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How Are Workers’ Comp Benefits Calculated After an Accident?

When you are injured on the job, your employer is required to provide you with workers’ compensation insurance. This coverage pays lost wages, medical bills, and other costs associated with your injury. Determining how your benefits may be calculated can be confusing. This article will help explain some of the basics of this type of coverage.

Lost Wages

The amount you receive from workers’ compensation will be different than your average weekly wage, which is what you would be making if you were still working. In most cases, your workers’ compensation will be roughly two-thirds of your average weekly wage, which is about the same as what you would bring home after taxes. 

Workers’ compensation insurance companies often use your last 52 weeks of pay to determine what your average weekly pay would be. Some states have laws that set a maximum you can earn on workers’ compensation while others do not.

Issues With Calculation

There are scenarios when calculating your workers’ compensation benefits can be difficult. If you have not worked for the employer for a full year, there will not be 52 weeks of salary to set an average weekly wage that is accurate. You may also work on commission and, if you cannot work, you will not be able to sell in order to earn commissions. 

Overtime, bonuses, and other salary payments must also be factored into your average weekly wage. Your employer must also base your workers’ compensation pay on your gross salary not your take-home pay. However, this is a common error many employers make when calculating lost wages.

Medical Costs

Your employer may require you to visit a specific healthcare provider. In some states, you must only visit that provider once and then may use your own doctor. Other states require you to continue seeing the doctor chosen by the workers’ compensation insurance company, while still others allow you to choose your own doctor from the start. 

All bills should be sent directly to the workers’ compensation insurance company, and you should not have to pay any copayments or deductibles at your visits. This includes doctor visits, medical tests, therapy, or any other medical treatment you must undergo to recover from your injuries.

Transportation and Prescriptions

The workers’ compensation company will also cover transportation costs you may incur in order to seek treatment for your injuries. This could be the cost of public transportation such as taxi services, ridesharing, buses, or trains. They may also cover the cost of parking, tolls, and other transportation related expenses. 

Prescriptions are also covered under your workers’ compensation coverage. Some companies provide you with a debit card you can use to purchase prescriptions while others ask you to submit claims separately to be reimbursed for prescription costs.

Do I Need a Lawyer?

A lawyer can help you understand your rights under the worker’s compensation law. Most states do not allow you to sue your employer for an injury on the job. Instead, an attorney will work with the insurance company, your employer, investigators, and others to help you get the right compensation. This is especially important when you want to be sure you get accurate lost wages compensation. 

Not only does the attorney deal with paperwork and all the other red tape that goes along with a workers’ compensation claim, they will also fight for your rights under the law. This allows you to focus on healing from your injury. There is research that shows stress can slow the healing process, so an attorney may actually help you heal faster and get back to work sooner.

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