A work-related injury can be expensive. Workers can miss out on pay due to time taken off work for treatments and healing. They must also cover their medical expenses. Fortunately, workers comp benefits are available.

You may wonder, what type of workers comp benefits am I eligible for? This article will explain what type of reimbursement you may be getting.

Which Workers Comp Benefits Might I Be Eligible to Receive?

Lost Wages

Lost wages cover workers for time taken off work to recover and attend doctor’s appointments and therapies. It can also provide reimbursement to workers with medical restrictions that may not allow them to return to their positions.

Workers comp pays injured workers 100% of their wage loss for the first 45 days after the injury. After those 45 days are up, benefits will be decreased as follows:

• Employees without dependents will receive 2/3 of their salaries (66%) for time taken off work.
• Employees with dependents will receive ¾ (75%) of their salaries.

Payments are based on your salary and include premiums like night pay and Sunday pay. Overtime is not included.

How Long Can I Receive Lost Wages Benefits?

Unfortunately, lost wage benefits cannot last forever. Your employer and insurance company want to get you back to work as soon as possible.

If your injury prohibits you from working at your regular position, they may try to find you another position within the company. If they don’t have a suitable position for you, they may reimburse you for training so you can find a position at another company.

If you feel you will be unable to work at full capacity on an ongoing basis, you may consider applying for Federal Disability Retirement benefits. These benefits are a good safety net for disabled workers.

However, technically, your employer must continue paying your lost wage workers comp benefits as long as your injury prevents you from returning to work.

How Do I Claim Wage Loss Workers Comp Benefits?

You must provide medical records that prove you are disabled for work to continue receiving lost wage benefits. Form CA-7 must be submitted to your supervisor or injury compensation specialist every two weeks along with medical evidence supporting your disability. The form can be obtained from your employment agency.

It is also up to you to notify your employer when you are ready to return to work in limited or full capacity. If your disability prohibits you from returning to work at full capacity, and you can only return at partial capacity, you must submit form CA-17. It tells your employer which activities are restricted by your disability.

Medical Benefits

Medical workers comp benefits cover any medical care needed for your work-related injury. It may include:

• Emergency care immediately after the injury
• Ongoing care including medications, surgery, and therapy
• Home modifications for workers who are permanently disabled due to their injury
• Travel Reimbursement: Your workers comp benefits may also reimburse travel expenses incurred commuting to and from doctor’s appointments and hospital visits

How Do I Claim Medical Workers Comp Benefits?

Workers who suffered a traumatic injury must use form CA-16 to claim medical workers comp benefits. The form will allow you to get medical treatment right away.

If your claim is approved, you will be entitled to continued medical care. If your claim is denied, your CA-16 will become invalid.

Form CA-16 is not issued for occupational diseases.

There are other forms you must use to receive different types of medical benefits as follows:

• Reimbursements: Reimbursements cover out-of-pocket expenses for medical treatments. To get reimbursed, you must provide Form HCFA-1500, Form CA-915, and proof of payments.
• Hospital Bills: Hospital bill payment requests must be submitted on Form UB-92. You must also include the hospital’s admission and discharge summary.
• Pharmacy Bills: Pharmacies typically charge the customer at the point of sale. You can receive reimbursement by submitting a claim that includes the NDC Code for the prescription drug and the vendor’s NCPDP number.
• Travel Reimbursements: Requests for travel reimbursements can be submitted on form OWCP-957.

Schedule Award

Schedule award often gets confused with lost wage workers comp benefits. But it is an entirely different thing. It compensates workers who are permanently impaired by a work-related injury.

Lost wage benefits cannot be paid concurrently with a scheduled award. It is typically awarded after wage loss benefits are completed.

To receive a schedule award, you must prove that you have reached Maximum Medical Improvement (MMI). This means that your condition is not likely to improve with continued medical treatment.

A schedule reward is based on the severity of the injury rather than the worker’s salary. If your condition worsens after your schedule award is approved, you may request an increase in your workers comp benefits.

How Do I Claim Schedule Award Benefits?

The CA-7 form can be used to claim scheduled award workers comp benefits. You will need a Department of Labor case number to file a CA-7.

If you have an ECOMP account, your case number will be on your dashboard. If you do not have an ECOMP account, you can choose the option to start a new CA-7.

You must provide your employer’s email address to grant them access to the form so they can fill out their required section. You must upload medical documentation that proves your injury to the ECOMP claim. You must also send your medical documents to Occupational Medical Services.

Conclusion

A work-related injury can be expensive. Workers comp benefits will help you get the compensation you need. This article explains the various types of benefits available. Good luck getting the coverage you require.