In the United States, workers’ compensation insurance protects employees who become ill or injured on the job. Reviewing and retrieving medical records is an essential process. It helps in finding medical evidence that lets the insurer make a fair decision about the workers’ compensation claim. An important consideration for any business is whether an employee on workers’ compensation can be terminated. Most states don’t allow employers to take action against employees who file for workers’ compensation. However, employers may legally terminate an employee as long as the termination is not in retaliation for filing the claim and is instead based on misconduct unrelated to the claim. Employers must use extreme caution and follow the appropriate procedures to avoid violating state or federal laws.
What Is Wrongful Termination?
To start, the termination cannot be motivated by retaliation against the employee for filing a workers’ compensation insurance claim or reporting a workplace hazard. In employment law, retaliation refers to taking an adverse employment action against an employee as a punishment for protected conduct. It is illegal for an employer to fire an employee solely for filing a workers’ compensation claim. As this is a form of protected conduct by law. This would be wrongful termination, which would give the employee the right to sue the employer.
Termination Laws To Keep In Mind
There are both federal and state laws that cover employment termination. Ensuring that an employee is protected from wrongful termination and the employer is protected from claims of wrongful terminations.
“At will” employment
An “at-will” employment state, means that both the employer and the employee can end the employment contract at any time for any reason, this however does not always apply when a workers’ compensation claim is involved. Labor laws prohibit employers from threatening to fire employees who want to file a claim for a workplace injury. The law also protects employees on workers’ compensation leave, however an employer can fire an employee that is receiving benefits under certain circumstances. If the employee is a key employee, such as a manager, supervisor, or the sole employee in a specific department. Without key employees, it is impossible to effectively run a business. So, in this instance if the employee will be out for an extended amount of time employers may choose to terminate the employee and fill the position so the business can continue to run smoothly.
Unrelated circumstances
Employers may terminate employees if they can demonstrate that the termination was unrelated to the workers’ compensation claim. This is where an employee was involved in conduct that, according to the employer’s policy, would result in termination for any employee regardless of injury or illness. For instance employees who are violent at work, steal, or are sexually harassing a coworker or client. You will need appropriate documentation to prove that this happened around the time the employee filed their claim. Meaning an employer can’t bring a claim of theft up a year after the fact to use it as an excuse to fire an employee who filed a workers’ compensation claim.
Benefit statutes
Workers’ compensation laws in most states only provide a portion of salary and medical benefits. These statutes generally do not provide leave on their own. In many states workers’ compensation laws don’t count as employment protection laws. This means that employers may terminate employees on workers’ compensation leave. However, as we said above, the termination can not solely be because the employee filed a claim. As a retaliation termination would fall under labor laws not workers’ compensation laws.
ADA/FMLA
Employees who receive workers’ compensation can sometimes also be eligible for Americans with Disabilities Act (ADA) and or Family Medical Leave (FMLA). If this is the case the employees leave would then become job protected as the ADA and FMLA laws are employment protection laws.
Workers’ compensation continues
An employee who was fired while on workers’ compensation leave will continue to receive their benefits. They remain eligible for their benefits until their doctor certifies that they can return to work even though they won’t be returning to the job they had when they got sick or injured. Generally, continued employment is not a requirement for continued workers’ compensation benefits.
Return-to-work dates
Injured or sick workers’ on workers’ compensation leave have to provide a return-to-work date. The date should be documented by the employee’s healthcare providers and given directly to their employer. If the employee will not return on the specified date, they have to provide notice beforehand as well as give a new return-to-work date signed off by their doctor. If an employee is medically cleared to come back to work but refuses to, they can be legally terminated.
Employer’s To-Do List
When it comes to terminating an employee on a workers’ compensation or medical leave of absence, a number of laws and various facts and circumstances come into play. Ideally, employers should consult with employment counsel before terminating employees in such situations. Numerous U.S. states have workers’ compensation laws that permit employees to sue in regular court (rather than in a workers’ comp forum) on the grounds that they were terminated in retaliation for claiming workers’ compensation benefits. Employers should prioritize efforts to return their employees to work. To keep yourself and your company safe from being accused of wrongful termination there are a few things you can do. Following this quick checklist will ensure that everything is above board on your end and you won’t have to worry about lawsuits because you’ve done what you need to and are prepared with evidence.
Prove the employee can’t return
This is for if an employee either refuses to return to work after their return-to-work date, or refuses to come back to work for “light duty” that their doctor has medically cleared them for. To do this, you need enough proof of the employee’s disability. You may be able to terminate the employee for excessive absence if the employee is not protected by the ADA or FMLA. You have to take any steps necessary to prove that the employee’s termination was for excessive absenteeism or refusal to return to work and not the result of them filing a claim.
Follow all FMLA laws
Employers with more than 50 workers are required by FMLA to give employees up to 12 weeks of unpaid leave. As long as the employee has a serious health condition and has worked for the company for at least 1 year and a minimum of 1,250 hours. You have to be sure to comply with these requirements. And that any leave period has expired before you terminate the employee.
Follow ADA laws
The ADA provides certain protections to injured employees that develop an injury that prevents them from performing work-related activities. Such as lifting or walking. Only injured employees who meet the ADA’s definition of disability will qualify for ADA protections. To qualify the employee must have an injury or illness that is severe enough to cause either temporary or permanent physical or mental impairment that “substantially limit” major life activities.
If the employee is eligible for ADA protections, employers have to make every effort to provide reasonable accommodations for the employee in their position within the company. Meaning the employer has done everything they can to allow the employee to continue their current job. If the employer can’t do that, then they must provide modified work or another role that meets requirements for a reasonable accommodation. For example, if the employee can not lift anything. The employee would have to be moved to a position where they don’t lift anything.
Follow your employee handbook
Before you fire an employee, it’s a good idea to read over your employee handbook. Just to make sure there are no other rights that you might violate by terminating them at that time.
Document everything
You’ll want to document everything on your end for any potential future issues. Firing an employee who has workers’ compensation benefits is a very delicate matter and needs a lot of proof. To avoid any wrongful termination claims, it’s essential for you to have documents that show the legal reason for the termination. This can be anything from complaints from other employees or customers, proof of poor work performance. Or proof of being intoxicated on the job. You’ll want dates and time stamps to show that these issues were recent and weren’t just brought up because the employee filed a claim.
Working With EZ
Each of our customers receives our undivided attention. We make every effort to make shopping for workers’ compensation insurance as simple and stress-free as possible. As soon as you submit our form, you will receive free, instant quotes from your dedicated agent. Who will provide you with individualized service and work to understand your needs. We want to ensure that you make the best possible decision and obtain the best coverage at the best price. Our services are entirely complimentary, so check out your quotes right away.
If you have further inquiries, please contact us at 877-670-3538. You will speak with a local insurance agent who will answer all of your questions. And assist you in locating the most suitable workers’ compensation policy for your business.
The information provided on this website does not, and is not intended to, constitute legal advice; instead, all information, content, and materials available on this site are for general informational purposes only. Information on this website may not constitute the most up-to-date legal or other information. Readers of this website should contact their attorney to obtain advice with respect to any particular legal matter.
Your workers’ compensation premium is calculated with a formula that has 3 primary components. First the type of business you own, second your claims history, and finally, your total payroll. The formula is Payroll (per $100) x Class Code Rate x Experience Modifier (if applicable) + State Taxes & Fees = Premium. The National Council on Compensation Insurance (NCCI), a trade association for the U.S insurance industry, and state agencies such as the Workers’ Compensation Insurance Rating Bureau (WCIRB) collect and analyze data to make sure that insurance companies in every state use the formula consistently and reliably. Below we’ll look at the specifics of each portion of the formula. As well as the full formula to help you understand how your premium will be calculated. We will also look into a few ways to lower your premiums.
1.Business Type
For this portion of the formula your company is put into a hazard group based on the likelihood that an accident will occur in the workplace. A business with a low risk profile, like a professional services firm, will have a different hazard group than a business with a higher risk potential, like a construction company. For each classification, the average cost per injury and death is first calculated. As you can imagine, workplace injuries from a construction site will likely cost more than injuries that could happen in an office setting. It’s very important that your employees are correctly classified, as it has a direct impact on your workers’ compensation premium. Additionally, if you classify your employees incorrectly you can face penalties and your insurer can even refuse to cover claims if they find the employee was put in a lower classification than they should have been.
2.Claims History
The next portion of the workers’ compensation premium formula is based on the amount of workplace accidents your company has had in the past. This is also called your experience modifier. Your company will compare this amount to the average accidents for businesses in your same classification with the same or similar amount of employees. The average modifier rate is set at 1.0 for the scale, the less injuries the lower your modifier rate is, the more injury claims you have the higher the number. During a specified measurement period (typically 1-3 years), if your business experiences less workplace accidents than the average, your premium will most likely be lower than what a similar business with more accidents paid. Having a lower premium is a huge incentive for businesses to do more to prevent workplace injuries.
3. Payroll
The final portion of the formula for workers’ compensation premiums is the total payroll of your business annually. The higher your payroll, the higher your workers’ compensation premium will be. This also means the more workers you have, the more potential for on the job injuries or illness. To make sure your payroll amount is accurate, every business is required to complete a workers’ compensation payroll audit a few months after their policy is renewed. If you don’t complete this audit you will face a penalty for noncompliance, so it is mandatory. If the audit shows that your payroll was actually higher than what you reported, you will have to pay the additional workers’ compensation premium on the correct information.
On the other hand, if you overestimate the amount of your payroll then you will be issued a refund for the overpayment of your premium once the insurance company adjusts the rates. Every state has a different average of how much they can expect per $100 of payroll. To find out more about your state’s rates check out our state by state workers’ compensation guides.
Ways To Lower Your Workers’ Compensation Rates
Now that you know what affects your premium rates, you’re able to calculate and get a rough estimate of what you could be paying. If you know your premium is likely to be more than you’d like, there are ways to start lowering your premiums to make it more affordable, as well as make your company safer not just financially, but physically as well.
Develop A Drug Policy
Certain industries are actually more prone to drug use and alcoholism in the workplace according to the Substance Abuse and Mental Health Services Administration (SAMHSA). For example, the mining industry has the highest rate of alcohol abuse at work sitting at 17.5% and right behind them is the construction industry at 16.5%. Since these industries are already considered high risk based on the type of work they do, it’s very important for these types of businesses to follow drug-free policies because their policies will already be more expensive. For drug use, Food industry workers sit at 19.1% and construction workers are at 14.4 percent.
You have the right as an employer to conduct drug tests on both current and prospective employees. Although, you’ll want to look into your state laws first as some states only allow drug testing once there’s a job offer on the table. However, making sure that your employees are not working under the influence of drugs or alcohol prevents catastrophic accidents. Promoting a drug free workplace can lower your workers’ compensation premiums as well as increase productivity, lower absences, lower employee turnover, and improve morale.
Aside from drug testing there’s a few other things you can do to help promote a drug-free workplace. For one, you can make it a point to educate your employees about the risks of working while impaired. You can also help workers who struggle with substance abuse by offering resources such as helpline numbers and treatment center information to help them seek treatment for their addiction.
Drug Free Policy State Discounts
Not only will a drug free workplace lower your premiums by preventing accidents, but in 13 states there is a discount for workers’ compensation premiums if you implement a drug-free policy within your business. The following 13 states already have discounts for drug-free work policies:
Alabama – 5% discount
Arkansas – 5% discount
Florida – 5% discount
Georgia – 7.5% if the drug-free workplace program is certified by the state Board of Workers’ Compensation.
Hawaii – 5% for safety and health programs
Idaho – Premium reductions for conducting drug and alcohol testing for current and prospective employees.
Kentucky – 5% discount
Mississippi – 5% discount
Ohio – 5 year phased-in premium reduction that can reach up to 20% discount.
New York – Workplace Safety and Loss Prevention Incentive Programs have a 6% discount.
South Carolina – 5% discount
Tennessee – 5% discount
Virginia – 5% discount
Safety Protocols
Creating a safe work environment can boost employee morale and reduce workers’ compensation costs. Establishing a culture of safety is easier than you might think, and you’re probably already doing some of this work.
Ensure that your employees have access to the tools and information necessary for their safety on the job.
If you have not already done so, schedule regular safety inspections.
Utilize daily safety checks to constantly remind employees to exercise caution while at work.
Plan weekly or monthly deep dive inspections.
Putting an emphasis on safety will not only reduce workplace accidents and injuries and lower your workers’ compensation premiums, but it will also demonstrate your concern for their well-being.
Safety Rewards
Check with your insurance provider to see if they will lower your premiums in light of the fact that your company has become safer over the past year. Typically, these types of safety bonuses are distributed after a period of one year in which fewer claims were filed. It is important to check with your insurer to determine whether or not safety rewards are currently being offered, as they are not guaranteed.
Review Employee Classifications
This recommendation may be so simple as to be overlooked. While it is true that each type of business will have a different overall rate, the costs associated with each classification of employee will also vary. For instance, a sheet metal worker will have different standards than a bookkeeper who rarely visits the production floor. Ensure that each employee is correctly classified in their current position according to your policy. This simple tip will save you a substantial amount of money.
Workers’ Compensation Insurance With EZ
The majority of states require businesses to carry workers’ compensation insurance. Which will not only protect your business but also your employees. Keeping your employees safe does not have to be an expensive endeavor for your company. There are numerous ways to promote safety routines and programs. All of which will help you reduce your workers’ compensation expenses. If the best practices for claims management are implemented and followed in a timely manner, your employees will be able to return to work as soon as they receive medical clearance to do so. Not only will production return to normal, but workers’ compensation costs will decrease as well.
Come to EZ for free, instant quotes from one of our licensed agents to help you look for the best workers’ compensation policy. If you already have workers’ compensation benefits but are looking for a better deal, we can assist you. Your EZ agent will be familiar with the local regulations and able to provide guidance as you shop around for the best policy at the most affordable price. Enter your zip code in the box above. Or call us at 877-670-3538 to speak with one of our licensed agents.
Workers’ compensation insurance is designed to protect you and your employees financially in the event of a workplace accident or unjust. Workers’ compensation insurance isn’t just a good idea, depending on your state it may be a legal requirement. When it comes to workers’ comp claims, the majority of them are approved because workers’ compensation is considered “no-fault”. Meaning that employees do not need to prove that their employer was at fault for their injury.
As long as the employee files their claim on time, has witnesses to their accident, and seeks medical treatment for their injury, the employee will receive benefits. There may come a time, however, when one of your employees files a claim that you find questionable. In this case, you do have options, including the option to contest the claim. Below we’ll look at how you can fight a questionable claim. As well as the impact workers’ compensation claims can have on a business.
Reasons To Dispute A Workers’ Comp Claim
You can’t fight a workers’ comp claim for no reason, you and your insurance company must have a legal basis for disputing any claims. Here are some of the reasons you could have for disputing a claim:
Your employee missed the deadline to file a claim
The wrong paperwork was used to file a claim
The injury didn’t happen at your company
Your employee quit before filing a claim
The injury happened while the employee was at work but was not working
The injury was intentional
Always File The Claim
Even if you suspect the workers’ compensation claim is false. You have to file it when the employee comes to you with it. You can be penalized if you fail to report a work-related injury with a full report of all related details as soon as possible. The insurance claim adjuster’s job is to determine whether or not the claim is valid or not. You are paying premiums to your insurance company so that they can handle these matters. If your report is thorough and you work closely with your adjuster, there is a good chance the adjuster will catch the fraudulent claim and deny it anyway. So, delaying or not filing a report because you think it’s invalid could backfire on you, best to just let the adjuster do their job.
Work With The Claims Adjuster
Once you’ve filed the workers’ compensation claim with your insurance company, an adjuster will be assigned to the case. They will contact you and the employee personally, as well as review all documents associated with the case including medical records. The adjuster ultimately decides if the claim will be denied, but at this point you will have more information about the claim than the adjuster. If you have reason to believe the employee lied, or was injured outside of work, now is the time to gather all information that supports why you think it’s invalid. Document, date, and save everything that indicates why you think the claim is fraudulent. Most importantly, inform your adjuster immediately that you believe the claim to be questionable. Indicating in your initial report that you believe there are reasons to deny the claim serves 2 purposes.
First, it lets the adjuster know they may need to file an extension early, since workers’ compensation claims have to be completed in a certain time frame, and disputing a claim will take more time to investigate. Secondly, marking your claim as questionable from the beginning will actually make your adjuster pay closer attention. They will spend more time looking through the paperwork, medical records, and searching for warning signs that otherwise may have been missed. Finding one of these red flags doesn’t necessarily mean anything, as accidents and coincidences do happen. But if an adjuster notices that more than one exists, they will look into it further to make sure if the claim is or isn’t fraudulent.
Warning Signs
A new hire who immediately filed a claim after being hired
An employee who has immediately hired an attorney after the injury
Claims from an employee who may have been “disgruntled”
Employees with poor attendance, poor work records, or financial issues
Injuries with no witnesses, or that happened in an area the employee isn’t assigned to normally work
Injuries that occur late on a Friday or right when they return to work on Monday
Learn Your State’s Procedure
While workers’ comp is mandatory in almost every state, each state has its own laws and procedures for dealing with claims. Including disputing them. You can call your insurance provider and ask about what you need to know about local procedures. So you don’t accidentally make a misstep and cause trouble for yourself or your company.
You have the option to dispute even if the adjuster doesn’t deny the claim after the investigation. In some states, such as Texas, you have to submit a form or attend a hearing to dispute the claim in front of a judge. In other states, such as New York, or Tennessee, you may have to appear before a judicial panel or speak with a state-assigned workers’ compensation arbitrator. However, regardless of the state your company is in, you will most likely have to defend your position orally, in writing, or both. You will also need to provide all of the evidence you gathered when you first filed the claim and informed the adjuster of your concerns. Remember the “document, date, and save all information” part? This is where that step comes in handy.
How Workers’ Comp Claims Affect Businesses
Workers’ compensation claims tend to have a greater impact on smaller businesses. This is because larger companies have deeper pockets and larger payrolls, allowing them to absorb the financial cost with not much issue. Regardless of how big or small your business is though, workers’ comp claims can cause your business issues. Below we’ve detailed how claims can affect you. So, you understand why it’s important to fight fraudulent claims to protect yourself. As well as explain why doing everything you can to avoid workplace accidents is even more important.
Premium Hikes
Your workers’ compensation insurance premiums are determined by your industry, number of employees, payroll, and claims history over the last 3 years. A single claim will not necessarily result in a higher premium. But depending on the nature of the claim and the resulting medical bills and disability benefits even one claim could make a mark on your record. The more often you have workers’ compensation claims the more likely it is that your premiums will increase.
Additionally, your insurer also takes your experience modification rate (EMR) into consideration. Your EMR is how insurance companies compare your claims history to other companies in the same industry. The average EMR is 1.0, the more claims you have the higher above average you are. And then the higher your premiums will be because your company will be considered a higher risk to insure. Regular safety training and following industry-specific safety guidelines can help reduce your premiums.
Administrative Costs
Processing a workers’ compensation claim can take a lot of time. Especially if you’ve signaled that you believe it’s fraudulent. The insurance company will want to examine all relevant evidence, including the employee’s medical records. Effectively giving you or your claims specialist more work to do. Your company may also need to spend a lot of time and money to fix or check any equipment that was involved. As well as repair it if needed. Especially if the machinery involved is found to be defective after the accident. There may also be more paperwork and more hours involved in reporting the incident to state and federal regulators. Particularly if an OSHA violation is suspected. New equipment or training that stems from a regulator’s requirement can take a chunk out of your bottom line.
Legal Action Expenses
If you believe it is false, and you decide to take it to court you could also end up paying. While your attorney will advise you on whether or not you should go to court in the first place. Keep in mind if you lose the case, you will have significantly higher legal fees than you would have if you settled the claim. So, if you are planning on disputing your claim make sure your legal team agrees with the decision. And that you have absolute proof that the claim was fraudulent.
Reputation Damage
Impact on your company’s brand is difficult to predict. Your reputation can be affected by the severity of the accident. Whether it is covered by local news outlets, and whether it spreads on social media. A serious accident, repeated incidents, or OSHA fines could make it difficult to be able to hire new employees or get new customers.
Working With EZ
Workers’ compensation isn’t just about protecting your employees, it’s also about protecting your business. Nobody wants to deny a legitimate claim. But if you encounter one of those rare cases it’s fraudulent, you should know you have rights as well. And remember, EZ.Insure is here to help if you have any questions about workers’ compensation insurance. Or any other commercial insurance for that matter. We will connect you with a highly trained licensed agent. Who will listen to all of your concerns and make sure you get the best policy. To get started, enter your zip code in the box below or call 977-670-3538 to speak with an agent today.
If you’re running a business, you probably know that you need workers’ compensation insurance to protect both your business and your employees in the event that they sustain an injury at work. Not only that, but most businesses have to have workers’ comp insurance in most states. But you might have also heard of employer liability insurance and might be wondering whether these are two separate types of policies, and if you need both.
So, we’re here to clear things up. Workers’ comp insurance and employer liability aren’t technically the same, but they do go hand-in-hand. When you buy workers’ compensation insurance, employee liability insurance is part of your policy. Employer liability is the part of your policy that protects your business from going bankrupt if you face a lawsuit and are liable for an employee’s workplace illness or injury.
Workers’ Compensation Insurance
You are probably more familiar with the term workers’ compensation than employer liability. Since, as we pointed out above, you most likely need this type of insurance to operate your business. And even if it wasn’t mandatory, this type of policy would be incredibly important: workers’ compensation insurance will pay for an employee’s medical expenses as well as a portion of their lost wages if the employee becomes ill or sustains an injury on the job.
For example, your workers’ comp policy would pay for medical care and lost wages if an employee gets an injury while doing heavy lifting, or after slipping and falling on a wet floor. It would also pay out if an employee got sick from long term exposure to dangerous chemicals on the job.
Workers’ comp insurance, like any other type of commercial insurance, comes with its own set of things it covers, as well as conditions and exclusions. Workers’ compensation insurance typically covers:
Medical care resulting from accidents that happen to workers while they are at work
Lost wages (within limits) after an employee is injured or becomes ill because of their job
Ongoing care needed as a result of an employee’s illness or injury
Funeral expenses, paid to the worker’s family if the employee passes away from their injury or illness
Treatment for repetitive stress injuries
Employer Liability
Now that we’ve looked broadly at workers’ compensation insurance and what it covers, we can take a closer look at employer liability insurance, which is included in a workers’ comp policy. This embedded policy is meant to cover your legal fees if an employee alleges that you were negligent in preventing, or even treating, the injury/illness that they are receiving workers’ comp payouts for.
For example, if an employee is injured while using a power drill, and workers’ compensation doesn’t cover all of their medical bills, or they want to seek damages for emotional distress, for example, your employee can seek more compensation in other ways. They can sue you for not properly maintaining the tool.
A claim like this can cost you a lot of money. But your employer liability insurance will cover the cost of any settlements or judgements made against you. And it’s important to note that whether or not you are liable, you are still responsible for covering the cost of defending yourself against any claims brought against you. So that makes it extra important to have proper employer liability coverage. Since it will also cover the cost of your defense.
But getting employer liability insurance is fairly straightforward. As we pointed out above, workers’ compensation usually includes employer liability as part of the policy. So, you’ll be getting a 2-for-1 deal, just make sure you have the right coverage for your business. If you’re unsure what you need. Speak to an EZ agent about how workers’ comp works in your state, and what kind of employer liability coverage your policy should have.
Types of Workplace Injury Cases
Claims for injuries sustained on the job can take many forms. let’s look more specifically at what employer liability covers. The following are examples of situations where you may benefit from having employer’s liability insurance. So, that you would not have to pay the costs of litigation. Or any eventual settlement, judgment, or damages awarded by the court out-of-pocket.
Consequential bodily injury – Imagine an employee has a serious accident that could end his or her life. The stress of the situation also causes a heart attack in a member of his immediate family. The other family member could actually sue your business for monetary damages. Since their condition was a direct result of your employee’s work injury.
Negligence – If your employee sustains an injury at work. They can claim that the accident was because your company did not have adequate safety measures in place to prevent it.
Third party over-action – If an employee is hurt on the job, they have the option of filing a lawsuit against a third party (like a machine manufacturer). The other business may in turn decide to file suit against you. And claim that you did not properly maintain your equipment, and this improper maintenance caused the accident.
Dual capacity – Let’s say your business designs and builds a piece of machinery. Say your employee sustains an injury while using this equipment. Your employee has the right to sue you in the capacity of their employer as well as the manufacturer.
Loss of consortium – This type of lawsuit is typically filed by a worker’s family member if an employee dies or suffers a catastrophic injury (such as neurological damage) that prevents him from working or performing their everyday duties and functions.
The Key Differences
Now that you know the basics of both workers’ compensation and employer liability insurance, it’s time to dive into the key differences between the two. These policies complement one another, but they do cover different things. When workers’ comp stops paying, your employer’s liability policy kicks in. Both policies cover injuries that happen on the job, but in different ways.
Here are some key differences between the two policies:
Workers’ compensation protects employees, and employer liability protects a business from lawsuits filed by third parties.
The state’s wage rate determines workers’ compensation insurance payouts. There is also a maximum amount. But payouts from employer’s liability insurance have no limit.
When compared to workers’ compensation, employer liability coverage is more extensive because it covers a wider variety of claims.
The Cost
As you saw above, you can get both of these coverages in a bundle as workers’ compensation insurance. So, let’s take a look at what that might cost. In general, the amount your business will have to pay for workers’ compensation insurance is typically calculated per every hundred dollars of your company payroll. While it’s impossible to give an exact figure without first taking into account the variables unique to your business. You can typically expect to pay anywhere from $0.60 to $2.27 per $100 of payroll for workers’ compensation.
In general, the amount you will end up paying can be affected by things like:
The state your business operates in – Please see our state-by-state workers’ compensations guides for more specific information on how this coverage works in your state. And how much you can expect to pay.
How many employees you have – The more employees you have, the greater the risk of injury in your workplace. Just by sheer numbers
How much you pay your employees – Again, your insurance company partially determines you rate on every $100 of payroll.
If you have seasonal workers
The type of work your business does – If all of your employees are office workers, your risk (and your cost) will be much lower than if your employees work with dangerous equipment or chemicals.
Claims history – Workplaces with few or no workers’ comp claims will be able to enjoy lower rates. So, make sure your workplace is as safe as possible!
It’s important to note that you might not technically need workers’ comp if you have few (or no) employees. In some states, employers with fewer than five employees do not have to carry workers’ comp. For example, in the state of Alabama, only businesses with five or more employees are mandated to carry workers’ compensation coverage.
With that being said, coverage is mandatory in most states for any company with even one worker. So, check out our state-by-state guides to workers’ comp. Then speak to an EZ agent for help finding out what your business needs and how much you can expect to pay for a policy.
How EZ Can Help
It is important to keep in mind that both your business and your employees will benefit from having workers’ compensation insurance that includes the right amount of employer liability. If you have any further questions about the specifics of workers’ compensation or employer liability, a knowledgeable EZ agent is available to answer them now. We help you find the best plans and our help is free! We can give you free, instant quotes, just enter your zip code into the bar above. Or speak to someone right now, call 877-670-3538.
Your small business can benefit from many different kinds of commercial insurance, including policies like general liability, commercial property, and small group health coverage. One of the most important policies to add to that list is workers’ compensation insurance.
With this type of policy, small business owners can protect their employees and themselves from the financial fallout of work-related injuries and illnesses. But do you actually need to carry this kind of coverage, or is it just good to have? Not only that, but how do you select the most appropriate workers’ compensation policy for your business, and what steps should you take to safeguard against worker’s compensation claims?
What Is Workers’ Compensation?
First, let’s explain what workers’ compensation is. Workers’ compensation, or workers’ comp, is an insurance policy that provides financial support to workers who are injured or become ill on the job. Employees who become ill or injured on the job are entitled to workers’ compensation benefits, within certain parameters, regardless of who was at fault: the employee, the employer, a coworker, a customer, or anyone else.
What Injuries Does Workers’ Compensation Cover?
Injuries that occur on the job are covered by workers’ compensation insurance for companies of all sizes, and regardless of how they occurred (such as a fall from a ladder). To give another example, if a delivery driver is in an auto accident while working, they may be entitled to workers’ compensation benefits.
Workers’ comp will generally also cover illnesses that are caused by workplace conditions. The state’s definition of “work-related illness” can include things like occupational lung disease, which has been linked to things like chemicals on the job and airborne particles. But be aware that different states and fields have different sets of regulations.
In addition, in many cases, employees can claim workers’ comp benefits for repetitive strain injuries like carpal tunnel syndrome, or for chronic conditions like back pain that manifest after a long period of time.
Workers’ Compensation Laws by State
Every state has its own set of laws and regulations when it comes to workers’ compensation. Below we’ve highlighted the basics for each state. If you would like more information about your state’s workers’ compensation laws and available policies, check out our state-by-state guide.
Alabama’s Workers’ Compensation Division is in charge of the state’s workers’ comp program. In Alabama, workers’ compensation insurance is mandatory for any business that regularly employs five or more people. In addition to being mandated by law, this coverage serves to safeguard both employees and the company.
Workers’ compensation not only benefits your employees by helping them pay for medical expenses and replacing a portion of their lost wages, but it also benefits you by shielding you from double payments, penalties, and fines, and by reducing your liability in the event of an accident on the job.
Any company in Alaska with one or more employees must have workers’ comp coverage. The only exception is if you have been authorized to self-insure (i.e., pay workers’ comp claims as they arise out of your own pocket rather than maintaining an insurance policy). In Alaska, workers’ compensation insurance is obligatory for nearly all workers, but this rule does not apply to the following groups of employees:
Part-time babysitters
Non-commercial cleaning staff
Employees hired to harvest crops, and other temporary or part-time workers
Officials in amateur sporting events
Contracted entertainers
Employees who work in commercial fishing
Taxi drivers who are employed under contracts
People who are receiving state subsidies for temporary help while performing required employment tasks
Players and coaches on professional hockey teams, so long as they have health insurance
Arizona operates under a “no fault” system for workers’ compensation. Because of this, it doesn’t matter who or what caused an accident at work, an injured worker is always entitled to medical care and compensation. The Industrial Commission of Arizona (ICA) handles workers’ compensation claims. Since its inception in 1925, the ICA has grown to include two departments: Claims and Administrative Law Judges.
The claims division’s employees can help, but they can’t give you legal advice. You can ask them anything you like about workers’ comp laws and they’ll know the answer. Hearing requests are sent from the Claims Division to the ALJ’s Hearing Division. Claims disputes, employer disputes, and insurance company disputes are all dealt with by the ALJ department.
When it comes to making sure that workers’ compensation laws in Arkansas are followed, it’s up to the Arkansas Workers’ Compensation Commission. The Commission is responsible for keeping tabs on workers’ compensation claims and benefits paid out across the state.
To legally protect your staff, a workers’ compensation insurance policy (or state approval to act as a self-insurer) is a necessity. In addition, the cost of workers’ compensation insurance must be covered in its entirety by your business; employees should not be required to contribute in any way. Failure to comply with these laws may result in civil penalties and the loss of liability protections afforded by workers’ compensation insurance and state law.
If you have employees in California, you must follow the state’s workers’ compensation laws. There are three things that must be done in order for your company to be in compliance:
Purchase workers’ compensation insurance to cover all required employees.
Provide new hires with a workers’ compensation pamphlet or brochure.
Put up a “Notice to Employees” poster around your workplace.
Additionally, it is illegal in the state of California to require employees to contribute to or offset the cost of workers’ compensation insurance. In contrast to health insurance and other benefits, there cannot be any payroll deductions required to provide coverage. In return, they generally can’t sue you if they get sick or hurt on the job.
The Colorado Division of Workers’ Compensation (DOWC) administers the state’s workers’ compensation system, which was established by the Colorado Workers’ Compensation Act of 1915. Workers’ compensation insurance is obligatory in Colorado for nearly any company with employees.
These cases are the exception to the rule:
Self-employed
Corporate officers
Limited liability company members
Workers’ compensation is optional for these workers but is still available if desired.
Any Connecticut business with one or more employees is mandated by law to have workers’ comp coverage. One notable exception is that companies do not have to carry insurance for domestic workers who put in fewer than 26 hours per week. Workers’ compensation insurance is required by law for all other employees, whether they are part-time, full-time, or seasonal.
In addition, being a business owner, member of an LLC, corporate executive, sole proprietor, or independent contractor does not necessitate workers’ compensation coverage. But even if this is the case for you, you may want to consider purchasing workers’ comp insurance because of the high cost of medical care. Workers’ compensation policies typically cover medical expenses and lost wages, while individual health insurance plans may not.
Any company with employees in Delaware must have workers’ compensation coverage in accordance with state law. Employees will be protected in the event of an accident or illness on the job, and your company will be protected from lawsuits as a result of this mandate.
Delaware law makes an exception for farms and ranches. But if they so choose, these businesses can still carry policies for their staff. If they don’t, they could be held responsible for any accidents that happen on the job. The Delaware Workers’ Compensation Fee Schedule is available for use as a resource for businesses and insurers in determining how much to pay for medical care for employees who have been injured on the job.
Workers’ compensation coverage is mandatory in Florida for businesses with four or more employees, per state law. However, the precise coverage you need will depend on factors such as the nature of your business, the size of your staff, and the types of employees you have.
In Florida, a workers’ compensation policy is mandatory for the following industries:
Businesses that employ at least one person in the construction industry. Keep in mind that corporate officers and members of limited liability companies (LLCs) are also considered employees.
Agricultural businesses employing at least six people. Coverage is also required if 12 temporary employees work more than 30 days in a season, but no more than 45 days in a calendar year.
Out-of-state employers with employees in Florida must have a workers’ compensation policy with an approved insurance carrier.
Contractors who use self-employed or independent contractors must ensure that they have workers’ compensation coverage for them before beginning a project in the state.
Any Georgia employer with three or more regular, temporary, or seasonal workers must carry workers’ comp insurance. Some workers, however, are exempt from this rule:
Railroad employees
Government employees in the United States
Farm laborers
Domestic employees
Workers’ compensation payments are based on the employee’s degree of injury or illness. Depending on the severity of the injury or illness, workers’ compensation benefits may be paid out for as long as 400 weeks.
In Hawaii, any company with employees must carry workers’ compensation insurance. This holds true for all workers, whether they are temp workers, seasonal workers, permanent workers, or full-time workers. Nonetheless, the laws requiring workers’ compensation in Hawaii are subject to a number of exemptions. The law does not require insurance for the following business owners and executives:
Independent contractors and sole proprietors
Business partners
Any corporate executive who owns at least half of the company
Members of limited liability companies (LLCs), if they are individuals (rather than business entities) and stand to receive at least 50% of the LLC’s value if the company is liquidated or sold.
You should seriously think about getting workers’ comp insurance even if it’s not mandated by law. It’s usually a good idea because individual health insurance policies rarely cover injuries sustained on the job, and those that do often don’t cover any lost wages.
Workers’ compensation insurance is mandatory in the state of Idaho for any business with one or more employees. Included are both regular and temporary workers, such as those employed during the summer and winter seasons. To comply with Idaho’s workers’ compensation laws, a policy must be in place before any employees can be hired. According to Idaho law, independent contractors fall under the category of employees, as well. To find out if your contract workers need insurance, talk to a representative from the Industrial Commission’s Employer Compliance division.
Workers’ compensation may not be mandatory in Idaho for some industries or classes of workers. Some examples are:
Domestic workers
Workers covered by the federal workers’ compensation law.
Pilots for dusting or agricultural spraying (these are only exempt under certain conditions)
Real estate brokers and salespeople who work on commission.
Volunteer ski patrollers
Secondary school athletic officials (grades 7-12)
Casual employees who work irregular hours and are unrelated to your business.
You may also be exempt if you are the owner of your business and:
You have no employees.
Your employees are your family and live in your home.
Workers’ compensation insurance is recommended even if your company is exempt from having to carry it. If you don’t have it, employees who get hurt or sick on the job can file a lawsuit against you.
Workers’ compensation insurance is mandatory in Illinois for most businesses. More than 91% of workers in Illinois are now covered by workers’ compensation insurance thanks to the state’s workers’ compensation law. Read up on the Illinois Workers’ Compensation Act to ensure you’re following the state’s legal requirements for workers’ compensation. Here are a few of the most crucial rules to remember:
Even if your employees are members of your family, you generally need coverage.
If you intentionally and deliberately fail to obtain coverage, you could be subject to a minimum $10,000 in penalties.
Employees have 45 days to inform their employers of an illness or injury.
Every six months, the Illinois Department of Employment Security updates its average weekly wage report.
Workers’ compensation benefits in the state of Illinois are subject to a three-business-day waiting period. This means that benefits will be paid out to an employee if they are still injured or ill on the fourth day following an accident or illness. If your worker misses work for more than two weeks in a row, they are eligible for compensation for those days. They will receive this benefit until they are healthy again.
Most employers in Indiana must carry workers’ compensation coverage. Workers who meet the criteria for independent contractor status as established by the IRS are a notable exception to this rule. A Workers’ Compensation Clearance Certificate and a $20 filing fee must be submitted to the Indiana Workers’ Compensation Board if any of your employees fall into this category. Independent contractors operating as sole proprietors are also subject to these rules.
There are some exceptions to the general rule that all Iowa employers must have workers’ compensation insurance. The following are examples of such exceptions:
Sole proprietors
Members of a limited liability company (LLC)
Partners in a partnership
Corporate executive officers owning at least 25% of common stock in the business.
Workers related to you.
Casual employees, whose work isn’t done for business purposes.
Employees earning less than $1,500 annually.
Some businesses are exempt from the state’s regulations, including those in the agricultural sector. Even if you are not required to have it by law, workers’ comp insurance is probably a good idea. Without insurance, you might have to foot the bill for a worker’s medical care if they get sick or hurt on the job. Employees who become ill or injured can also sue your business.
Workers’ compensation insurance is required by law in Kansas, with a few exceptions. Certain types of employers and employees are not included:
Employers in specific agricultural occupations
Firefighters who work for relief associations
Independent contractors who work in real estate
Employers paying no more than $20,000 in annual gross payroll.
Keep in mind that the $20,000 threshold applies to all payments, including wages earned outside of Kansas, for the purposes of a workers’ compensation exemption. Pay for partners and dependents of sole proprietors is not included.
Any company in Kentucky with even one worker must have workers’ comp coverage. You’ll also need proof of insurance, or a certificate of insurance, in the form of a letter from your insurer, outlining key provisions of your policy. Insurance certificates must be prominently displayed in the workplace in Kentucky. Kentucky’s workers’ compensation law provides an exemption for the following categories of workers:
Agricultural workers
Members of a religious group or sect that are morally opposed to insurance coverage
Housekeepers in a private residence with fewer than two other regular employees
Any person performing home improvement, maintenance, or repair work for a religious or philanthropic organization in exchange for food or other support for a period of fewer than 20 days.
Employees in Kentucky can actually opt out of workers’ compensation coverage by filing a Form 4 Waiver with the Department of Workers’ Claims. Once the waiver is issued, it will remain in effect until it is revoked. If a worker gets sick or hurt on the job but has declined insurance, they can still sue their employer in court. Here, the burden of proof shifts to the worker, who must show that the employer was negligent or malicious.
The state of Kentucky prohibits employers from requiring employees to sign a Form 4 Waiver as a condition of employment. Employees’ waivers are only valid if they are signed voluntarily. If businesses require employees to sign Form 4 Waivers, they risk legal repercussions.
If you have even one employee in Louisiana, state law mandates that you purchase workers’ compensation insurance. This includes all workers who are:
Full-time
Part-time
Minors
Seasonal workers
Keep in mind that you might not need workers’ compensation insurance if you don’t have any employees. If a corporate executive owns more than a predetermined percentage of the company, they can often get out of paying for this insurance. It’s also worth noting that the workers’ compensation regulations you must follow will change depending on the nature of your company. But, in general, if you have workers, you’ll need one of these policies in Louisiana.
Workers’ compensation insurance is mandatory in the state of Maine for most businesses. However, this law does not apply to the following employers and employees:
Employers in agriculture or aquaculture with seasonal or casual workers, if they have at least $25,000 in employer liability insurance and $5,000 in medical payments coverage.
Agricultural or aquacultural businesses with six or fewer employees that have at least $100,000 in liability insurance and at least $5,000 in medical payments coverage.
Domestic workers in a private home.
Sole proprietors who don’t have any employees.
Independent contractors hired on a project basis who are not full-time employees.
You are required to carry workers’ compensation insurance unless you are exempt. Without it, employees who get hurt or sick on the job can sue you for damages. Fines and criminal charges could also be levied against you and your company.
Both full-time and part-time workers in Maryland must be covered by workers’ compensation insurance. But the state of Maryland does not mandate workers’ compensation for agricultural employers with fewer than three employees, or an annual payroll of less than $15,000. Workers’ compensation insurance is optional in the state of Maryland for sole proprietors, partners in a business partnership, and independent contractors. But if you are in this category, you may want to consider buying this insurance to safeguard yourself against the high cost of medical care.
No matter how many employees you have or how many hours they work per week, you are required to carry workers’ compensation insurance in the state of Massachusetts. The only exception to this rule is domestic service workers, who must work a minimum of 16 hours per week in order to be eligible for workers’ compensation coverage. Moreover, sole proprietors are exempt from needing workers’ compensation insurance.
The Department of Industrial Accidents (DIA) is responsible for enforcing the workers’ compensation law in Massachusetts. They do not, though, have authority over the rates or class codes used to calculate workers’ compensation premiums. Instead, the Workers’ Compensation Rating and Inspection Bureau of Massachusetts (WCRIBMA) establishes these rates and codes.
Most businesses in Michigan are required to have workers’ compensation insurance by the Workers’ Disability Compensation Act. Workers’ compensation insurance is required if your business has three or more employees, or if any single employee works more than 35 hours per week for 13 weeks or longer.
In Michigan, workers’ compensation insurance is mandatory for both public and private sector employers.The state law, though, is not strictly applied in the following cases:
Employers with agricultural workers, unless they have three or more employees working more than 35 hours per week for 13 weeks.
Housekeepers and other domestic workers
Sole proprietors who are classified as self-employed.
Family members working as employees for a relative
Independent contractors
Workers’ compensation insurance laws and regulations in Michigan are very important to learn, since businesses risk financial penalties for noncompliance.
The Workers’ Compensation Act of Minnesota specifies the rules governing workers’ compensation in Minnesota. In the state of Minnesota, workers’ compensation insurance is mandatory for all businesses. However, there are a few cases where this law does not apply:
Household employees in a private home earning less than $1,000 in a three-month period.
Farm workers who do not earn more than a certain amount of money, as well as the farmer’s or employer’s immediate family members (spouse, parent, or child) who also work on the farm.
Casual employees who work only once or infrequently and are not employed permanently or on a regular basis.
If you have five or more employees in Mississippi, you are required by law to carry workers’ compensation insurance. But there are a few exemptions to the workers’ compensation rules in Mississippi. Workers’ compensation insurance is optional in your state for the following categories of workers:
Domestic workers
Farm workers
Employees of non-profit organizations
Religious or cultural organization employees
Independent contractors
Employees of the federal government
Certain maritime or transportation workers who are covered by federal workers’ compensation laws.
The state of Mississippi now has no-fault workers’ compensation insurance thanks to the Workers’ Compensation Act. That means that employees won’t have to worry about covering the costs of medical care or lost wages due to an injury on the job, regardless of who was at fault.
Any company in the state of Missouri with five or more employees is required by law to carry workers’ compensation coverage. All LLC participants and company executives need to be covered. In addition, if a construction company employs even one person, it must have insurance. Workers’ compensation insurance is not mandatory in the state for the following categories of workers:
Farm workers
Domestic workers
Some real estate agents
Direct vendors
Owner-operators of commercial motor vehicles (commercial truckers)
Consider purchasing a policy even if you don’t think you need it because your company has fewer than five workers. Without workers’ compensation, your company would be responsible for covering the cost of an injured worker’s medical treatment out of its own funds. In addition, if an employee is hurt or gets sick while on the job, they could sue your business.
Businesses operating in Montana are subject to stringent regulations regarding workers’ compensation. Unless exempt, every company that employs people must have workers’ compensation insurance. This rule applies to all companies, regardless of whether their workers are regulars or temp workers. With that being said, workers’ compensation insurance is not necessary for all types of employees, including:
Domestic or household workers
Commission-based salespeople in real estate, securities, or insurance
Newspaper deliverers
Freelance writers who are paid per article
Licensed barbers or cosmetologists employed by a cosmetology firm on a contract basis
In accordance with Nebraska law, any company with at least one employee must maintain workers’ compensation coverage. The following, though, are not covered by Nebraska’s workers’ compensation laws:
Railroad companies
Domestic workers who are employed in private residences.
Businesses employing agricultural workers.
Employees of sole proprietorships, partnerships, and LLCs are exempt from the requirement to carry workers’ compensation insurance as well. In addition, the state does not require workers’ compensation for corporate executives who own more than 25% of their company’s common stock. Executive officers of nonprofits in the state who earn less than $1,000 per year are also exempt.
Any of the above can buy this type of insurance if they choose to, though. This is a smart move because medical insurance typically does not pay for lost wages and only partially covers injuries sustained at work. If a company’s top executive wants to purchase workers’ comp insurance, they must inform both the insurance provider and the company secretary.
Workers’ compensation insurance is mandatory in the state of Nevada for any employer, be they an individual, a business, a nonprofit, or a publicly traded company with employees. The term “employee” refers to anyone who works for a company either directly or through a contract of hire or an apprenticeship. There is an exemption, though, for casual workers not related to your business who worked for less than 20 days and were paid less than $500.
Nevada is one of only a handful of states that requires workers’ compensation insurance to be carried by sole proprietors, independent contractors, subcontractors, and their employees. Unless they qualify as an “independent enterprise,” they are employees.
The state of New Hampshire mandates that all businesses carry workers’ compensation insurance. Employees who become ill or injured on the job are eligible to receive workers’ compensation benefits after four days of disability. But there is no need to wait the standard three days if:
The disability lasts for at least 14 days.
They return to a temporary, alternative job within five days.
The typical compensation for an injured worker is 60% of their regular weekly wage. Gross earnings in the 26-52 weeks prior to the injury will be added up and then divided by the number of weeks to get an estimate of their average weekly salary. Their weekly allotment will be based on their starting salary if they haven’t been with the company for 26 weeks.
Workers’ compensation does not apply to people who are sole proprietors, partners, or independent contractors. However, you have the option to purchase workers’ compensation if you fall into this category. Considering the high cost of healthcare, this is a prudent move, especially for those in dangerous professions.
Officers of corporations and members of LLCs are exempt from workers’ comp as long as their company has no more than three executives. But once a fourth executive or LLC member is brought on board, workers’ compensation insurance must be purchased. Subcontractors with no employees may also be required to obtain insurance by the project’s general contractor.
The state of New Jersey mandates that all businesses have workers’ compensation coverage. Even if your New Jersey business is an LLC or only hires seasonal or part-time employees, you are still required by law to carry workers’ compensation insurance. If you are unable to provide proof of insurance, you may be subject to a fine or criminal charges. There are some types of employees/business owners for whom workers’ compensation is not mandatory in New Jersey:
The state of New Mexico has strict requirements for employers to carry workers’ compensation insurance. Businesses with three or more employees are required to carry workers’ compensation insurance, and all construction companies, regardless of size, must do the same.
The state considers anyone who works for a company to be an employee of that company. The “three or more” rule applies to business owners who also perform work within the company. The mandated coverage extends to both full-time and part-time employees, as well as seasonal and remote workers. But there are a few exemptions to these rules:
Household employees
Real estate brokers
Employees of the federal government who are covered by the Federal Employees Compensation Act or other federal programs.
Contractors who work on their own
Even if insurance isn’t mandated in New Mexico, residents are urged to protect themselves by purchasing this type of coverage voluntarily. This will safeguard your company from legal action and provide financial security if they incur medical expenses. An Election to be Subject form must be filed with the Workers’ Compensation Association (WCA) before an exempt employer can voluntarily purchase coverage.
Workers’ compensation insurance is mandatory in the state of New York for any business with employees. There are narrow exceptions to this rule that an employer can take advantage of under state law. Having worker’s compensation insurance is recommended even if you are exempt. Without workers’ compensation, an employee who sustains an injury while on the job may be responsible for covering the full cost of their treatment out-of-pocket because their regular health insurance policy may not cover occupational injuries, and they may sue you for damages.
Businesses with three or more employees in North Carolina must comply with the NC Workers’ Compensation Act (NCWCA) and obtain workers’ compensation insurance. There are some exemptions to this rule in North Carolina due to the broad definition of “employee.” For example, workers’ compensation is not required for people who are self-employed or who are members or partners in a limited liability company.
Before hiring any staff in North Dakota, most companies are required by law to obtain workers’ compensation insurance, but some workers in North Dakota do not have to be insured. If they can prove their independence, independent contractors are exempt from having to purchase workers’ compensation. The individual asserting independent contractor status must provide evidence to support their position.
A determination by North Dakota Workforce Safety & Insurance (WSI) that an individual is exempt from workers’ compensation because they are an independent contractor will remain in effect for the duration of that calendar year. In order to receive an exemption, businesses or contractors should get in touch with WSI and ask for a “Independent Contractor Verification Application.”
The state of Ohio requires all businesses with employees to have workers’ compensation coverage. Officers of a corporation are employees unless they are serving pro bono. The following, though, do not fit Ohio’s definition of an employee:
Domestic workers earning less than $160 per quarter, such as cooks or gardeners.
Most volunteers
Workers’ compensation insurance is mandatory for those working part-time, but in the event of an injury, the part-time worker’s benefits would be determined by a formula that factors in the person’s typical working hours.
In Oklahoma, almost all businesses are mandated to carry workers’ comp coverage. Your state’s laws regarding workers’ compensation may provide exemptions for certain categories of workers, employers, and business owners:
People who are self-employed (sole proprietors)
Members of a limited liability company (LLC) who own at least 10% of the capital.
Members of a partnership
Stockholders in a business who own at least 10% of capital.
Family businesses with five or fewer family-related employees
In addition, independent contractors are not eligible for workers’ compensation coverage because they are not considered employees. To determine whether an individual is an independent contractor or an employee, the state of Oklahoma employs a rigorous, multi-factor test. The government takes into account the following:
The contract’s nature
The degree to which the principal employer has control over the work.
Whether the individual works in a specific occupation or runs a business for others
Whether the individual works under supervision or on their own
If your worker is considered an independent contractor, you are not required by Oklahoma law to provide them with workers’ compensation coverage. But you should still look into workers’ compensation even if your employees are exempt, because gaps in coverage can leave your company vulnerable to lawsuits.
Having workers’ comp insurance is a legal requirement for most businesses in Oregon. With that being said, workers’ comp is optional for the following types of workers:
People who work in a private home providing a domestic service, such as home health aides
Gardening, maintenance, repair, or remodeling workers hired by a homeowner.
Casual workers
Employees with annual earnings of less than $500
The state of Oregon does not mandate that you purchase workers’ compensation insurance for these workers, but you are free to do so if you choose. Lack of workers’ compensation coverage can leave you and/or your business vulnerable to lawsuits, so it’s a good idea to look into it even if your employees are exempt.
Employers in the state of Pennsylvania must cover their employees with workers’ compensation insurance. Workers’ compensation benefits in Pennsylvania include payment of a portion of lost wages and medical costs for any employee who sustains an on-the-job injury, regardless of whether they work full-time, part-time, or seasonal hours. If all of a Pennsylvania business’s employees fall into an exempt category, like railroad workers, longshoremen, federal employees, and domestic workers, the business is exempt from carrying workers’ compensation insurance.
If you’re a sole proprietor or self-employed, you don’t have to worry about getting workers’ comp. But self-employed workers in Pennsylvania are still eligible for lost wage and other benefits under a workers’ compensation policy, so it is a good idea to purchase coverage even though it is not mandated by law. It’s also possible that a business that wants to hire you as an independent contractor will be hesitant to do so if you don’t have your own insurance.
If you or your employee are exempt from workers’ compensation coverage, you must file an exemption application and supporting documentation with the Bureau of Workers’ Compensation of the Pennsylvania Department of Labor and Industry.
If you have employees in Rhode Island, the law requires you to carry workers’ compensation insurance. Posters showing proof of workers’ comp insurance, including the name of your insurance provider, must be displayed in the workplace. There is a potential $250 fine for not doing so.
You can include an employee in your workers’ comp policy even if they are exempt from required coverage. In the event of an accident on the job, this can help safeguard both them and your company.
Businesses with four or more employees in South Carolina are required to carry workers’ compensation insurance. All employees, whether full- or part-time, as well as unpaid or compensated family members, are counted here. This is also true for nonprofit organizations.
Subcontractors must be included in the general contractor’s insurance policy unless they have their own policy. If an employee of a subcontractor is injured on the job, the general contractor can avoid legal trouble by relying on the subcontractor’s workers’ compensation coverage. There is no legal requirement for sole proprietors, partners, independent contractors, or members of an LLC to purchase workers’ compensation insurance for themselves.
Even if it’s not mandated in your state, you should get workers’ comp insurance. Injuries sustained at work may not be fully covered by your health insurance, leaving you with costly out-of-pocket expenses. In addition, unlike workers’ comp, health insurance does not compensate for income loss.
Unlike in many other states, businesses in South Dakota are not mandated to have workers’ comp insurance. But in order to protect themselves from potential lawsuits, businesses are strongly encouraged to purchase workers’ compensation insurance. Purchasing workers’ compensation insurance will shield you from liability should an employee sustain an injury on the job and sue you for negligence.
If you’re self-employed or working on a contract basis, getting this insurance may be required or simply make good financial sense. Work-related injuries may not be fully covered by health insurance, even if you have it. Furthermore, unlike workers’ compensation, health insurance will never pay for lost wages in the event of an illness or injury.
In Tennessee, having workers’ compensation insurance is not only recommended, but mandated by law. Businesses with five or more employees in Tennessee, including family members, part-time workers, and corporate officers, are required to carry workers’ compensation insurance.
Furthermore, construction businesses and trades with one or more employees are required to carry workers’ compensation. If you are a sole proprietor, partner, officer, or LLC member of a construction company, though, you may qualify for an exemption. Employers in the coal mining industry must cover their workers with workers’ comp insurance.
Even if your business’s size makes it exempt from being required to carry workers’ compensation insurance, you can still purchase a policy. An “Exempt Employers Notice of Acceptance of the Tennessee Workers’ Compensation Act” must be filed with the Tennessee Bureau of Workers’ Compensation prior to the purchase of any such policy. You will have to submit Form I-8 to the state to opt into carrying workers’ compensation insurance, and you must also use that same form to notify the state when you no longer wish to carry workers’ compensation insurance.
Unlike the majority of other states, Texas does not mandate that businesses have workers’ compensation insurance, though businesses that opt out still need to inform both the state and their employees that they do not provide workers’ comp. Having said that, there are specific categories of businesses and employees who must be covered by workers’ compensation. If you are a sole proprietor, independent contractor, or otherwise self-employed, you may wish to protect yourself financially by purchasing workers’ compensation insurance even though it is not mandated by law. Potential customers may insist that you carry this coverage.
And, if you work in a hazardous field or perform physically demanding tasks, investing in workers’ compensation insurance is a prudent financial move. If you sustain an injury at work, your health insurance provider may not pay for all of your necessary medical care. In addition, unlike workers’ compensation, health insurance never pays for lost wages.
Most employers in the state of Utah need to have workers’ compensation coverage. Workers’ compensation insurance must be purchased to cover any and all employees beginning with the first hired. Employees of sole proprietorships, LLCs, partnerships, and independent contractors are not required to carry this coverage, though.
The corporate officers and directors of your company may or may not be required to carry workers’ compensation insurance. But you will be required to apply for an exemption from the Utah Labor Commission and notify your workers’ compensation insurer if you choose not to purchase workers’ comp. Even if it is not mandated by law, investing in workers’ comp is a sensible financial move. If you get hurt on the job, your health insurance may not pay for all of your medical expenses. In addition, unlike workers’ compensation, health insurance never pays for lost wages.
The state of Vermont requires all businesses with employees to carry workers’ compensation insurance, with the following exceptions:
Sole proprietors or partners in unincorporated businesses
Members of limited liability companies (LLCs) and corporate officers
Casual workers, or those who are not employed in the core functions of the business.
Someone who participates in amateur sports.
A person employed in agriculture or other farm jobs whose employer has an annual payroll of less than $10,000.
Certain elected officials and volunteers
Vermont law mandates that you have workers’ compensation insurance if an independent contractor provides labor for your project. You are not responsible for providing insurance if the contractor is working alone.
Businesses with three or more regular or temporary employees in Virginia must have workers’ comp coverage. In addition, businesses that contract out work to outside parties must count those contractors as employees for the purposes of workers’ compensation.
In Virginia, sole proprietors who employ neither regular employees nor independent contractors are exempt from the requirement to carry workers’ compensation coverage. Virginia’s Workers’ Compensation Commission (VWC) does not require sole proprietors to file an exemption or waiver form. With that being said, the state treats you as an employee for workers’ comp purposes if you are an executive or corporate officer at your company. But it does allow you to opt out of insurance coverage if you so choose. To opt out, you will have to:
Have valid workers’ compensation coverage for your company’s other employees.
Fill out a Rejection of Coverage form and submit it to the Virginia Workers’ Compensation Commission.
File a copy of the form with your insurance company.
In the state of Washington, workers’ compensation insurance is mandatory for any company with employees. Coverage is typically obligatory if you have any employees, including independent contractors and part-timers. However, the following employees are not subject to the state’s workers’ compensation laws:
Domestic workers, when there is only one employed, and they do not work more than 40 hours per week.
Gardening, maintenance, and repair workers in private homes
Musicians and entertainers at specific events
Children under the age of 18 who are employed by a parent for farm work.
Cosmetologists and barbers who rent or lease their space.
In the state of West Virginia, workers’ compensation insurance is mandatory for any company with employees. There are a few loopholes in West Virginia’s workers’ compensation laws, though. You won’t need workers’ comp insurance for:
Fewer than three employees who work temporary jobs lasting no more than ten days per quarter.
Five or fewer agricultural workers
Domestic workers
Church employees
Athletes in professional sports
Temporary state employees
Emergency service volunteers
Longshore and harbor workers
Workers’ compensation insurance is optional for sole proprietors and independent contractors in West Virginia. If you fall into this category, though, it is highly recommended that you purchase insurance to cover the costs associated with a work-related injury. Injuries sustained on the job are not always fully covered by health insurance, and lost wages are never covered, unlike with workers’ comp.
Almost all employers in Wisconsin are required to carry workers’ compensation insurance. All employees, whether full- or part-time, as well as their dependents of any age, must be insured. The Wisconsin Workers’ Compensation Act mandates insurance for almost all workers, but there are some exceptions depending on the nature of the job. Exceptions to the need for workers’ compensation include:
Domestic workers
Volunteers, including those in nonprofit organizations, who are paid in cash or other items worth $10 or less per week.
Members of a religious sect
Employees of Native American tribal enterprises (including casinos), unless the tribe chooses to waive sovereign immunity and voluntarily participate in state workers’ compensation.
The majority of real estate brokers, agents, and salespeople
Certain federal employees who are covered by federal workers’ compensation programs.
Most employers in Wyoming are required by law to purchase workers’ compensation insurance to cover their employees. Those who are exempt from mandatory insurance coverage include:
Casual workers
The majority of professional athletes
Domestic workers in private households
Private duty nurses who work for an individual
Employees of the federal government
Volunteers for some organizations
Although some Wyoming businesses may be exempt from carrying workers’ compensation insurance, it is important to note that all businesses in the state are required to register with the Division of Workers’ Compensation and Unemployment Insurance. Furthermore, the following business owners are exempt from the provisions of the Wyoming Workers’ Compensation Act regarding workers’ compensation insurance:
Independent contractors and sole proprietors
Partners
Limited liability company (LLC) members
Corporate executives
The aforementioned proprietors are free to invest in a workers’ comp policy if they so desire. Getting workers’ comp is a smart financial move, because medical insurance won’t compensate you for lost wages and may not fully cover injuries sustained on the job.
EZ Can Help
Even if you have only one non-family employee, it is likely that you will need to include the price of workers’ compensation insurance in your business budget. But don’t worry: an EZ agent can tell you exactly how much coverage you need, and find the right policy for you, at the right price. And if you’re also considering group health insurance, general liability insurance, commercial property insurance, or any other policies for your small business, we can help you find the best policy – or the best bundle – around.
Please get in touch if you have any questions about our small group medical, general liability, and workers’ compensation insurance. Licensed EZ insurance agents can assist with determining which state regulations apply to your business and can explain your insurance options once you give us some information about your company, its needs, and your risks. After they get to know you and your business, your EZ agent will work with you to locate a policy that meets your requirements at a price you can afford. Call 877-670-3538 right now to get started.
You buy workers’ compensation insurance to cover employees in the event of a work-related illness or injury. But not every business owner knows the risks to their business if they opt out of coverage. Or the risk of not having enough coverage to meet your company’s specific needs. Most states have a law that requires workers’ compensation insurance after you have a certain number of employees so not having coverage could be illegal. Leaving your business vulnerable to large claims and possible lawsuits that could leave it bankrupt is the last thing you want to do. Below we’ve made a list of the most common myths about workers’ compensation. And what the facts are so you don’t get misled and make a decision based on some bad advice.
Myth 1: Small Low Risk Businesses Don’t Need Workers’ Compensation
In most states, workers’ compensation insurance is required by law, and many require it as soon as you hire your first employee. It’s important to understand your state’s requirements to avoid compliance issues. Businesses that choose not to carry workers’ compensation insurance despite being required to may be subject to severe penalties and fines. Additionally, injuries can occur even in low-risk industries, so you should be covered no matter how safe your job is. Not to mention, the costs associated with work-related injuries, including medical expenses and lost wages, can build up quickly especially if you don’t have proper coverage. Having a proper workers’ compensation insurance policy in place will protect your business from all angles.
Myth 2: I Only Have A Couple Employees, I Can Pay Out Of Pocket For An Accident
Most states do allow you to self-fund workers’ compensation claims, however it’s not easy to do it. A self-insured workers’ compensation plan is one where you, the employer, assume the financial risk for providing workers’ compensation benefits to your employees. Instead of paying a set monthly premium to an insurance company or state-sponsored workers’ compensation fund, self-insured businesses pay the cost of each claim out-of-pocket as they happen. Since a self insured company assumes this financial risk, it must have the financial resources to meet the obligation.
So for smaller businesses this might not be a viable option. There are even some states who won’t even allow companies to self-insure. And even if your state does allow it you have to apply for the permission to self-insure. Which includes state-specific requirements for example you could have to prove you have a networth of at least $500,000 among other things. Essentially you have to prove you can foot the bill for any and all workers’ compensation costs for every employee that you have.
Myth 3: I Don’t Have Employees, I Use Subcontractors So I Don’t Need Coverage
When you bid on a job your possible client may request proof of workers’ compensation insurance for yourself and any subcontractors who will be working with you. For instance, if you are an electrician and bid on a wiring job for a school, the school will need to know that you and your team all have coverage before they’ll even consider your bid. If you don’t have coverage and you or a crew member are injured on the job, your health insurance can deny coverage because it’s a work related injury. Many health insurance policies will not cover these types of injuries.
At most you can buy yourself a workers’ compensation policy and require any subcontractors you hire to have their own valid policy. Before your team begins working make sure that they have a valid certificate of insurance. If they don’t, and they get injured, you may be held responsible for any injuries which is a huge financial risk.
Myth 4: Seasonal Businesses Don’t Need Coverage
You need the insurance while your business is operating. The majority of insurance companies will write you a seasonal business policy, so long as you clearly define your open and closed period. For example if you have a pool cleaning/maintenance business and only operate between April and October, your insurance company will activate your service in April and pause it in October. That way you are covered while you’re open and don’t have to pay premiums when you’re closed.
Myth 5: I Only Employ My Family Members, I Don’t Need To Cover Them.
In most cases, a family member who works for you is still considered an employee. Like any other employees that are required to be covered. Damages for on-the-job injuries can cost hundreds of thousands of dollars, without a proper policy you risk footing all of that and then some. You leave your business open to punitive damages, as well as lawsuits along with all those medical bills. Just because they’re family does not guarantee they won’t sue you.
Myth 6: My Employees Work From Home They Don’t Need Coverage
You may believe that workers’ compensation does not apply to home-based employees because you cannot control their working conditions. However, that is wrong. You are still obligated to provide a safe workplace for employees. Even if they work from home or a remote location just as you would for an employee who works on site. All employees are entitled to workers’ compensation benefits. Although home-based employees might have a harder time proving that their injuries are work related.
Myth 7: If My Employee Doesn’t File A Claim The Day Of The Injury They Can’t File It Later
There are numerous reasons why an employee may delay filing for workers’ compensation. For example, if your employee slips and falls while moving boxes. The employee might get up and feel a little sore but otherwise fine. But over the next week or so their back becomes increasingly stiff and painful. They go to the doctor and the doctor informs them that they actually have an injury, and it was most likely due to their fall and continuing to move boxes has only made the injury worse. Even though your employee did not immediately report the fall, they are still eligible to file for workers’ compensation. Every state has a statute of limitations for how long your employee has to file a claim. So just because they didn’t file that day doesn’t mean they can’t still claim.
Myth 8: Worker’s Compensation Stops Employees From Suing
This is only half true. Yes, if the employee receives workers’ compensation they cannot sue you for the injury itself. However, there are certain circumstances where they can still file a suit against you. For example if the injury was caused by faulty machinery that didn’t have proper maintenance or safety precautions. The employee could sue you for negligence for not properly maintaining the equipment. Or if you manufacture the piece of equipment that injured your employee they can sue you for product liability.
Myth 9: If The Accident Is The Employee’s Fault They Can’t File A Claim
This is another common misconception about workers’ compensation insurance, but it’s mostly untrue. The misunderstanding likely comes from you confusing workers’ compensation claims with a personal injury lawsuit. It is true that in order to file a personal injury lawsuit, the employee’s injuries had to have been the company’s fault. But that isn’t the case with workers’ compensation. Workers’ compensation is mostly no-fault. Meaning if your employee has a work related injury or illness, they are eligible to file a claim. Regardless of who was at fault. It makes no difference if you believe they should have been paying more attention or could have avoided the accident. The only exceptions to the workers’ compensation no fault rule is if your employee was under the influence of drugs and alcohol at the time of their injury. Or if they intentionally hurt themselves to attempt workers’ compensation fraud.
Myth 10: I Don’t Need An Insurance Agent To Get The Best Policy
This is a difficult myth; a do-it-yourself approach could lead to costly errors. Despite the fact that there are several online tools and carriers that can help you buy a policy. But they can’t help with everything the way an agent can. For example, if you fill your application out and select the wrong classification code for your employees. You will end up owing a massive fine at the end of the year audit. Or your insurance provider could deny you coverage due to the misclassification or other error. We highly recommend consulting with a licensed agent who specializes in workers’ compensation insurance. They will recommend the appropriate coverage and guide you through the process step by step.
Here at EZ, we connect you with your own personal insurance specialist who can quickly compare plans available in your area all while staying within your budget. And they do it all for free! That’s right none of our services cost you anything. Our only goal is to make sure you get the best workers’ compensation coverage, and any other business insurance coverage for that matter. To get started, enter your zip code in the box below or call 977-670-3538 to speak with an agent today.
Even if you suspect the workers’ compensation claim is false. You have to file it when the employee comes to you with it. You can be penalized if you fail to report a work-related injury with a full report of all related details as soon as possible. The insurance claim adjuster’s job is to determine whether or not the claim is valid or not. You are paying premiums to your insurance company so that they can handle these matters. If your report is thorough and you work closely with your adjuster, there is a good chance the adjuster will catch the fraudulent claim and deny it anyway. So, delaying or not filing a report because you think it’s invalid could backfire on you, best to just let the adjuster do their job. 
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