Compensation/Benefits

1. Compensation/Benefits By : Mindy Altice and Chris Harris

2. What is Workers' Compensation? • Workers' Compensation is insurance, paid for by your employer, that provides cash benefits and medical care if you become disabled because of an injury or illness related to your job. • All employees are covered by the Workers' Compensation Law. • If death results, benefits are payable to your surviving spouse and dependents as defined by law.

3. Special Federal Statutes • There are some special federal laws which provide additional protection to certain classes of worker: • The Jones Act (The Merchant Marine Act) provides seamen with the ability to seek benefits known as "maintenance and cure" when they are injured as a result of their employer's negligence while working on U.S.-flagged vessels. • The Federal Employment Liability Act (FELA) makes railroads engaged in interstate commerce liabile to employees, where the employees' injuries result from the railroad's negligence. • The Longshore and Harbor Worker's Compensation Act (LHWCA) provides Worker's Compensation benefits to certain classes of employees of private maritime employers. • The Black Lung Benefits Act provides compensation to miners suffering from "black lung" disease (pneumoconiosis).

4. Virginia Workers’ Compensation • The Virginia Workers' Compensation Act ("the Act") was enacted on March 21, 1918, and became effective on January 1, 1919. • The Act was originally modeled on Indiana's statute. • Virginia was the thirty-seventh state to pass a workers' compensation law. • The Act provides a no-fault remedy for workers who are injured in their employment. • "No-fault" • The worker must establish the conditions for compensability set out in the Act before he or she can recover benefits. http://www.vwc.state.va.us/

5. Who’s Liable for Payment? • When compensability of a work-related injury is established, the employer becomes liable for payment of the benefits provided in the Act. • Generally, employers secure this liability by purchasing workers' compensation liability insurance. • As long as the employer has this insurance, benefits are generally paid by the insurance company directly to the injured worker. • Over three million workers, approximately 98 percent of Virginia's workforce, are covered by workers' compensation insurance.

6. The Act’s Inception • The Act was intended to provide a comprehensive benefit structure for injured employees. • It provides wage loss benefits as well as reimbursement for medical expenses related to the compensable injury. • The Virginia Workers' Compensation Commission administers the provisions of the Act generally, and acts as an adjudicator where a dispute arises between the parties as to workers' rights or employers' obligations. .

7. What Are Your Responsibilities? • Give notice to the employer as soon as possible. • File a claim with the Workers' Compensation Commission within two years from • The date of the accident • The date the doctor diagnoses an occupational disease. • Select a doctor from a panel of three provided by the employer/carrier. • Do not change doctors without employer/carrier permission or after a hearing by the Commission. • Seek and accept employment if released to light duty, and cooperate with "rehabilitation counselors." http://www.workerscompensationlawfirms.com

8. Limits for Filing a Claim • An employee must file a claim with the Workers' Compensation Commission within two years from the date of the accident or any right to benefits may be lost. • Claims for an occupational disease must be filed within two years from the date the doctor tells the employee the disease is work related, or five years from the date the employee was last exposed to the work condition causing the disease, whichever is sooner. • If no claim is filed with the Commission or no award entered, the employer may stop paying medical expenses or wage loss at any time.

9. BENEFITS • Benefits available to injured workers vary by bargaining unit. • Such benefits include: • Additional wages • Health insurance coverage • Retirement service credit • Priority • Information on other benefits is detailed in the various union contracts.

10. Benefits Under the Act • Wage Replacement • (Temporary total or limited) • Lifetime Medical Benefits • Permanent or Partial injuries • Permanent and Total Disability • Death Benefits • Cost of Living Increase • Vocational Rehabilitation http://www.vwc.state.va.us/bene_amts.htm

11. Wage Replacement (Temporary total or partial) • While temporarily unable to perform any work, an employee is entitled to 2/3 of his or her gross average weekly wage up to a set maximum weekly limit. • There must be seven (7) days of disability before benefits are payable. • If disabled for more than three weeks, the employee receives payment for the first seven days. • Benefits cannot exceed 500 weeks unless the person is totally and permanently disabled.

12. Lifetime Medical Benefits • Medical expenses for conditions caused by the accident or occupational disease are payable for as long as necessary, provided a claim was filed by the employee within the required time period. • The employee must select a doctor from a panel of three physicians provided by the employer/carrier. • If a panel is not offered after notice of the accident, the employee may seek treatment from any physician. • The treating physician may refer the employee to other doctors. Once treatment begins, the physician cannot be changed without approval of the employer/carrier or after a hearing by the Commission. • The employee must cooperate with medical treatment or the weekly benefits may be suspended. • Medical bills should be sent to the insurance carrier for payment.

13. Permanent Partial Injury • Separate benefits are payable for the permanent loss of use of a body part such as an arm, leg, finger, or eye. • Vision and hearing loss, as well as disfigurement may also be compensated. • This does not include the back, neck or body as a whole. • Benefits are for a specific number of weeks depending on the percentage of loss. • The employee can receive these benefits while working if maximum medical improvement has been reached.

14. Permanent and Total Disability • Lifetime wage benefits may be payable if an individual loses both hands, arms, feet, legs, eyes, or any two in the same accident, or is paralyzed or disabled from a severe brain injury.

15. Death Benefits • A surviving spouse, children under 18, children under 23 enrolled full time in an accredited educational institution, parents in destitute circumstances or other qualifying dependents may be entitled to wage loss benefits. • Death benefits include funeral expenses not to exceed $10,000 and transportation cost of $1,000.

16. Cost of Living Increase • A person receiving temporary total, permanent or death benefits is entitled to cost of living increases effective October 1 of each year if the date of the accident is prior to July 1 of that year and if the combination of compensation and Social Security benefits are less than 80% of the pre-injury earnings. • Cost of living increases must be specifically requested by the employee.

17. Vocational Rehabilitation • Employees who are released to light duty work must prove that they are actively looking for a light duty job, even if they expect to return to their regular job. • You must accept all suitable positions offered, or risk suspension of benefits. • Where appropriate, an employee may be entitled to retraining.

18. What is a Cafeteria Plan? • A cafeteria plan is a separate written plan maintained by an employer for employees that meets the specific requirements of and regulations of section 125 of the Internal Revenue Code. • It provides participants an opportunity to receive certain benefits on a pretax basis. • Participants in a cafeteria plan must be permitted to choose among at least one taxable benefit (such as cash) and one qualified benefit. http://www.irs.gov/govt/fslg/article/0,,id=112720,00.html#1

19. Qualified Benefit • A qualified benefit is a benefit that does not defer compensation and is excludable from an employee’s gross income under a specific provision of the Code, without being subject to the principles of constructive receipt. • Qualified benefits include: • Accident and health benefits (but not Archer medical savings accounts or long-term care insurance). • Adoption assistance • Dependent care assistance • Group-term life insurance coverage • Health savings accounts, including distributions to pay long-term care services

20. What Ferrum has to offer . . . http://www.ferrum.edu/hr/benefits.htm And Ferrum’s Workers Compensation Form http://www.ferrum.edu/hr/Documents/RMAccidReport.rtf

21. No Questions Please!!!!The End!