Types of Workers’ Compensation Benefits

Employers buy workers' comp insurance to help employees injured at work. Benefits vary by state but typically include four types. Learn what your plan covers and how to get compensation from your employer if you are injured.

Medical Benefits

When an employee sustains a work-related injury or illness, medical benefits cover the cost of necessary medical treatment. This includes any medically required interventions. These benefits help alleviate pain, prevent complications, and expedite healing.

In addition to immediate medical care, these benefits also cover ongoing treatments that may be necessary for a worker's recovery. This may include follow-up appointments, specialist consultations, medical equipment, prosthetics, and assistive devices. As a result, injured workers can receive comprehensive care tailored to their specific needs, optimizing their chances of a successful recovery and minimizing the risk of long-term impairment.

These benefits also serve as a preventive measure by promoting early intervention and timely medical attention. By providing immediate access to medical care, employers and insurance carriers can address injuries and illnesses early, preventing them from worsening and potentially reducing the need for more invasive or extensive treatments.

Managed Care

Managed care in workers' compensation is a comprehensive approach to overseeing and coordinating healthcare services for injured employees. A key element of managed care in workers' compensation is establishing a provider network that consists of healthcare providers, such as doctors, hospitals, and specialists. 

Utilization management is another aspect that involves reviewing and authorizing medical treatments to ensure they are necessary and appropriate for work-related injury or illness. Trained professionals, such as nurses or medical directors, evaluate treatment requests based on established guidelines and evidence-based medicine. 

A pharmacy benefits manager (PBM) is crucial in managing medication-related aspects of workers' compensation. PBMs collaborate with pharmacies, healthcare providers, and insurance companies to control costs and monitor medication. 

Medical care management focuses on coordinating and overseeing the overall healthcare journey of injured employees. Case managers assist injured workers in navigating the healthcare system, scheduling appointments, and coordinating services. 

Rehabilitation Benefits

The primary objective of workers' comp rehabilitation benefits is to facilitate the physical and emotional healing of individuals who have been injured on the job. Medical treatment—including surgeries, therapy sessions, and medications—addresses the immediate and long-term needs of the injured worker. This approach alleviates pain, restores functionality, and improves overall health.

Furthermore, rehabilitation benefits extend beyond physical recovery and job reintegration. They acknowledge the psychological impact of work-related injuries, offering counseling services, support groups, and mental health treatment as needed. This comprehensive approach recognizes the importance of addressing injured workers' physical and emotional well-being.

Disability Benefits

The eligibility for workers' compensation disability benefits typically depends on the severity of the injury or illness and its impact on the employee's ability to work. The benefits are categorized into different types based on the nature and duration of the disability.

Temporary disability benefits are provided to workers who cannot perform their jobs due to work-related injuries or illnesses. These benefits cover a portion of the employee's lost wages during the recovery period.

Permanent partial disability benefits are available for employees who have suffered a permanent impairment or disability but can still perform some work tasks. These benefits compensate the worker for the loss of earning capacity caused by the disability.

Permanent total disability benefits are provided to workers who cannot engage in gainful employment due to their work-related conditions. These benefits aim to replace a significant portion of the worker's lost wages for the remainder of their life.

Gilbert, Blaszcyk & Milburn, LLP in Suffolk County, NY, ensure you receive the benefits you deserve if you've been injured on the job. With over 25 years of representing injured workers, we conveniently have offices throughout Suffolk County in Patchogue, Riverhead, and Melville. Contact us for a free, no-obligation initial consultation.