Defining Different Types of Workers’ Compensation Injuries

Workers’ compensation policy provides compensation for workplace injuries. It is a monetary benefit that employees receive in the event of workplace-related injuries. This monetary compensation has been made compulsory by the Workmen's Compensation Act 1923, to be given by employers to their employees who suffer any injuries due to workplace accidents.
The act covers a range of injuries and only the covered injury categories will be compensated.

Also Read: Key Features of Workmen's Compensation Policy Explained

Here are the types of injuries that are covered under the Workmen's Compensation Act 1923.

Permanent Total Disability

Permanent total disability includes types of workers’ compensation injuries that prevent employees from performing any of their prior duties and responsibilities ever again. It means the injury has a long-term or permanent impact on their ability to earn a livelihood.

If the employee suffers from permanent total disability, they are entitled to 60% of their monthly salary multiplied by the relevant factor (worker’s age) or an amount of ₹1,70,000, whichever is higher.

Permanent Partial Disability

Permanent partial disability is a workplace injury that renders employees from performing their duties to the same capabilities as before the injury, for the rest of their employment. The workers’ compensation act provides compensation for such injuries based on the type of injury and its impact on the employee’s loss of earning capability.

The Workmen's Compensation Act provides a detailed list of types of workplace accidents leading to permanent partial injuries. Compensation for this type of injury is decided based on this list.

Temporary Disablement

Temporary disablement injuries are workplace injuries that temporarily leave employees incapable of earning their livelihood. In such cases, compensation is provided every two weeks, at 25% of their monthly income, which is 50% of their earned wages.

However, to receive compensation under this liability, the employee must undergo a medical examination. Moreover, after a month of injury, the employee on temporary disability leave must undergo a medical examination every subsequent month if they continue to claim disability.

Death

In the event of an employee's death due to a workplace accident, the employee’s immediate dependents are entitled to compensation. The compensation provided to the beneficiary is 50% of the employee’s monthly wages multiplied by the relevant factor (employee’s age) or an amount of ₹1,40,000, whichever is higher. Moreover, ₹5,000 will be paid as funeral expenses to the eldest surviving dependent of the deceased employee.

Also Read: Workmen's Compensation Insurance Coverage and Injury Leave

To get workers’ compensation benefits, the employees need to meet certain criteria.

• The employee must be defined as an “employee” under the Workmen's Compensation policy of 1923.
• The injury or illness to the employee must have happened while they were performing their duties. Any injuries or illnesses that occur outside the workplace location are not covered.
• The workplace injury must have resulted in permanent or partial disability, temporary or permanent total disability or death of the employee.
• The employee must inform the employer about the workplace injury or illness within the specified time limit. Failure to report the injury or illness in a timely and proper manner to the employer can lead to claim rejection.
• After any workplace injury, the employee must be treated immediately by a professional doctor. The doctor’s certificate and report will help in filing the workmen's compensation claim.

Medical Expense Coverage

The workers' compensation policy provides financial coverage for all medical expenses related to treating injured employees due to workplace accidents. This includes hospitalisation bills, medication and medical treatment expenses. Thus, the employee can focus on recovery without worrying about money.

Income Aid

While recovering from any types of occupational disease or injury, employees still need an income source, especially if they are the sole earners. In such situations, the workmen's compensation policy’s monetary benefits help them stay afloat.

Disability Benefits

The workers' compensation policy also provides financial support in case employees suffer from injuries resulting in disability. The compensation provided is calculated based on the type and degree of disability, helping employees cope with the disability and maintain their living standards.

Rehabilitation Support

The WC insurance policy also provides rehabilitation support after workplace injury or disablement. This helps employees recover sooner and earn their livelihood.

Accidental Death Benefits

In case of an employee's unfortunate death, the workers' compensation policy provides financial support to the deceased employee’s direct dependents. The compensation includes either 50% of the monthly wages or ₹1,40,000.

Intimate the Insurer

The first step is to inform the policy provider about the incident as soon as possible. At the latest, it should be done within 7 days of any type of workplace accident.

Submit the Form and Evidences

To initiate the claim, the workmen's compensation claim form needs to be submitted. Moreover, attach all the documented evidence related to the incident. The evidence acts as proof during the claim procedure. Make sure to submit them within 30 days of the date of the actual incident.

Submit the Documents

Collect all the supporting documents, such as doctor’s prescriptions, hospital bills and medical records, for the compensation procedure.

Document Review

After all the evidence and documents are submitted to the insurer, the insurer's insurance agent will review them and proceed with the settlement process within 30 days. The final verdict is given in the court of law.

Also Read: How Does Workmen's Compensation Injury Settlement Work?

Understanding the types of workers' compensation injuries is necessary for both employees and employers. All injuries and disabilities have different compensation thresholds and terms and conditions for getting them. With this knowledge, employees can get their rightful claim to compensation, and employers will be able to pay their due compensation accurately.

However, all this knowledge of workers' compensation can only be useful when employers have bought a WC insurance policy for their employees. A workmen compensation policy provides legal coverage to employers in the event of employee-related injuries and issues. Moreover, it gives financial support to employees when their income is affected due to any workplace injury.

With TATA AIG workmen's compensation, employers can fulfil their obligations, and employees can be safeguarded against financial stress. Our other SME Insurance plans, such as group health insurance and fire and burglary insurance, help organisations promote asset and employee safety and enhance brand image. Moreover, our easy online purchase and streamlined claim settlement process add to the benefits of getting a business insurance policy with us.

Also Read: Workmen Compensation Insurance Policy Tariff Guide

What are the most common workers' comp injuries?

Some of the most common injuries claimed under workers’ compensation are sprains, strains, muscle sprains, cuts, bone fractures, and lacerations.

What injuries are not covered under the Workmen's Compensation Act 1923?

Certain workplace injuries are not covered under the Workmen's Compensation Act 1923. These include injuries under the influence of intoxication, self-inflicted injuries, injuries not resulting in extended disablement, and injuries due to wilful disobedience at the workplace.

What is the maximum compensation for workmen's compensation injuries?

The maximum compensation payout in the unfortunate event of an employee’s death due to workplace injury is 60% of their monthly wages or ₹1,70,000, whichever is higher.