At Spine and Joint Institute of Milwaukee, we understand that injuries sustained at work are physically and emotionally challenging. Workers’ compensation is designed to help employees recover by providing financial support for medical expenses, lost wages, and more. However, it’s essential to understand what workers’ compensation does and does not cover to ensure you’re fully informed about your rights and options. Here’s what you should know about workers’ compensation insurance coverage.
What Does Workers’ Comp Cover?
Medical expenses. Workers’ compensation covers medical treatment related to your work injury or illness. This includes:
Diagnostic tests (such as X-rays, MRIs, and other imaging)
Lost wages. Workers’ compensation can replace some of your lost income if your injury prevents you from working. Generally, you will receive a percentage of your average weekly wage up to a state-set maximum. The amount and duration of wage replacement will depend on your injury’s severity and ability to return to work.
Permanent disability benefits. If a work injury results in long-term disability, workers’ compensation may provide ongoing benefits. There are two types of permanent disability benefits:
Partial disability: When you can still work but need accommodations or adjustments to your tasks.
Total disability: When you are unable to return to work at all.
Vocational rehabilitation. Workers’ compensation can cover vocational rehabilitation services if your injury prevents you from returning to your previous job. This includes job training or job placement assistance to help you transition to a different role accommodating your injury.
Death benefits. In the unfortunate event that a work-related injury leads to death, workers’ compensation may provide benefits to the surviving spouse, children, or other dependents. These benefits help cover funeral costs and offer ongoing financial support to the family.
What Workers’ Compensation Does Not Cover
Pain and suffering. While workers’ compensation covers medical expenses and lost wages, it does not provide compensation for emotional distress, pain, or suffering caused by the injury. Unlike a personal injury claim, workers’ compensation does not allow you to seek compensation for physical or emotional pain resulting from the accident.
Pre-existing conditions. Workers’ compensation does not cover injuries or conditions before your work accident unless the work-related event aggravated or worsened the pre-existing condition. For example, if you have a prior back injury and a new workplace injury causes it to flare up, workers’ compensation may cover the aggravation but not the original injury.
Injuries caused by alcohol or drug use. If your injury occurred due to being under the influence of drugs or alcohol, workers’ compensation benefits may be denied. Employers are not liable for injuries caused by intoxication or illegal substances.
Injuries that occur off the job. Workers’ compensation only covers injuries sustained while you are on the job or performing work-related tasks. If you are injured while off duty or during a personal activity (like driving to or from work), workers’ compensation will not apply.
Employer negligence or fault. Workers’ compensation is a no-fault system, meaning you do not have to prove that your employer was negligent for your injury to be covered. However, if your injury was caused by someone other than your employer or co-workers (for example, a defective product or a third-party vehicle accident). In that case, you may pursue a separate personal injury claim outside workers’ compensation.
Schedule an Appointment with Spine and Joint Institute of Milwaukee Today
Workers’ compensation is a valuable benefit that provides essential financial support and medical coverage in the event of a work injury. While it offers a comprehensive range of benefits, understanding its limitations is crucial. At Spine and Joint Institute of Milwaukee, our experienced specialists can assess your condition, provide effective treatment, and help streamline the workers’ compensation process through thorough documentation. We’ll ensure you receive the care you deserve and help with the records required for your claim.
Contact us by submitting a form online or calling our office at (414) 643-9000 to schedule an appointment and to learn more about how we can help you recover.
Spine and Joint Institute of Milwaukee offers medical treatment for those who have suffered injuries at work. We provide the care you need and assistance with your workers' compensation claim.
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