Workers' Compensation

Workers' Compensation, a state-regulated insurance program, covers the cost of lost wages and medical bills for injured workers. The program functions as a no-fault system, thus the benefits of the program begin immediately, without the need for the employer or employee to admit fault for the injury (this is not applicable for situations involving drugs, self-inflicted injuries, injuries obtained while violating company policy, inadequate training, or third party liability).

The insurance company is allowed a sixth month PWP (pay without prejudice) period, in which the company can provide monetary services without assuming full responsibility for the claim; during this time, benefits may be modified or terminated within seven days of written notice. This period may be extended to one year, given the permission of the injured worker.

Workers' Compensation medical benefits include: reasonable medical care, mileage for injury-related travel, medical equipment, vocational services, and prosthetic devices. After the initial physician visit, in which the employer may direct the employee to a provider under the company's plan, the injured worker may choose his own provider. The injured worker is permitted to change treating physicians once at his own discretion, and afterward with insurer permission.

Wage benefits may be temporary or permanent. If an injury disables an employee for over six days, he may qualify for TTD (Temporary Total Disability), in which he receives a certain percentage of his/or her AWW (Average Weekly Wage), to a maximum of the SAWW (State Average Weekly Wage). These payments may be continued for a totally disabled worker for up to three years. TPD (Temporary Partial Disability) covers injured workers with partial work capacity for up to five years. After full utilization of temporary benefits, a disabled worker may qualify for PTD (Permanent and Total Disability.) The worker may also choose, in the case of a permanent loss of function, to accept a lump-sum wage payment from the insurance provider (scarring and functional loss are included in measurement of this payment, though pain is not).