Workers’ Comp
Is All We Do
Is All We Do
Workers’ Compensation Benefits
What benefits does workers’ comp provide?
1. Medical Care. Workers’ compensation typically covers the reasonable expense of medical care necessary to treat a work injury or illness. This includes visits to the doctor, hospital bills, medicine, surgery, prosthetic devices, and rehabilitation. By receiving the medical care they need, employees can make a full recovery and return to work as soon as possible.
2. Temporary Total Disability Compensation. This covers for the time an injured employee is unable to do any work because of a work injury or illness, as determined by a doctor. However, no compensation is paid for the first 3 days after an injury or illness unless the disability prevents the injured worker from working for more than a total of 14 days. In that case, the injured worker will be paid for the first 3 days of disability. This type of compensation ends upon returning to work or reaching medical stability.
3. Temporary Partial Disability Compensation. This is paid if a work injury or illness prevents the employee from earning his or her full regular wage while recovering. For example, when injured employees are given fewer hours to work or given light-duty jobs that pay less than their regular jobs, they are entitled to temporary partial disability compensation in addition to their wages.
4. Permanent Partial Disability Compensation. If the work injury or illness leaves the worker with a permanent impairment, this compensation begins when a doctor concludes that the worker has reached medical stability. The duration of this compensation is determined according to an “ impairment rating” provided by a physician.
5. Permanent Total Disability Compensation. This is paid if the work-related injury or illness leaves the worker with a permanent disability or impairment that prevents a return to his or her former job or any other job that is reasonably available to the worker. Such benefits are intended to make up for the loss of earning capacity due to the disability, ensuring financial support for the long term.
6. Benefits in Case of Death. If an employee dies from a work injury or illness, workers’ compensation will pay up to $9,000 for funeral and burial expenses. Also, the deceased worker’s spouse, dependent children, and other dependents may be entitled to monthly payments. While nothing can fully make up for the loss of a loved one, workers’ compensation can help alleviate some of the financial hardships associated with their death.
7. Legal Protection. In general, workers’ compensation provides legal protection for both employees and employers. Workers are normally entitled to benefits regardless of who was at fault for the injury or illness, keeping them from having to prove negligence in court. Meanwhile, employers are protected from lawsuits filed by injured employees seeking greater benefit than what would have been provided by workers’ compensation.
8. Promoting Workplace Safety. By providing financial incentives for employers to implement effective safety measures and maintain safe working environments, workers’ compensation helps reduce the risk of work-related injuries and illnesses. By prioritizing safety, employers not only protect their employees, but also benefit from fewer disruptions to their operations and lower insurance premiums.
Workers’ comp benefits are in 3 categories:
1. Medical care
2. Temporary disability payments
3. Permanent disability payments
Your medical care is covered for as long as you have issues with whatever body part was injured. If you tore your rotator cuff, you would receive medical care, surgery, physical therapy, and ongoing care, if necessary.
Temporary disability payments are for replacing the wages for any days of work missed due to your injury. Basically, it pays two-thirds of your average weekly wage while you are unable to work.
Permanent disability payments are compensation for the amount of permanent impairment that remains after treatment. For example, if you have surgery on your shoulder, it will likely not be at 100% afterward. You would receive compensation for the percentage of permanent disability that remained after treatment had brought you to a medically stable condition—maximum medical improvement (MMI)—which is the point where you are not getting worse, but also are not likely to improve much physically.
There is also compensation for death and for permanent total disability if those are the results.
Your wage replacement under workers’ compensation is calculated at two-thirds of your average weekly wage (AWW). You also may receive an additional $20 per week for your spouse and each dependent child (up to 4 max). Your AWW is calculated in many different ways depending on how you normally got paid, whether you have overtime, if you have two jobs, etc. Unfortunately, insurance carriers often calculate the AWW to pay you as little as possible. It is best to obtain 12 months’ worth of payroll records showing hours worked, overtime, bonuses, seasonal pay, etc. Your attorney can help you determine if you are being paid the highest rate possible for your injury.
If your workers’ comp claim includes disability payments, then it is unlikely that you will also be able to claim unemployment while injured. This is because for unemployment benefits, you must be “able and available for work.” If you are terminated and your doctor has released you to return to work either completely or with restrictions (i.e., light-duty work), then you should be able to qualify for unemployment benefits. Of course, if you have been terminated and your workers’ comp claim has been denied, then you will most likely qualify for unemployment benefits. Your specific situation may need to be analyzed and it is best to seek the opinion of an attorney.
Utah law does not require an employer to continue medical insurance while an employee is off work and receiving workers’ compensation benefits because of a workplace injury or illness. The Family and Medical Leave Act (FMLA) provides for a certain amount of time where an employee can keep their job and health insurance, although the employee may still be required to cover their portion of the premiums.
Yes, the workers' comp wage payments compensate for the loss of both incomes. The combined compensation for both jobs cannot exceed the state average wage ($916 per week as of January 2020).
The Americans with Disabilities Act does not apply specifically to workers’ comp. You may be able to receive training and rehabilitation skills in order to be accommodated at a different position or job as part of your claim. You may also qualify for Social Security Disability benefits. It is advisable to consult with your attorney regarding any additional benefits you may qualify to receive.
The Americans with Disabilities Act (ADA) makes it unlawful for an employer to discriminate in employment against a qualified individual with a disability. The ADA requirements only apply to employers with 15 or more employees. Whether injured workers are protected by the ADA will depend on if they meet the ADA’s definition of an “individual with a disability.” They must have an impairment that substantially limits a major life activity, and have a “record of” or be “regarded as” having such an impairment. They also must be able to perform the essential functions of a job currently held or desired, with or without accommodations. Not every employee injured on the job will meet the ADA definition.
Most cases can be settled to avoid lengthy litigation. Your case is only as good as the evidence that can be accumulated. Most cases are disputed over medical evidence regarding how severe the injury is or whether your work accident was the cause of your injury or current treatment needs. Either way, it comes down to how strong your doctor’s record is. Your case is worth the cost of medical treatment plus your missed wages plus the amount of permanent disability. Workers’ compensation cases are valued based on the amount of wages you were earning when injured, so the same injury on two different people can be worth very different dollar amounts. Your free case evaluation can include an estimate of the value of your claim. A denied claim is worth $0... until you decide to fight it. Our goal is to get you taken care of medically and get the highest amount of compensation possible for your injury.
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