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Summary of differences between federal and state regulations
There is no federal workers’ compensation requirement for most private employers.
Insurance requirement: Self-insurance by private carrier, individual employer, or groups of employers
Exemptions from WC: Employers with a total gross annual payroll of less than $20,000 for all workers. Agricultural employers are not required to secure coverage but may do so voluntarily.
Effective May 15, 2011, workers’ compensation coverage may be denied if an injury results from the employee's: deliberate intent to cause injury; willful failure to use a guard or protection which is required by any statute and provided for the employee; willful failure to use a reasonable and proper guard and protection voluntarily furnished by the employer; reckless violation of the employer's workplace safety rules or regulations; or voluntary participation in fighting or horseplay with a co-employee for any reason, work related or otherwise. These exceptions do not apply when it was reasonable (under the circumstances) to not use such equipment, or if the employer approved the work engaged in at the time of an accident or injury to be performed without such equipment.
Medical benefits provided: Full
Physician selection: Employer selects physician.
Benefits for temporary total disability (TTD): 66 2/3 percent of worker’s wage for the duration of disability. Total amount payable is $100,000. Benefits subject to UI and Social Security benefit offsets.
Benefits for permanent total disability (PTD): 66 2/3 percent of worker’s wage for the duration of disability. Total amount payable is $125,000. Benefits subject to UI and Social Security benefit offsets.
Benefits for permanent partial disability (PPD): 66 2/3 percent of worker’s wage for up to 415 weeks. Total amount payable is $100,000 for a work disability and $50,000 for a functional disability. Benefits subject to UI and Social Security benefit offsets.
Scheduled awards: Scheduled awards are paid in addition to and upon termination of temporary total disability benefits. Awards are reduced by number of weeks of TTD benefits received.
Disfigurement benefits: When a disfigurement is a handicap in obtaining or retaining employment, compensation will be paid up to a maximum of 415 weeks.
Death benefits for surviving spouse and children: Initial payment of $40,000. 66 2/3 percent of employee’s wage. Children receive benefits beyond age 18 if physically or mentally disabled, or until age 23 if full-time students. Total maximum payable is $250,000 excluding dependent children. Benefits subject to UI and Social Security benefit offsets.
Maximum burial allowance: $5,000
Waiting period: 7 days for temporary total and permanent partial disability. Compensation is retroactive if disability continues for 3 consecutive weeks from date of injury.
Rehabilitation: Both vocational rehabilitation (VR) and physical rehabilitation (PR) are covered. Employers may be required to provide PR & VR by Director of WC. Employers also pay TTD or TPD during rehab, and in absence of Federal & State funds, pay VR costs for a maximum of 36 weeks, and $3,500 to the employee for board, lodging, and travel; and in unusual cases, an additional 36 weeks and $2,000 may be approved. Employees must accept both PR and VR or have their compensation suspended. Employees receive TTD benefits plus board, lodging, and travel during VR.
Attorney fees: 25 percent, statute, determined by agency
Occupational hearing loss statutes: Employee has 1 year to file for compensation. Benefits for one ear are $13,470, both are $49,390.
Federal
Contacts
None.
Regulations
None.