Types of Workers’ Compensation Claims

There are multiple types of workers’ compensation claims. The different claims apply in different situations. Some claims can be combined, while others cannot due to the nature of the individual claims.

Claims for workers’ compensation typically are divided into four different categories. For all of the segments of the workers’ compensation claims, the compensation is based only on injuries and lost wages tied to the employee’s job responsibilities. This is to say that if a worker is injured while working for another company or while participating in some sort of social activity or even doing work at home, the policy will not cover the individual.

The first type of claim is an incident only claim. This type is the most straightforward. In this type of claim, an employee does something while at work that results in an injury. The individual immediately reports the incident to the manager or HR department and the claim is passed on to the insurance company for processing. The agency is then required to determine what compensation and benefits need to be paid out for the incident, which is then passed on to the victim of the incident. These claims must be filed as soon as possible or else the company may face strict fines and penalties.

The second type of claim is medical only. This type of claim is used by employees who have suffered an injury that requires some amount of care by a doctor. Basic doctor visits as well as follow-up appointments are covered if they go beyond what the employee’s health insurance plan will cover. If the doctor decides that the employee can return to work without any delays, the compensation provided will cover the medical bills and nothing else.

Lost time claims, the third type, pay out benefits when an employee is unable to return to work due to an injury. This category has three subcategories based on the total amount of time between the injury and the return date.

Death is the final type of claim. If an employee dies from injuries suffered while at work or illnesses contracted while working, the employee’s family is eligible for compensation and benefits through the workers’ compensation policy.

Contact Us

If you have been injured while at work and have been denied workers’ compensation benefits, contact a Charleston workers’ compensation lawyer from the Steinberg Law Firm at 843-720-2800.