The Most Common Workers Compensation Claims

A workers' comp claim (formerly known as Workers’ Comp) is a formal request made by workers who suffer an injury because of their work. This system puts forth financial support to cover medical bills, lost wages and depending on the severity, disability or death benefits.

This protection, in the form of workers' compensation insurance, offers mental relief, knowing workers will not face financial hardship if the unexpected happens on the job. It is a key part of maintaining a fair and safe working environment, ensuring workers can focus on recovery without stressing over their income or medical expenditures.

Also Read Workmen Compensation Claim Settlement Process

There exist various workers' compensation policies created to cover diverse kinds of disabilities workers may experience because of work-related injuries. Here is a breakdown of the key types of worker’s compensation insurance policies:

Temporary Total Disability

This applies to employees who are temporarily unable to work due to a workplace-related illness or injury. Once they have recovered, they are able to resume their usual responsibilities.

Temporary Partial Disability

This cover supports employees who are able to work but in a limited role and with reduced pay. It helps make up for the loss of income until they are fully recovered and can return to their usual duties.

Permanent Total Disability

This coverage applies to employees who experience illnesses or injuries that permanently prevent them from going back to jobs in any capacity. The benefits are intended to offer long-term financial assistance.

Also Read: What Are The Features of Workman Compensation Policy?

Permanent Partial Disability

This cover applies to employees who suffer a permanent injury that partially affects their capability to work. The policy offers compensation based on the severity of the disability and how it influences the employee’s capacity to secure a living.

The most common workmen compensation cases employees file provide insight into occupational illnesses and workplace injuries. Generally, the maximum claims for workmen compensation insurance are for the following types of injuries:

Sprains and Strains

Sprains and strains are among the most reported injuries in workers’ compensation claims. These injuries are common and can be quite painful and disruptive to daily life. Sprains and strains occur in any workplace or job, though those in physical or manual labour roles face a higher risk.

Activities like pulling, falling or twisting—especially when performing physical tasks or lifting heavy objects can lead to these injuries. It is crucial to take care when operating machinery, handling heavy loads or engaging in physical work.

Concussions

Concussions in the workplace can occur due to a fall or other head-related impacts, and they are often the subject of workmen compensation claims due to the severity of the injury.

These injuries are considered among the most serious since the lasting effects on a person’s brain are profound. Concussions may lead to symptoms like headaches, memory loss, insomnia and sensitivity to noise.

Certain safety measures are enforced in industries with a higher risk of workplace concussions, such as mandatory hard hats for all onsite supervisors and workers in active construction zones.

Lacerations and Contusions

Injuries like lacerations or contusions often result from interacting with work equipment or machinery. While these terms may sound alarming, a contusion is simply a bruise and a laceration is a scrape, cut or gash on the skin.

These injuries may occur in any work environment, and while they are typically minor, they can also become more severe (such as a deep gash or severed limb).

Businesses generally secure a workmen compensation policy online or offline to make sure employees are shielded in such incidents. Such a policy provides essential financial coverage for health expenses, lost wages and rehabilitation costs, offering mental satisfaction to employers and employees in the face of unforeseen workplace accidents.

Repetitive Stress Injuries (RSIs)

Repetitive stress injuries are quite common and typically result from repeated motion or movement at work. Carpal tunnel syndrome is one such example of an RSI. Whether you are a graphic designer, receptionist, health aide or factory worker, anyone can be at risk for these types of injuries.

The symptoms often include throbbing, gradual pain, cramping and stiffness. The affected area may also feel weak or numb at times, but these symptoms develop over time due to the nature of the injury.

Note: RSIs can be more challenging to prove in a workers' comp claim as they develop gradually. Hence, it is crucial to report the injury to your employer as soon as you experience pain and to get written documentation of the injury.

Slips, Trips and Falls

Slip-and-fall injuries are common in various work environments. They occur unexpectedly, triggered by loose carpeting, wet floors or objects on the ground. These incidents often lead to "reaction injuries", where a person tries to catch themselves during a fall and gets injured. Falls from scaffolds, ladders or other elevated platforms also result in injuries.

These injuries are frequent among factory workers, construction workers, and manual labourers. In fact, slip-and-fall incidents are among the most common workmen compensation insurance claims. While these injuries may not cause immediate pain, they should not be underestimated. These injuries intensify over a day or two and cause significant discomfort.

Workplace Burns and Electrocution

When you think of burn incidents at work, you might imagine employees working in a restaurant kitchen. And that is absolutely true—scalds and burns are common for food service workers.

As the saying goes, "Those who cannot handle the heat must stay out of the kitchen.” Nonetheless, those working in kitchens face that heat daily, making burns a significant occupational hazard.

The International Journal of Environmental Research and Public Health states that individuals working with chemicals, hot furnaces, electrical sources and steam are also at risk of burns and electrocution, which fall under this category. These injuries range in severity and are typically covered by a workmen compensation policy.

Also Read: How Does Workmen Compensation Injury Settlement Work?

The most crucial thing is knowing the risks linked with your job prior to beginning work for your recruiter. Some jobs are at a higher risk of work-related injury than others. Factory workers, construction workers and manual labourers are at a larger risk of work-related injuries because of the physical requirements of the job, along with the equipment and tools they use daily. That does not mean other jobs do not have risks. You can get hurt anytime, anywhere.

At TATA AIG, we get it—your employees are your business’s backbone. Our workmen compensation policy is designed to give them the protection they deserve, making sure they are covered during a work-related illness or injury.

For SMEs, prioritising employee safety is a game-changer. With TATA AIG’s SME insurance policy, you can relax knowing your team and business operations are cared for, leaving you to focus on scaling your business without worry.

• What illnesses or injuries are usually not covered by workmen's compensation insurance?

  Workmen's compensation insurance typically excludes coverage for illnesses or injuries resulting from civil disturbances, war, substance abuse, self-inflicted harm or accidents that occur outside of work-related activities.

• Are there any pre-existing medical conditions that could be excluded from coverage under workers' compensation insurance?

  Absolutely. Pre-existing medical conditions not worsened by job-related tasks or workplace are typically not covered under the workmen compensation policy.

• What is the typical processing time for a workers’ comp claim?

  The processing time for a workmen compensation policy claim can vary based on the case’s complexity and the investigation involved. However, quick reporting and effective communication can help speed up the procedure.