For workers who are injured in the workplace by far one of the best recourses they have, and also one of the best known, is workers’ compensation. Workers’ compensation is designed to help workers and their families by providing compensation for medical expenses and partial wage replacement while the employee is recovering and unable to work. However, while workers’ compensation is a great tool that provides very important coverage to millions of US workers, it is not without its shortcomings and all too often legitimately injured workers may find themselves embroiled in a bitter dispute with insurance companies when they should instead be focusing on their recoveries.
What Does Workers’ Compensation Cover?
Workers’ compensation is designed to provide guaranteed coverage to the injured employee, but it comes at the cost of relinquishing the right to sue employers for workplace injuries. In that way workers’ compensation protects both employees and employers. The three core areas of coverage include the following:
- Medical coverage
- Income replacement
- Death benefits
Medical benefits are of course designed to pay for the cost of medical treatment associated with the covered injury. Death benefits provide the families of fatally injured workers with compensation. The income replacement benefits meanwhile fall into several different categories of coverage:
Temporary Income Benefits (TIBs) – Provides 70% of an employee’s average weekly wages for up to two years, or until the covered worker reaches maximum medical improvement (MMI) or is released by a doctor to return to work.
Impairment Income Benefits (IIBs) – Impairment income benefits are paid once the employee reaches the MMI threshold and is determined to have some permanent physical damage. Depending on the impairment rating additional payments in the form of IIBs will be paid which consist of 70% of the worker’s average weekly wage.
Supplemental Income Benefits (SIBs) – Supplemental income benefits are designed to supplement the income of an injured employee whose earning capacity is reduced as a result of his or her workplace injury. The benefit pays 80% of the difference between the worker’s original average weekly wages and his or her lower current wages.
Lifetime Income Benefits (LIBs) – Lifetime income benefits are paid to workers who sustain significant impairment which falls fall into a list of possible injuries including the following as listed by the Texas Department of Insurance:
- Total and permanent loss of sight in both eyes;
- Loss of both feet at or above the ankle;
- Loss of both hands at or above the wrist;
- Loss of one foot at or above the ankle and the loss of one hand, at or above the wrist;
- An injury to the spine that results in permanent and complete paralysis of both arms, both legs, or one arm and one leg;
- A physically traumatic injury to the brain resulting in incurable insanity or imbecility;
- Third degree burns that cover at least 40 percent of the body and require grafting, or
- Third degree burns covering the majority of either both hands or one hand and the face.
Lifetime income benefits pay 75% of the worker’s average weekly wages, but increase 3% each year to account for inflation and the resulting rising cost of living.
Dies & Parkhurst Helps Workers’ Get Fair Coverage
In an ideal world the insurance companies would be eager to do right by injured workers and to provide full and fair coverage. Unfortunately, however, it is not uncommon for insurance companies to try to argue over the extent of the worker’s injuries or to look for other methods of disqualifying the worker for coverage, underpaying, or delaying payment. Dies & Parkhurst is experienced in workers’ compensation litigation and our experience, dedication, and commitment to our clients will ensure that they receive all of the workers’ compensation that they deserve.