Frequently Asked Questions
May I pay for the worker’s injury myself and not have the worker file a claim?
No. You cannot deny your workers the right to
file a claim with WSI. If you pay the
claim costs “out of pocket,” you may be assuming liability for that claim and
exposing your company to future medical costs and expensive litigation. Once a claim is determined to be
compensable, WSI will pay benefits.
What is a medical expense assessment?
By law, you are required to reimburse WSI for the first $250 of medical expenses paid on each
claim. Similar to a deductible, the initial costs of claims are transferred directly to the employers incurring the
losses.
When are assessment payments due?
Once billed, employers have 30 days to pay the medical
expense assessment. The employer may
not bill the injured worker for any part of the assessment.
What is the penalty for late payment of assessments?
Penalties for late payments are severe. If WSI does not receive payment from the
employer within 30 days of the first billing, penalties amounting to 125% of
the assessment may be added.
How are disability (wage replacement) benefits paid?
Disability benefits are paid at a rate of 66 2/3 of the
worker’s gross weekly wage at the time of disability, not to exceed the state’s
statutory maximum benefit. There is also a statutory minimum benefit. The TTD
cannot go below the statutory minimum, unless the worker’s preinjury net wage
was lower than the statutory minimum, in which case the worker would receive
benefits equal to their preinjury net wage. Benefit checks are mailed to the injured worker.
How do injured workers’ claims affect my workers’ compensation account and premium?
It depends upon the severity of the injury and the number
of claims recently experienced by your company. It also depends on the length of time the injured worker is off
work. If you have questions regarding
the impact on your premium, please contact our Policyholder Services
Department. You may request a loss run
report from us that lists all claims and medical costs paid on your account.
May I contact the injured worker’s doctor?
Yes. Your active involvement is strongly encouraged to promote a safe and early return to work
for the injured worker. Providing the doctor with a job description that outlines the injured worker’s job duties is
also beneficial as it will assist the doctor in making decisions on
return-to-work issues.
What happens if new information has been obtained regarding a claim that has already been accepted?
Please notify WSI immediately for further investigation.
What is a prior injury questionnaire?
This is a form that is completed by the injured worker
as part of the claim filing process. On
this form, they list all prior injuries or health problems (whether work
related or not) that they have had to the area of the body that was injured at
work.
What is defined as seasonal work?
It is those occupations that are not permanent or that do not customarily operate throughout the entire year. Seasonal employment is determined by what is customary with respect to
the employer at the time of injury.
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