When you can’t work, one of the first concerns to cross your mind will be how you’ll manage to pay your bills. Thankfully, if you suffer from an injury at the workplace, you’re backed by workers compensation insurance. Once you qualify for these benefits, you won’t have to worry about racking up high medical bills or going without a weekly paycheck.
But as with any kind of insurance, there is a process you must undertake before you can receive benefits. Knowing how long it takes before you’ll receive workers compensation pay can help you financially plan out the coming days and weeks as you work to get healthy.
Qualifying for Workers Compensation
When you’re injured on the job, it doesn’t really matter whose fault it is. That’s because workers compensation protects you whether you’re at fault or your company is at fault.
Several types of workplace injuries are covered under workers comp. The most common include traumatic, one-time injuries, such as car accidents, falls, broken bones, and injuries that arise from equipment use.
Injuries that come about from repetitive movements, such as carpal tunnel or back pain, are also covered by workers compensation. Illnesses that develop due to your work or your workplace environment, perhaps breathing problems due to hazardous fumes or mental anguish from stress, are also covered.
As soon as you discover that you’ve been injured (assuming it’s not an emergency that requires immediate care), you should inform your boss. They will likely refer you to a doctor that’s part of their medical network.
Be sure to report your injury as soon as possible. If you wait too long, you may no longer be covered under workers compensation insurance.
The process for filing for workers compensation benefits is rather straightforward. You’ll fill out a form called a DWC-1 to initiate your workers compensation claim.
Workers Compensation Benefits
Workers’ compensation benefits vary depending on the severity of your injury.
At the very least, your medical bills will be covered. This includes your initial visit with the doctor, as well as follow-up visits, various treatments, and rehabilitation.
Should you be too injured to return to work, temporary disability benefits will kick in. At this point, you’ll receive a weekly payment equal to two-thirds of your regular pay. In most circumstances, you’ll be eligible to receive these payments for up to 104 weeks. If you suffered a more severe injury, your payment may be extended to 240 weeks.
Workers Compensation Payments
You may be concerned about the fact that workers compensation only pays you two-thirds of your average weekly pay. However, note that workers comp payments are not taxable, so you’ll keep the entire amount you receive.
Workers’ compensation payments generally arrive within 14 days of your claim being approved, and in most cases, the insurance company will offer a direct deposit option so that the money goes directly to your bank account. However, there may be instances when you have to wait longer than the typical two weeks. The most common reason for late payments is having your initial claim denied.
What If Workers Compensation Denies Me?
It is a sad reality that there may be times when you are legitimately injured at work, yet your workers compensation claim is still denied.
There are several reasons why a claim may be denied. The most common is the belief that you haven’t actually been injured or don’t require medical treatment. Obviously, this won’t apply to you if you’ve suffered a visible injury, such as a laceration or broken arm, but it could occur if you suffer soft tissue injury, repetitive stress injuries, mental anguish, or another injury that cannot be clearly seen.
Your workers compensation claim may also be denied if there is doubt as to whether your injury was sustained at work or caused by your work. Some employers may try to argue that your injury actually occurred at home or at another job.
Lastly, your claim may be denied if it’s believed that you are well enough to return to work. Again, this is more likely the case for so-called “invisible injuries”, but it may also occur if you have a pushy employer who doesn’t want you to keep collecting benefits.
If your workers compensation claim is denied, you do have recourse. You can file an appeal, providing more evidence of your injury.
How Can I Pay Bills While Waiting for Workers Comp Payments?
If you’re the sole breadwinner of your family, it can be nerve-wracking to think about how you’ll stay on top of bills while waiting for your workers compensation payments to arrive. It can be especially concerning if your initial claim is denied.
A popular way to keep money coming in while waiting for your temporary disability payments is to use paid leave, such as sick days or vacation time. Obviously, this is only an option if you have accrued time.
A benefit to using paid leave is that you can be reimbursed for vacation days or PTO when your benefits finally arrive. This is because PTO is considered a part of your wages; using time off is like using a part of your paycheck.
While you may be tempted to find a second job while waiting for your benefits check, there are a couple of important reasons why you should refrain from doing this.
For starters, you may be accused of workers compensation fraud if it’s believed that you are still able to work. This is a serious accusation and being found guilty can result in cancellation of your benefits, fines, and maybe even jail time.
Beyond that, any income you make needs to be reported to the state. The state will then deduct money from your weekly benefits pay to depend on how much you make. Should you find a job that pays as much or more than your regular job, your benefits may be canceled completely.
You can also file for State Disability through EDD. While you have been working there have been deductions from your paychecks to a disability fund to be used in the case that you are unable to work because of injury or illness. While waiting for your employer’s workers compensation carrier to decide if they are going to provide workers compensation temporary disability benefits you can receive state disability benefits. If the workers compensation carrier decides to accept your case and pay you benefits, then EDD will stop making payments, and workers compensation will reimburse EDD for the payments that they have made to you. To ensure that you receive your workers compensation benefits promptly it is important to speak to an experienced workers compensation attorney as soon as possible.