work or making a claim for lost income. You must prove disability with medical reports. Your disability can only be proved with medical reports. You must see a doctor who is approved by the Workers’ Compensation Board. The doctor must file reports on the Board’s forms. The reports must include information about your injury, your work status, and whether you are able to work.
The amount of your weekly compensation checks is also known as your “rate.” Your rate will depend on three things: (1) how much you were earning before you got hurt; (2) the date of your accident; and, (3) your level of disability. The most you can get is two-thirds of your salary before the accident. However, your payments will be limited by the maximum legal rate for your date of accident.
The maximum rate for a case depends on the date of the accident. The maximum weekly rates in recent years have been as follows:
|Date of Accident||Maximum Weekly Rate|
|7/1/1992 — 6/30/2007||$400|
|7/1/2007 — 6/30/2008||$500|
|7/1/2008 — 6/30/2009||$550|
|7/1/2009 — 6/30/2010||$600|
|7/1/2010 — 6/30/2011||$739.83|
|7/1/2012 — 6/30/2013||$792.07|
|7/1/2013 — 6/30/2014||$803.21|
|7/1/2014 — 6/30/2015||$808.65|
|7/1/2015 — 6/30/2016||$844.29|
Since 2010, the maximum weekly rate has changed on July 1 each year, and that should continue in the future.
Workers’ compensation directly pays all of the medical bills for an on-the-job accident directly. The injured worker should never pay a doctor out of pocket for medical treatment in a workers’ compensation case. The Workers’ Compensation Board has medical treatment guidelines for many common injuries. Many routine medical treatments and tests are approved by the guidelines. Your doctor can also file forms asking the Board to approve treatment that is not included in the guidelines. This called an application for a variance.
The law also provides money awards for some kinds of injury if there is permanent damage. Whether there is an award depends on many things, including what body part was injured, the date of the accident, and how much time was missed from work, among other reasons. The Workers’ Compensation Law provides money awards for permanent loss of use of an arm, leg, hand, foot, finger, toe, eye (vision loss) or ear (hearing loss). There are also money awards for permanent facial disfigurement (but not for scars anywhere else). For any other injury, the only compensation benefits are for time out of work.
The amount of compensation to which a person may be entitled also depends on his or her degree of disability. A person may be either totally or partially disabled. Total disability is an inability to do any kind of work whatsoever. Partial disability means that a person can do some type of work, even if they cannot do the type of work they were doing at the time of the accident. For example, a concert pianist who loses a finger may be totally disabled from his work as a musician, but is only considered partially disabled because he still has the ability to do other kinds of work. The weekly payment for partial disability is almost always less than the weekly payment for total disability.
If you are permanently partially disabled from work because of your injury, then you may receive workers’ compensation benefits for up to ten years, although in many cases there is a shorter time period. There are time limits on permanent partial disability awards. The number of weeks of payment depends on the level of disability. The different periods are shown on the chart below:
|Degree of Disability||Weeks of benefits|
|96% - 99%||525 weeks|
In the workers’ compensation system, a person who is permanently totally disabled is unable do any work of any kind, even on a part-time basis. If you are permanently totally disabled from all work, then you may be paid for life.
Legal Editor: Robert Grey, December 2014 (updated February 2016)
Changes may occur in this area of law. The information provided is brought to you as a public service with the help and assistance of volunteer legal editors, and is intended to help you better understand the law in general. It is not intended to be legal advice regarding your particular problem or to substitute for the advice of a lawyer.