What does Workers’ Compensation do?
Workers’ compensation is a state law that requires employers to provide insurance coverage to employees if they are injured on the job. Workers’ compensation was created to replace the traditional tort law system, in which employers could be sued for large amounts of money and workers would not be guaranteed compensation for their on the job injuries. Under workers’ compensation in Hawaii, so long as an employee can show that his injury is work-related, an injured worker will be guaranteed compensation regardless of who caused the accident.
Are All Hawaii Employers Required to Provide Workers’ Compensation?
Generally yes. However there are a few situations under which workers do not have to be covered by workers’ compensation. These exceptions include:
- Volunteers or other unpaid workers
- Students that work in exchange for room, board or tuition
- People who work on behalf of religious groups (priests, rabbis, etc.)
- Certain stockholders
- Real estate agents and brokers
- Domestic workers that are paid less than $225 per calendar quarter
Note, that employers can file to have the excluded workers be covered under their workers’ compensation policy if they choose to do so. The general rule is that if an employer has two or more workers, that work full or part-time, the employer is required to provide coverage for his employees.
I’ve Been Injured at Work in Hawaii, What Should I do?
- Report your injury to your employer or supervisor as soon as you can. Your notice of injury should be in writing and should describe how you sustained your injury as well as the date your injury occurred. Notice should be given to your employer within three days of your injury or from when you discovered your injury. Your employer will then have seven days to report your injury to the Hawaii Disability Compensation Division via a WC-1 form (Employer’s Report of Industrial Injury). You should also receive a copy of this form once your employer has completed it.
- Receive medical attention from a doctor. You have the right to choose your own doctor to take care of your injury, but you will only be covered for one physician for your injury. Your doctor will then provide you will initial treatment and confirm that your injuries are work-related for your employer’s insurance carrier. Afterwards, you should expect to receive compensation benefits within a week or so.
What Types of Workers’ Compensation Benefits are Available in Hawaii?
Workers compensation will compensate you for any relevant medical costs, so long as the medical costs are in relation to your work-related injury. Workers compensation is also used primarily to compensate workers for lost wages because of their injury. These income benefits include:
- Temporary Total Disability (TTD)
If you have sustained an injury that has completely stopped you from working, but this injury is still in the process of healing, you may qualify for Temporary Total Disability (TTD) benefits. TTD benefits are equal to two-thirds of your average weekly wage from before your injury. However, if your average weekly wage from before your injury is less than the state average weekly wage, you will be paid your full wage from before your injury. These benefits will be paid to your until your injury has reached its Maximum Medical Improvement (MMI). There is a three day waiting period after your injury before you can receive compensation.
- Permanent Total Disability (PTD)
Sometimes injuries never fully heal, and if you still cannot work after your injury has reached MMI, you may qualify for Permanent Total Disability (PTD) benefits. In order for an injury to be considered permanent and total, it must fit the following criteria:
- Complete and permanent blindness in both eyes.
- Loss of both feet at or above the ankle.
- Loss of both hands at or above the wrist.
- Loss of one hand and one foot.
- A head injury that results in incurable imbecility or insanity.
The amount of compensation for PTD benefits is equal to two-thirds of your average weekly wage from before your injury. Your PTD benefits cannot be higher than the state’s average weekly wage, or below 25 percent of it.
- Permanent Partial Disability (PPD)
If you are only partially disabled because of your injury, but your injury has healed as much as it ever will, you may qualify for Permanent Partial Disability (PPD) benefits. PPD benefits are determined using a list of “scheduled” injuries, all of which have their own allocated amount of compensable weeks. To calculate how much total compensation you will receive for PPD payments, multiply the amount of compensation you would receive for a TTD payment and multiply it by the amount of compensable weeks for your injury.
- Temporary Disability Insurance (TDI)
In some cases employees might miss work because of an off-the-job injury or sickness (this includes pregnancy), in such a case you may qualify for Temporary Disability Insurance (TDI). To qualify for TDI benefits, you must have worked for a company for at least 14 weeks, worked for than 20 hours, and earned an average weekly wage of at least $400. This type of benefit varies depending on what policy your employer has. TDI will cover a portion of your wage, but will not cover any other expenses.
You may also receive compensation for vocational rehabilitation and retraining, as well as compensation for disfigurement. You average weekly wage is based on your average weekly wages for 52 weeks before your injury.
What Should I do if My Hawaii Workers’ Compensation Claim is Denied?
Claims are not denied very often, and when they are it is usually because a claim is filed incorrectly. In that situation, it could jeopardize your right to compensation if your claim is challenged by your employer or his insurer.
The best course of action, if your employer does not file a claim on your behalf, is to file one yourself via a WC-5 form. If your claim is challenged, you should retain an experienced Hawaii workers’ compensation attorney. Retaining a workers’ compensation attorney will make sure that you are properly informed about all of the aspects of your case, and will give you the best chance to win compensation if your case is appealed. Additionally, workers’ compensation attorneys are paid on contingency, meaning they won’t charge you up front.
The claims process is complicated, and requires a detailed knowledge of law to fully comprehend. This is why your employer or his insurer will have an attorney if your case goes to a hearing. So don’t be unprepared in that situation. After a hearing, you will receive a ruling in less than 60 days from a Division Hearing Officer, but this ruling can be appealed if necessary.