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Blog Authored by:  Garry Watts, CPCU

What benefits are available under Workers’ Compensation?

Workers’ Compensation Benefits are available to employees who are unable to work because of a work related accident or illness.  The injured employee will be indemnified for lost wages as a result of the work related injury if he/she is medically authorized off from work.  Typically, lost time benefits are a percentage of the injured employee’s pre-injury wage.  In addition to all medical expenses related to the treatment, rehabilitation is also typically covered.

What is a waiting period?

It is the period from the date of the injury to when the workers’ compensation benefits start accruing.  The waiting period may be paid retroactively as determined by your states designated retroactive period.

In the tri-state area, Minnesota, Wisconsin and Iowa all have three day waiting periods.  There is a difference, though, in how the three days are applied in each state.

  • Minnesota:  Includes the date of injury plus two days = Friday injury means employee must return to work by Monday or it would become a loss of time claim.
  • Wisconsin:  Excludes date of injury and Sundays = Friday injury means employee must return to work by Tuesday or it’s a loss of time claim.
  • Iowa:  Excludes date of injury and last day worked = Friday injury means the employee must return to work by Wednesday or it is a loss of time injury.

What is the disability date for occupation disease?

The date of injury is set by the first time an employee loses time due to the injury or disability.  This time may be paid or unpaid.

What is an IME?

An Independent Medical Exam (IME) is a medical exam of the injured worker by a medical professional other than the treating doctor who conducted the original examination of the injured worker.  The insurance company or employers are entitled to an IME to challenge the treating physician’s diagnosis, the recommended treatment plan, or whether the injury is work related.

What happens if parties have a dispute that cannot be resolved?

Workers, employers and insurance carriers may file an application for hearings to resolve disputes.  Employees file most hearing applications.  The application notifies the state of the dispute and initiates the legal process.  Legal disputes can be settled by stipulation, arbitration and proceeding with a formal hearing.

Posted 9:11 AM  View Comments

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