What Are Workers’ Compensation Benefits & Do You Qualify?
Important: We updated this article in December 2023 to make sure all info below is both current and correct. You’re here because you or someone you love has a workplace injury — and it may impact your ability to work for life. Workers’ compensation benefits exist to provide the care you need when going back to work right away isn’t an option. Answering the question “What are workers’ compensation benefits?” is complex. Every state has small differences in how injured workers apply, qualify, and pay amounts. But despite these differences, most workers’ compensation programs offer similar benefits.
What Are Workers’ Compensation Benefits? Understanding the 4 Different Categories
To answer the question, “What are workers’ compensation benefits?” You must first realize they fall under four unique categories:
- Lost wages. These are temporary partial wage replacement payments the insurer pays while you heal from your job-related injury or illness. In most states, these cash benefits equal about two-thirds of your usual job income.
- Medical benefits. Your employer’s insurer must pay eligible medical costs for your work-related injury or illness. Insurers usually pay for all medical care until you fully recover and start working again. Your employer’s insurance company typically pays for your medical expenses directly so you never see them.
- Survivor benefits, sometimes called death benefits. If an employee dies from a work-related illness or injury, surviving family members may qualify for these payments.
- Reemployment benefits, also known as vocational rehabilitation. You may get this benefit incrementally or in a lump sum payment. You can use these benefits for training in a new occupation or as a “job relocation” form of compensation. In other words, if you need to learn new skills or move to find a new job, that’s what this money pays for.
What Are Workers’ Compensation Benefits Like for Those Who Need Time Off to Recover?
There are 4 specific types of disability benefits that fall under the “lost wages” category. These include:
1. Temporary Total Disability Benefits (TTD)
You can receive TTD cash benefits from when your total disability starts until you’re back on the job. Once you medically recover and can work again, this payment stops.
2. Temporary Partial Disability Benefits (TPD)
You can receive TPD cash benefits only while you’re partially disabled from your work injuries. If, for example, you can return to work on a part-time basis, but cannot work full time due to your work-related injury or illness, you qualify for TPD payments. This compensation covers part of your weekly gross earnings, but not your entire paycheck.
3. Permanent Partial Disability Benefits (PPD)
PPD is another form of compensation you get in addition to temporary disability benefits. Your doctor may determine you’re able to work again. However, you may have some permanent physical loss (such as amputation or loss of use of a body part). This payment is based on the percentage of loss determined by your workers’ compensation doctor. Then, your disability payment rate depends on your estimated amount of lost wages. Your employer’s insurer may make this payment in a lump sum or in increments, depending on your state’s laws.
4. Permanent Total Disability Benefits (PTD)
You can get PTD benefits if your injury limits your ability to work so you can no longer earn your regular income level. If eligible, these permanent disability benefits are paid until your death in most states. Your employer’s insurance carrier determines your permanent total disability benefits amount based on:
- The nature of your injury or occupational disease
- Your current age, educational level, and job history
- Degree of your physical impairment
- Your ability to undergo job retraining, if your state agency offers this option
- Availability of suitable work in the geographical areas near your home
Important: If you don’t need 3-7 days off to recover from your accident, then you likely only qualify for medical benefits, not ongoing compensation.
What Are Workers’ Compensation Benefits Like for Families of Deceased Employees?
In the case of a work-related death, the insurer will pay for a portion of funeral expenses. The employer’s insurance carrier may also provide compensation to a surviving spouse and eligible dependents. The amount of these death benefits varies depending on which state you live and work in. In addition to these payments, the insurance carrier may also pay weekly compensation to the employee’s dependents at the PTD rate for a certain amount of time, depending on the survivors’ status.
What Workers’ Compensation Insurance Benefits Exist for Those with Minor Injuries?
If you have a very minor injury, you should still seek medical attention immediately after your work-related incident. This ensures you don’t miss anything that could cause lasting harm down the road (like a concussion, for example). You may treat minor work-related injuries with a first aid kit, of course. But if you do seek medical care at the closest clinic, your employer’s insurance should cover that bill.
How Do I Know Whether My Employer Has Workers’ Compensation Coverage?
State laws determine which employers must provide workers’ compensation insurance coverage for their employees. In most cases, an employer with at least one full-time employee must provide workers’ compensation insurance coverage. Texas is one notable exception, as it’s the only U.S. state where coverage is 100% optional for employers.
Who Decides if I Qualify?
In most cases, the employer’s insurance provider evaluates your initial claim and decides if you qualify. Some states review initial workers’ comp claims through their respective workers’ compensation review boards and make a determination.
Many states only require their workers’ compensation board to review disputed claims. If an insurance company denies your claim, you can file an appeal to dispute their decision. At that point, the state’s workers’ compensation board usually mediates the dispute ultimately makes a determination regarding the workers’ compensation case.
How to Get Free Expert Help Maximizing Any Benefits Your Employer May Owe You
We hope this guide sufficiently answered the question, “What are workers’ compensation benefits?” If you are filing an initial workers’ compensation claim or were already denied benefits, a workers’ comp attorney can help you. These attorneys always offer free, no-obligation consultations that start with just one phone call. It’s the fastest, easiest way to know where you stand.
Ready to speak to an expert for free about your workers’ comp case? Click the button below to start your free online benefits quiz now and see if you may qualify:
