Insured Solutions
Insured Solutions
Workers' Compensation University

Client FAQs

What is workers’ compensation?

Workers’ compensation, often called workers’ comp or WC, is an insurance program that protects employers when an employee is hurt on the job. More...

What are the penalties for not having workers’ comp?

Just say “NO!” Employers should never think they can slide by without workers’ comp. More...

What does DWC stand for?

DWC is an abbreviation for Division of Workers’ Compensation. More...

What is a Medical Provider Network?

An MPN, or Multiple Provider Network, is a group of health care providers approved to treat injured workers within a specific state’s workers’ compensation program. More...

What are rating bureaus?

Insurers collect a mountain of data in the course of doing business. Those insurance carriers send their workers’ comp stats to rating bureaus to analyze the WC claims. More...

What criteria do insurance carriers use to determine workers’ comp premiums?

What a company does can bring risk to an insurance carrier. More...

What is the experience modification rate?

The experience modification rate is usually shortened to MOD. More...

What is a PEO?

PEO is short for Professional Employer Organization. More...

What is workers’ comp through a PEO? How is it different?

In the workers’ comp arena, a PEO like Insured Solutions knows the ins and outs of workers’ comp. More...

Can owners be excluded from covering themselves on workers’ comp?

Yes, up to 5 owners can exclude themselves from workers’ comp with a direct write policy. More...

When should you report a workers’ comp claim?

Injuries should be reported immediately – within 24 hours. More...

Can an employer terminate an employee who is out on workers’ comp leave?

Of course an employer CAN fire an employee on workers’ comp leave, but SHOULD they? More...

Are prescription drugs covered under workers’ comp?

All prescription drugs are covered under workers’ comp, although some drugs require an approval process. More...

Is medical care covered even if there is no lost time?

Yes, medical care is always covered under workers’ comp even when there is no lost time. More...

What are monopolistic states?

Legislatures in a handful of states mandate that companies buy workers’ comp directly from their states instead of the open marketplace. More...

What is subrogation?

A right of subrogation creates a means for insurers to go after a third party who was at fault and caused the insurer to lose money in the form of claim dollars. More...

What is a waiver of subrogation?

A waiver of subrogation, commonly known as WOS, is inserted as a contract clause that waives or releases the right of an insurer to sue a third party. More...

From injury to claim: A step-by-step guide to workers’ comp.

Step 1. When a complaint of pain or an injury occurs on the job, it must be reported to a supervisor or manager. More...

If an employer finds out about a prospect’s/employee’s previous claims, what should they do?

Previous injuries can be found after a job offer is made by using a Post Offer Medical Questionnaire followed by a medical evaluation based on the EFJ (Essential Functions of the Job). More...

Can an employer submit a claim for an undocumented employee injured on the job?

Every employee, regardless of legal status to work in the U.S., are covered under the employer’s workers’ comp plan and receives the same care and benefits as any other worker. More...

Are part-time employees covered under workers’ comp?

Part-time work equals full-time workers' comp benefits. More...

Are independent contractors covered?

Independent contractors are not eligible for workers' compensation coverage and employers are not required by state law to purchase coverage for independent contractors. More...

As a contractor, what is needed to make sure subcontractors are covered?

Just as we make sure as individuals to keep our health and auto insurance up to date, so contractors who use subcontractors on their jobsites should require a current workers’ comp certificate as proof of coverage. More...

What can you do if you hire a contractor and their employee is injured?

Contracting with an outside company can be a risky proposition when it comes to workers’ comp. But there are steps that the prepared employer can take. More...

Can a terminated employee file a workers’ comp claim?

Any ex-employee can file a workers’ comp claim within one year of injury. More...

If an employer hires a family member, can the employer pay a doctor directly?

An employer can pay for a family member/employee's injury as long as they report that injury as a claim to workers' comp and the claim is assigned a claim number. More...

Should an employer report minor claims?

All soft tissue injuries must be reported - no exceptions. More...

Should an employer report a workers’ comp claim late? If they do, is there a penalty?

Your client should always report injuries or complaints of pain even if they are treated on site. More...

In the case of an auto accident should an employee file under workers’ comp or car insurance?

When an employee is in an auto accident during the “course of employment,” they should file under both car and workers’ comp insurance. More...

What are the specific variables for different industries and how are they classified?

Rating bureaus assign individual class codes to each industry type. More...

How are workers’ comp premiums determined?

To determine an employer’s workers’ comp premium, a calculation is made from several rating elements. More...

What are the costs associated with late claims?

A claim can be late because an employee didn't report an injury immediately, there may be an attempt to defraud workers' comp, or the employee may think the injury is not serious. More...

Can employees pay part of workers’ comp?

Employees cannot pay part of their employer’s workers’ comp. More...

How do you avoid workers’ comp fraud?

No business wants their WC claim count and dollar amounts to rise, but they especially don’t want suspected fraudulent claims to go through their WC. More...

Is behavioral testing available to help reduce workers’ comp fraud?

Yes, there are tools that can help prevent fraud by eliminating questionable hires before they can commit fraud. More...

What are the penalties to an employee who makes a false claim?

Workers’ comp fraud is illegal and states levy fines (up to $10k) plus jail time (up to 2 years) to anyone caught lying about an injury. More...

What can you do if you are suspicious of a fraudulent claim?

A paper trail is essential if fraud is suspected. For Insured Solutions’ clients, a tool called a “Red Flag” kit guides them through the process of documentation. More...

How does an employer determine which level of care an injured employee needs - the ER or the clinic?

When an employee is injured, rule number one: if something is broken, if there is a lot of blood or if they are unconscious, they immediately go to the emergency room. More...

When should an employer keep human resources in house and when should they outsource HR?

Human resources (HR) is essential to an employer’s workers’ comp survival. More...

How does the legal system integrate with workers’ comp?

Just as each state has its own unique laws and regulations governing its citizens, so do state DWCs. More...

Are employees covered under workers’ comp while driving to work?

States disagree on the “driving to work” question. More...

Are employees covered under workers’ comp while working off site?

As long as an employee is being paid, they are covered by workers’ comp. More...

Are employees always covered under workers’ comp while working on site?

States vary on whether employees are covered in every circumstance while on company property. More...

Is an employee covered under workers’ comp if an injury occurs on a different business property?

Employees are covered no matter where they are as long as they are on company business.

If an injury is sustained at a previous employer and it shows up at the new employer, what happens?

A workers’ comp claim never really leaves its employer/carrier of origin – no matter how much time passes. More...

Are remote workers covered under workers’ comp?

Yes, remote workers are covered under workers comp as long as they were on a submitted PEO payroll and the premium is not in arrears. More...

When are lost wages awarded for workers’ comp and how are they calculated?

When employees are hurt on the job, they may miss work. As a benefit, a portion of their lost wages are paid back to them through workers’ comp. More...

Should I be on offense or defense with workers’ comp?

Offense, offense, offense. It is crucial as an employer. It’s the only way an employer can take charge of workers’ comp. More...

How are benefits handled when an employee dies and who receives those funds?

When an employee dies on the job or his/her death is connected to the job, the employer must report the death within 8 hours. More...

Disclaimer

The information herein represents 40 years of daily involvement with workers’ compensation during which time legislative laws have and continue to change on a state by state basis. The information herein is NOT legal nor is it intended to represent a legal position. For real-time state-specific guidance, you should consult with your assigned lost-time (carrier) adjuster who is required to have annual state-based re-certification training enabling them to best represent your interest in real time.