Lesson 10: Workers Comp and Employers Liability

Question 1

Occupational Safety and Health Act of 1970 (OSH Act)

Answer 1

passed to prevent workers from being killed or otherwise harmed at work. The law requires employers to provide their employees with working conditions that are free of known dangers.

Question 2

What does workers comp provide

Answer 2

medical benefits and wages to employees suffering from job-related injuries or diseases during employment in exchange for a mandatory waive of the employee’s right to sue the employer for negligence under tort law.

Question 3

What is workers comp

Answer 3

a form of accident insurance paid by employers. No payroll deductions are taken out of employees’ salaries for workers’ comp.

Question 4

Workers comp policy format

Answer 4

policy has an information page, general section, coverages, liabilities, other states’ insurance, premiums, and conditions. It provides coverage for every type of employer and occupation with specific exclusions.

Question 5

What does workers comp cover

Answer 5

employees excluding injuries sustained while intoxicated, committing or attempting to commit suicide, failure to use safety devices they are trained to use, and injury to a worker while employed in violation of the law with the insured’s knowledge

Question 6

Workers comp - Part I (Workers Comp)

Answer 6

only applies to statutory benefits. Workers’ Compensation includes a ‘Miscellaneous Provision Section’ with the following information:

1) Premiums: (a) Payroll and classification/experience determines the rate. (b) An audit will determine the final premium at the end of the policy period.
2) The insurer has the right to inspect the workplace.
3) Cancellation: (a) The insured can cancel the policy at any time. (b) Under GA law, the insurer must give 75-days notice before cancellation.

Question 7

Workers comp - Part II (Employers Liability)

Answer 7

covers the basic limits, which are $100,000 per accident for injuries; $100,000 per employee for disease; and $500,000 aggregate (annually) for the disease. For example, think of the medical costs associated with a coal miner developing black lung due to exposure.

Question 8

Employer duty

Answer 8

legally obligated to take reasonably care to ensure workplaces are safe

Question 9

Risk pool

Answer 9

Insurance companies acn form a pool which can provide insurance against catastrophic risk such as a chemical fire

Question 10

Exclusive remedy doctrine

Answer 10

a worker gives up his or her rights to sue and can legally pursue damages.

Question 11

Medical treatment benefit

Answer 11

If an employee is injured or becomes ill due tot heir work/workplace, he can file a workers’ comp claim to help pay for treatment, including: doctor’s appointments; hospital and ER visits; medications; therapy and rehab; recovery equipment

Question 12

Disability benefit

Answer 12

usually 4 categories

Question 13

Temporary total disability

Answer 13

injured employee is completely unable to work for a certain amount of time but will return to work at full capacity

Question 14

Temporary partial disability

Answer 14

injured employee can work at a reduced capacity without needing time off; i.e. employee with broken wrist may be partially disabled and be able to work for half days until it heals

Question 15

Permanent Total Disability

Answer 15

leaves an employee completely unable to work, never returning to their previous role

Question 16

Permanent partial disability

Answer 16

employee can return to work but will never work the same capacity as before the injury

Question 17

Does workers comp provide lost income?

Answer 17

if a disabled employee has to take time away to recover, workers’ comp can help the employee recover some of their lost income until they return. If the employee has a permanent disability, workers’ comp can give disability benefits for life

Question 18

Physical or vocational rehab benefit

Answer 18

Workers comp can assist w/ ongoing care, including physical therapy, vocational rehab, and can cover the cost of new training or certifications

Question 19

Death and funeral services benefit

Answer 19

if an employee dies due to a work related injury or illness, workers comp can provide benefits tot he family/beneficiary for funeral expenses and lost income

Question 20

Right to inspect

Answer 20

Insurer has right to inspect workplace

Question 21

Typical occupations exempt from workers’ comp

Answer 21

1) employers with fewer than 3 employees
2) agricultural workers
3) railroad workers
4) casual, part-time employees (someone paid to cut grass, load furniture on a truck)
5) domestic employees
6) real estate brokers

federal govt employees also exempt

Question 22

Other workers Comp exclusions

Answer 22

The Merchant Marine Act of 1920 (Jones Act)
This coverage provides seamen with a negligence remedy for on-the-job injury without having to overcome fellow servant liability. Employers can obtain coverage under a workers’ compensation policy by purchasing a maritime coverage endorsement.

The United States Longshore and Harbor Workers Compensation Act (USL&H)
The Longshore and Harbor Workers’ Compensation Act (USL&H) is a federal workers’ compensation act providing benefits for particular maritime employees and civilian employees on military bases.

Question 23

Workers Comp - Employers Liability

Answer 23

coverage for the legal liability of employers arising out of injuries or disease to cover claims, which are not subject to compensation loss.

Question 24

Who can sue an employer?

Answer 24

Exempt employees.
Spouses & children of Injured workers.
Spouses sue for loss of consortium.

Question 25

Elements of employers’ liability claim

Answer 25

Covers claims if the original suit is brought in the United States, its territories, possessions or Canada. Gross Negligence must be proven.

Employers Liability is needed to fill gaps in the compensation coverage and covers claims which are not subject to compensation laws.

Question 26

Workers’ comp second injury funds

Answer 26

remove disincentives for hiring disabled people; help pay the additional loss resulting from combined injuries; and relieve an employer from some of the burden for multiple injuries

Question 27

How are benefits calculated?

Answer 27

for employees with partial disabilities, a benefits table is used to calculate benefits