Worker’s compensation insurance provides coverage for injured workers. According to the terms of the insurance, workers must be performing work duties or within the defined workplace. If their workplace is remote, victims must prove they were sent by the employer to perform services at the location. A worker that is denied coverage through worker’s compensation may have a viable claim against the employer or their insurer.
Covering Medical Expenses for A Worker
Worker’s compensation insurance provides employers with coverage for their workers if a worker is involved in a work-related accident. The insurance policy provides complete payments for all medical treatment and expenses incurred by the worker. The employer is required to complete a claim for the worker and submit it within the time allowances.
A claims adjuster is assigned to the claim and determines if the worker is eligible for coverage. If they do not submit a claim or deny coverage, the worker can file a legal claim. Employers need workers comp to cover injured workers and prevent a financial loss.
Providing Wage Replacement While the Worker Recovers
Wage replacement is available for eligible workers who cannot return to work immediately. The benefits provide the workers up to 80 to 90% of their wages while they recover from their injuries. The workers who can return to work on light duty are not eligible for wage replacement.
The worker’s doctor must provide information about the patient’s recovery and determine how long they will be out of work. If the employer doesn’t provide wage replacement for eligible workers, the worker could sue the company to recover the lost wages.
The Potential for a Lawsuit
If the employer refuses to file a worker’s compensation claim, the worker is within their rights to start a legal claim. If the insurer refuses to provide worker’s compensation benefits, the worker has the right to seek compensation through the court. The worker must prove they were eligible for the benefits and was denied. They will need all documentation from their claim.
The Penalty of OSHA Violations
If the work injury was related to an OSHA violation, the government agency can investigate the employer. The agency will inspect the property and equipment related to the alleged violation, and if there is an OSHA violation, the employer could face penalties.
The Projected Outcome of a Lawsuit
The projected outcome of the lawsuit depends on the severity of the worker’s injuries and their economic losses. If the worker is unable to remain gainfully employed or sustained a permanent injury or disability, the monetary award could be substantial if they win their case. Some employers could incur a greater financial loss if they do not comply with the law and purchase and maintain the worker’s compensation insurance as required. For some employers, the financial loss could lead to a complete shutdown of their company.
Federal laws require all employers who hire more than one worker to purchase and maintain worker’s compensation insurance. A failure to obtain the coverage could lead to legal claims that bankrupt the company. Workers who are eligible for worker’s compensation are able to start a claim for benefits and economic losses. If they have permanent injuries and were denied coverage, the worker may have a more substantial claim against the employer.
