Workers' Compensation

Lesson 1

What Is Workers' Compensation?

The first lesson will go over the basic concepts in workers' compensation. You'll learn how your chances of being involved in a workers' compensation case—either as employee, employer, paralegal, or human resource coordinator—are much higher than you might expect. Every year, hundreds of thousands of claims are filed. In this lesson, you'll review how the system works, how claims are filed, and why it's so vital for you to know and understand the basic workers' compensation system.

Workers' Compensation Benefits

Would you like to know exactly what benefits an injured worker is entitled to receive? Are you unsure what terms like temporary total disability, permanent total disability, temporary partial, and many of the other terms used to describe workers' compensation benefits really mean? This lesson will take the mystery out of them all. It will go through each type of benefit, avoiding the legal jargon to provide a down-to-earth explanation of the benefit system in the workers' compensation system.

Federal Workers' Compensation

In this lesson, you'll examine the workers' compensation system that covers all federal employees. This is a huge and multilayered bureaucracy, but the lesson will go through it step by step to show you how the federal system, which covers hundreds of thousands of federal workers, is both similar to and different from the state systems. You'll also examine some of the new initiatives created to track workers' compensation fraud and to prevent government agencies from making double or triple payments for the same injuries.

Social Security, Medicare, and Medicaid

How do Social Security, Medicare, and Medicaid interact with workers' compensation benefits? This lesson will answer that question. It will begin with an overview of these three systems and then talk about how these agencies work with state and federal workers' compensation agencies to provide different levels of payments and benefits. If you've ever been injured on the job, are close to retirement, are pregnant, or are in any way disabled, then you need to know how all of these systems work together, as well as what types of benefits you can receive from each.

Employers' and Employees' Roles

So far, the lessons have focused on the workers' compensation system, from benefits to the relationships between other government agencies. This lesson will get specific about who is covered under workers' compensation statutes. What, for instance, qualifies a person as an "employee?" Are business owners covered by workers' compensation? How many employees must you have before you're legally obligated to make payments to the state workers' compensation fund? This lesson will answer those questions and many others.

What Qualifies as an Injury?

What types of injuries are covered under workers' compensation? People assume that if you slip and hurt yourself on the job, your injury will be covered. But is it? What about other types of injuries, such as repetitive stress injuries or psychological trauma? Are they covered as well? In this lesson, you'll learn how injuries are classified under workers' compensation systems and the rules that employees must follow in determining which injuries are covered and which are not.

Medical Benefits

It's time to get specific about medical benefits provided under workers' compensation. How much is the injured employee obligated to pay out of pocket? How many treatments may the employee receive? What about physical therapy or chiropractic care? This lesson will address those questions and show you some less traditional remedies. Just what types of treatment will the workers' compensation system pay for and what types will they force the employee to pay for?

Disability Benefits

This lesson will talk about the amount of money an injured employee will receive for different types of injuries. You'll learn the precise details about the dollar amounts an injured employee can expect to receive, and the lesson will break it down by the classification of benefits as temporary or total temporary disability. It will also go over how injuries are reclassified as permanent and what that means for the benefits paid out. Finally, you'll explore how benefits are actually paid and the possibilities of lump-sum payments.

Hearings

This lesson will focus on what happens when an injured employee comes into conflict with their employer about benefits. Suppose that the employer wants to terminate benefits; what recourse does the employee have? The employee can request a hearing for a judicial decision about benefits. You'll examine how these hearings are scheduled, what evidence can be brought up at a hearing, the function of administrative law judges, and how attorneys get paid to represent people at workers' compensation hearings.

Jurisdiction and Awards

How are workers' compensation awards paid out? Can an injured employee opt for a lump sum instead of a regular monthly payment? How do workers' compensation boards enforce their judgments against employers and insurance companies? Those are just a few of the questions that will be answered as you examine the issues surrounding obtaining an award. Finally, you'll also explore the power that workers' compensation boards have to enforce their regulations, not only against employers, employees and insurance companies, but also against doctors and other medical professionals.

Insurance and Workers' Compensation

Most employers don't pay workers' compensation benefits from their own budgets. Instead, they obtain workers' compensation insurance. In this lesson, you'll examine all of the issues surrounding how workers' compensation insurance works, from issuing the policy to paying out claims. Along the way, you'll learn how insurance companies make money from issuing policies and specify certain types of injuries that justify an insurance company's refusal to pay a claim. You'll also examine the role of the insurance defense attorney, who is hired by the insurance company to represent companies in workers' compensation hearings.

Appeals

In the final lesson, you'll follow a workers' compensation case through the appellate process. What powers do appellate courts have in workers' compensation cases? Can they modify the award of benefits or completely terminate them? What is the procedure that an employee must follow to bring an appeal when their benefits have been terminated? The lesson will answer these questions and explore the role of higher courts in workers' compensation cases.