The exact number varies by state, but there’s a MINIMUM amount, and a MAXIMUM amount, so it’s not always 2/3, but if you make more than the min, and less than the max, it’s about 2/3. That’s because 1/3 of your paycheck goes out in taxes – and you don’t PAY taxes on workers comp benefits. If you were to get MORE than that, you’d bring home more money on workers comp than you would working – which is not the point of insurance.
No, not every “injury” at work is compensable. Typically, if you’re involved in a fight, and fighting isn’t in your job description, the injury from the fight is not going to be covered. If you have a heart attack because your arteries are clogged, it’s not going to be covered.
Which doctor you can see depends on which state you live in. Some require you to see a panel physician, and if you’re still being treated after 90 days, you can see whoever you want. BUT, Workers Comp medical benefits are paid on the Medicare scale, and doctors can’t bill you the difference, so some doctors won’t take wc clients.
I don’t think there’s a hard timeline with how long your claim can be left open. Most companies try to get them closed within a year for medical only claims, and within 3-5 years for serious claims.
Just saw your extra questions. There’s a WAIT before lost wages kicks in. Typically, it’s five days – you have to MISS more than 5 consecutive days, then lost wages pay retroactive to day one. If you miss four days – no lost wages coverage. If you miss four days, go back for three days, then the five day count begins again. Medical bills have NO bearing on lost wages – it’s purely about days of work missed.
Regarding the injury time limit – the EMPLOYER has three days to report the injury to the department of labor and industry, AFTER being notified by the employee. The longer an employee waits to report an injury, the harder it is to prove the injury happened – the more likely that they’ll be declined. MOST injuries are reported within an hour, but they SHOULD be reported within a day. If you go back two weeks to try to report an injury, you’ll be flagged as a potential fraud case.
