What Does Workers’ Compensation Cover?


By Jason Weinstock on January 3, 2020
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In a previous blog, I wrote about how workers’ compensation is the exclusive remedy for employees to recover benefits for an injury that occurred at work. Does workers compensation cover every injury that occurs at work? No, workers’ compensation doesn’t automatically apply to all injuries just because they occurred at work. The injury must arise from the course and scope of employment. Meaning, if an employee faints hits their head and is injured at work, they must show that the cause of them fainting arose from their employment and not some personal pre-disposed health condition.

If you are injured at work and the injury arose out of the course and scope of your employment, the Nevada Industrial Insurance Act was developed to protect injured workers and their employers. Workers’ compensation insurance protects employers by offering them an insurance policy that pays medical and other benefits to the injured worker, when they have a legitimate claim.

So how does workers compensation protect an injured employee?

The Nevada Industrial Insurance Act creates a method for injured workers to recover for their injuries without having to prove fault. Unlike a traditional negligence claim, which requires someone to show their injuries are caused because someone else breached a duty owed, workers’ compensation insurance does not require an injured employee to show their injury occurred because of someone else’s wrongdoing. A legitimate claim can arise because your hand slipped while using a saw or because the ladder you were using broke. This non-fault system, in theory, makes getting coverage much easier than it would be if an injured worker had to show that their injury was in no way their fault. In a negligence claim, like a personal injury car accident claim, your damages or recovery can be reduced by your amount of fault, as Nevada is a comparative negligence jurisdiction. Having a non-fault system is a great protection for injured workers. Intentional acts by an employee to injure themselves are not covered by workers’ compensation.

What does workers’ compensation cover for an injured worker?

If an employee suffers an accident at work that results in a legitimate injury, which is deemed to have arisen out of the course and scope of employment, then workers’ compensation covers medical costs and other financial benefits. Once you have an accepted workers’ compensation claim you are entitled to medical treatment with approved providers. There are no out-of-pocket co-pays, like when you see a doctor under private health insurance. The workers’ compensation insurance company pays for prescriptions and treatment. The workers’ compensation insurance company will even reimburse you for the mileage driven to get to your doctors and therapy appointments, if mileage requirements are met.

Financial benefits “covered” by workers’ compensation include: temporary total disability (money for time missed from work, because the doctor says you cannot work or your employer has no light duty), temporary partial disability (money to make up the difference between what you are receiving from your employer and what your daily rate is), and permanent partial disability (a monetary settlement for permanent impairment resulting from the injury).
Other covered benefits can include possible lifetime reopening rights and vocational rehabilitation (training for a new career if you can’t return to work for your previous employer).

I have written blogs on many of the individual benefits workers’ compensation covers/provides, but if you have questions or concerns Give me a call or send an email for a free consultation.

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