It is not uncommon for employees to get hurt on the job, no matter what industry they work in.
The top 5 highest incidence rates of workplace injuries in 2020 (per 10,000 Full-Time Equivalent (FTE)) employees were:
- Nursing assistants (approx. 370 incidents)
- Heavy truck and tractor-trailer truck drivers (approx. 360 incidents)
- Laborers and freight, stock, and material movers (approx. 350 incidents)
- Light truck drivers (approx. 340 incidents)
- Construction laborers (approx. 250 incidents)
Workers’ Compensation insurance is required by law, in almost every state, and is designed to ensure payment by employers for some part of the cost of injuries, or in some cases, of occupational diseases, received by employees in the course of their work.
Health or medical insurance doesn’t substitute for workers’ comp coverage. Employees are only covered for on-the-job injuries or job-related illnesses.
Coverage is necessary regardless of fault; injured workers are typically eligible for workers’ compensation, even if their injuries resulted from their own negligence.
Why you need workers’ compensation insurance
If you have one or more employees and do not carry workers compensation insurance, you will be liable for these costs and subject to fines based on your operation’s base state.
Workers compensation insurance is required and provides coverage for:
- Medical expenses (doctor bills, physical therapy, prescriptions)
- Wage benefits
- Disability benefits (if an injury becomes permanent)
- Death benefits
States who require workers’ compensation coverage impose substantial penalties for companies that do not comply.
Reviewing and understanding your state’s regulations should be your priority as your state will determine where to shop for a policy and which employees must be covered.
For example, some states, like Georgia, do not require coverage until companies have three employees.
In Pennsylvania, workers’ compensation liability is mandatory for any employer who (unless otherwise exempt):
- employs at least one employee who could be injured or develop a work-related disease in this state, or
- could be injured outside the state if the employment is principally localized in Pennsylvania, or
- could be injured outside the state, while under a contract of hire made in Pennsylvania, if the employment is not principally localized in any state, if the employment is principally localized in a state whose workers’ compensation laws do not apply, or the employment is outside the United States and Canada
The policy will only provide coverage within state lines, so you may need to obtain multi-state coverage for each state.
Don’t forget, some states require that all truck drivers be covered by workers’ compensation insurance, regardless of being an owner-operator.
If there was an accident, fault is usually not considered when filing a workers’ compensation claim, as the employee must only show that he or she got hurt in the course and scope of employment.
For example, if you were making a delivery and driving on your typical route when your car began to skid on ice and then crashed, your claim should be covered. However, if you had taken a detour to run a personal errand, it may not be covered.
How to shop workers’ compensation insurance
Now that you understand the basics of workers’ compensation, what do you need to know to get started?
Choose the correct classification code: A classification code is a three-to-four-digit number assigned by a state rating bureau or NCCI and is assigned to a specific job duty, which allows employers to accurately classify their employees. There is a level of risk associated with each employee group, as well as the total employee payroll, making accuracy extremely important for your insurance premium.
Estimate and Monitor Payroll: Your payroll is likely to change over a year. When buying workers’ compensation coverage, you will need to estimate your annual payroll based on current circumstances. At the end of the year, your audit will include checking the actual payroll, and your insurance carrier will issue a credit or bill as needed.
To improve cash flow, monitor and report your current payroll throughout the year. Some insurers will adjust your coverage, and therefore your premium, as payroll fluctuates.
To estimate the workers’ compensation cost for an employee: divide their annual pay by 100, then multiply that number by your workers’ compensation insurance rate to get your estimated premium.
To estimate the average cost per employee: divide total premium by number of employees to get the average cost per employee.
Review Your Audit and Policy Annually: During your annual renewal process, your insurer will conduct an audit. When reviewing, check for errors and make necessary updates on your business model, size, geographic market, or payroll.
If you are interested in a quote, please call CNS Insurance at 717.625.0066 or email us at firstname.lastname@example.org.
How to file a workers’ compensation claim
Filing a workers’ compensation claim as soon as possible is important. Report a workplace injury or illness if:
- The injured person is an employee of your business
- Your employee became sick due to their work
- The employee gets injured because of job-related duties
- If the employee gets hurt in the workplace
No matter how an accident occurred, it is important to conduct a comprehensive investigation. If it turns out a third-party’s negligence contributed to your injury, you could simultaneously declare a third-party claim against that individual or entity while you recover workers’ compensation benefits.
Before filing a claim, you’ll need to gather:
- Company information (account number and location, policy number)
- Injured employee information (name, date of birth, address, phone number, Social Security number, age, gender, etc.)
- Details of the incident (date of incident, type of injury, exact body part injured, the cause of injury, estimated number of days the employee will lose, anticipated return date, any witnesses, etc.)
Once the necessary information is collected, you should file the claim with your insurance company as soon as possible.
This process can differ depending on the state your business operates in as some states require a window of time to report their workers’ compensation claim to their insurance carrier.
For example, New York requires reports to be filed within 30 days while in Tennessee, an employee should report a work-related injury to his or her supervisor within 15 days of the date of the injury or date that a doctor first tells an employee the injury is related to work.
Make sure your employee gets the right injury treatment
Your employee needs to get the proper medical treatment if they are injured on the job.
Our Physicians, Nurse Practitioners, and Physician Assistants are all trained to treat non-life and limb-threatening injuries, and we offer:
- Evaluation and treatment of workplace injuries
- Work status summaries (provided to employer after each patient visit)
- In-house X-rays
- Post-accident drug and alcohol testing
- Return-to-Work evaluations
- Case Management (continued work injury care coordination)
Our Occupational Medicine Team can develop a custom workplace safety plan for your company. You may need a combination of services like physicals, COVID-19 testing, and drug testing, and you may also need these services performed on-site.