Different types of jobs come with different levels of physical risk. While most jobs these days are pretty safe, there’s always a chance you can get hurt at work. Luckily, that’s why the United States has worker’s compensation. So, if you get hurt at work, you may qualify for worker’s compensation– which can help to pay for your medical costs or even fully cover them.
Who Qualifies
Just because a person becomes injured or sick on the job doesn’t mean that they will automatically qualify for worker’s compensation. Worker’s compensation benefits can vary by state in the United States. This article will focus on the average eligibility requirements used in the United States, but reader’s should know that the requirements listed here may not be the requirements in his or her home state. Some businesses are required to have worker’s compensation programs. Sole proprietorships and some other small businesses, like some LLCs, are not. Larger businesses are usually required to have a worker’s compensation program.
Any employer who hopes to be covered by worker’s compensation must have worker’s compensation insurance, and of course, be an employee at the workplace where they got injured or became sick at. From there, the insurance must determine if the injury or illness is work-related or not. Then, the employee has to meet the deadlines (set by the state) for reporting the injury or illness and filing a claim for worker’s compensation.
Different types of work environments may also have different requirements for accepting a worker’s compensation claim. These specialized careers usually include domestic and agricultural workers. Temp workers, no matter the job environment, may also have varying conditions for qualifying for worker’s compensation.
How to Get Prescriptions Covered
Through worker’s compensation laws, prescriptions that directly relate to helping your injury need to be covered by your employer. However, with the bureaucratic process as it is, individual employees can make getting prescriptions tricky at times. They can do this by setting their own rules from where prescriptions can be filled to how they are paid for.
A lot of these rules are tied to insurance. Worker’s compensation works best (easiest) when the employer has health insurance through his or her workplace. The business owner can often determine which insurance plans employees can choose from. Which insurance provider the business owner picks can dictate which pharmacies a person can use and whether or not the prescriptions need to be picked up in person or if they can be delivered. Once both of those things are determined, the insurance provider can decide how the prescriptions are covered. Sometimes they are covered with a health insurance debit card or are paid for by the employee and reimbursed later.
Sometimes, insurance companies will work with a pharmacy benefit management company. Top PBMs will have some kind of specialization. When dealing with situations like these, it’s best that an employer tries to work with a PBM that has a worker’s compensation specialty.
How Much Money to Expect
In regards to everything related to worker’s compensation, nothing varies more than how much money an employee can expect to get after filing a claim. Some of the things that will determine how much money a person can expect include how hurt or ill the employee became, when the injury happened, why the injury happened, and how long a person had to be out of work because of their injury or illness.
Until a person files a claim, it will be next to impossible to know how much money he or she will receive. Employers may be able to give a rough estimate, but employees should not rely on getting the exact amount their employer names. In severe cases, it is likely best that an employee hires a lawyer to work out the paperwork and fees. However, a lawyer is not necessary in most cases.
Worker’s compensation is messy and confusing– both for employees and business owners. If a business owner does not offer his or her employees health insurance that covers worker’s compensation, he or she may have to pay out of their own pocket. Business owners would do well to pick insurance that covers prescriptions as well.
