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Workers' comp, short for workers' compensation, is a set of laws designed to protect workers. They ensure employees who become injured or disabled while at work that they will be provided with fixed monetary awards. This effectively eliminates the need for court cases and litigation.
Workers' comp also provides benefits for the family of the worker should the worker pass away because of work-related accidents or illness. The laws are also designed to protect fellow workers and employers by limiting the amount of money an employee can claim from an employer. In most cases, workers' comp also eliminates fellow employees from liability for the co-workers accident.
The Federal Employment Compensation Act has statutes set in place that are limited to federal employees, or workers employed in some way in interstate commerce. Many of its rules are the same as the workers' comp laws. These laws are limited to death or disability while performing employee duties, but the death or disability must not have been caused while under the influence of intoxication or by willful neglect of the employee's duties.
This act covers medical expenses due to disability, and the employee may have to undergo retraining. A disabled worker will receive two thirds of their monthly salary and may receive more if the injuries are permanent. The employee may also receive more if they have a family. Compensation is also provided for dependants of a worker who dies from work-related causes.
Within the Industrial Commission, there are two divisions that monitor the activities of insurance agents. One is The Claims Division and the other is the Administrative Law Judge (ALJ). They also oversee any disputes that arise between claimants, employers and insurance agents.
The Claims Division is responsible for the regulation of insurance carriers. They ensure that workers' comp claims are dealt with in accordance to state laws and rules. The Claims Division processes around 6,000 claims per day. It deals with workers' comp claims from injured workers and doctors who have attended the accident scene. Every year, the Claims Division decides on around 30,000 workers' comp claims, with problems ranging from loss of earning capacity to bad faith issues with employers.
The ALJ, or hearing division, resolves disputes that arise in workers' comp cases. During the workers' comp case, a wide variety of issues can be referred to the ALJ. These can include continuing benefits, reopening of claims, supportive care, compensation and the loss of earning capacity. The Claims Division will file a request regarding the dispute and send it to the ALJ. The final outcome of the dispute then rests with the ALJ.