Expert answers to all your business insurance questions.
What does workers’ comp cover, anyway?
- Workers' Comp Basics
What workers’ comp covers:
Workers’ comp covers any injury or illness related to an employee’s job. For example, an employee can claim workers’ comp benefits if they hurt their back while lifting a heavy object at work. Or, they could also claim benefits if they get burned by harsh chemicals or suffer hearing damage from working near really loud machines. Even repetitive use injuries like carpal tunnel can qualify for benefits.
And here’s something important: an employee will also be covered by workers’ comp if the accident was their fault. This means that if a new employee gets careless and gets their hand cut in a food prep machine, they’ll still be entitled to workers’ comp benefits. (Seriously, keep an eye on the rookies.)
So that’s what is covered. Let’s talk about what workers’ comp won’t pay for.
Here’s what workers’ comp does not cover:
There are a few situations where workers’ comp won’t apply.
First, workers’ comp insurers can deny claims for injuries that happen because an employee didn’t follow workplace safety rules. If your team member fell off a platform because they weren’t wearing the required safety gear, workers’ comp probably won’t pay for their injury.
Workers’ comp also won’t cover injuries that happen on lunch breaks and other “off the clock” times. It doesn’t cover injuries that happen on the commute to and from work. And injuries that happen on company outings sometimes aren’t covered, either.
Finally, workers’ comp won’t pay for injuries that happen because an employee committed a crime on the job. So if your employee gets a black eye because they started a fight at your office, they’re out of luck.
What kinds of benefits does workers’ comp provide?
Okay, so your employee has qualified for workers’ comp. What exactly are they getting?
Basically, any medical care they need to treat their injury will be paid for. If they can’t work for a while, they may receive some income replacement money. If they are permanently unable to do the job they did before, workers’ comp can also cover the cost of training for another kind of job. (Also, if an employee dies, workers’ comp will pay death benefits to their family.)