Lesson 15: Workers' Compensation Insurance

Self-Insurance

An employer assumes all workers' compensation liability by self-insuring. The employer sets up a state fund to pay workers compensation claims. The employer files evidence of its existence with the state's WC authority. The employer is responsible for benefit costs, claim expenses, and medical and legal services

The Jones Act

Anyone aboard a boat or seaman are covered under what federal workers compensation law?

Monopolistic states

Employers are required to purchase workers' compensation insurance if they want to be insured against WC claims. The state does not allow private insurers to compete against these funds.

elective

If the state is _____, the state may choose not to subject the law. If the employer choses this, the employer is denied all rights provided under the law regarding employee claims.

medical disability

In a particular state, injured workers are determined to b permanently and totally disabled if they lose both lower limbs, regardless of earning ability. This is an example of _____ _______.

compulsory

In the majority of states, workers' compensation laws are_____, meaning that the employer is required to comply with all provisions of the law.

Fellow Servant Rule

In the past, one of the employer defenses against employee liability claims was the ____ . This rule was often used to shield employers from employee liability claims, stating that the injury was caused by a fellow employee; therefore, the employer could not be held liable.

Monopolistic State

In these states, employers are required to purchase workers' compensation insurance from the state if they want to be insured against Workers Compensation claims. The state does not allow private insurers to compete against these funds.

$100,000 per person

Part 2, Employer's liability has an occupational disease limit of:

$100,000 per accident

Part 2, Employer's liability provides a minimum limit of:

Federal Employer Liability Act

Postal workers and railroad workers are covered under which federal workers compensation law?

private insurance

The employer purchases workers' compensation insurance from a private insurer. The insurance company pays benefits as required by law.

Individual Employer Groups

The states allow individual employers to form groups typically required to the employers to be in the same business or have a minimum amount of workers' compensation premium.

Disability/Loss of Income Benefits

These benefits are designed to compensate employees who cannot work as because of a work-related injury. Benefits are intended to replace a percentage of lost income.

Survivor/Death Benefits

These benefits are paid to a surviving spouse, children, or other relatives of an employee who died from a work-related injury. Generally, the benefits include a weekly benefit and a specific amount for funeral and burial expenses.

Rehabilitation Benefits

These benefits include medical rehabilitation and vocational rehabilitation. Typically, these benefits pay for things such as physical therapy or vocational retraining for a different job. Usually, any reasonable and justifiable expense for these purposes will be paid.

Medical Benefits

These benefits pay the cost of different kinds of medical services that may be needed because of an employment-related injury. Most medical expenses are covered without limit to cost or length of time paid.

Competitive states

This allows employers to choose between purchasing WC from a state fund or a private insurance company. Private insurers are allowed to compete with the state.

Part One: Workers' Compensation

Under the state workers' compensation laws, which part of the policy covers compensation and other benefits required?

Employers Liability

Under workers compensation laws, damages the employer is required to pay under common law that result from an employees' work-related injury is covered under:

The employer

Who pays the costs that result from work-related injuries and occupational diseases under the workers' compensation system?

no matter who is at fault

Workers' compensation laws are based on the belief that employers should pay the cost of most work-related injuries and occupational diseases:

Medical benefits

______ do not have a dollar limit or time limit on covered expenses.