Workman's Comp. vs. "On the job injury" - what's the diff?

[emeleel]

I'm curious about something, and thought perhaps some of you more knowledgable business-types could tell me what this is.

As you know, my mother recently fell at work and broke her hip. This happened when she got her foot tangled in a keyboard cord. (She'd been sitting down, jumped up to get something off another desk, and fell before she even realized she was tangled, because she was moving so fast.)

Of course, we assumed Workman's Comp would be covering everything, but instead, she's being covered by "On the job injury" coverage. It's taking care of everything wonderfully, I have NO complaints, I'm just curious as to what the difference between the two would be.

I'm figuring perhaps WC is related to job-inherent dangers, and OTJI is just for any ol' accident that just so happens to occur at work? Am I close?

****

Just to show how wonderful this coverage is - my mom is unable to go home right now because she is unable to put any weight on her injured leg at all for at least 10 more weeks. (It's not cemented.) Getting in the house is next to impossible because of how it's situated on a hill, with lots of steep steps to get in. Even if she could get in, the house inside is not all that great for getting around.

They were checking into assisted living, but happened across a studio apartment that has a standing shower. This OTJI coverage is paying for this apartment for at least 3 months, maybe longer, daily home health for bathing, dressing, laundry and shopping and physical therapy 3 days a week! And, they moved out the apartment's double bed and moved in a hospital bed for her! Basically, whatever she needs to recover, they are paying for, no matter how long it takes. If she were having to file this on her own insurance (HMO) she'd probably get chucked in a cheap nursing home at best or shot home even if it hard to get home. UAB is really taking care of my mommy!

[magenta321]

Can't help with your ?, but I'm glad they are taking good care of your mom. That's rare these days!

[brian_igo]

I'm not familiar with the legal difference between the two, and I haven't heard of "on the job injuries" as a seperate class from workmans compensation. But since workman's compensation standards and definitions are set at the state level, this could be something that is unique to Alabama.

Does anyone have a local view?


Brian

[frazzledspice]

One possible difference:

Workmen's Comp might pay you for life (at least if you're a NY resident.)

My husband's stepfather died in a car accident after being called into work on an emergency in the middle of the night. My mother-in-law received monthly payments till her kids were 18, and a smaller monthly payment for the rest of her life.

My friend slid on the ice outside the school where she was an Art teacher. She received monthly payments from Workmen's Comp for many years due to back trouble sustained in the fall. She had to go for periodic checkups. She was permitted to earn $9,000 a year while collecting payments, but if she earned more, she'd lose it completely.

She had her fourth child a year later. While he was little, she became an adjunct professor in the Ed Department of one of the city colleges, working with two students, earning less than $9,000 a year.

I know that there were people more disabled than she was who weren't working the system....in a sense they subsidized her so she could afford to stay home with her fourth child....

On the other hand, my friend in St. Louis, a former flight attendant, had been injured on a 747 when the plane lurched and a loaded food cart hurtled into her below the flight deck, pinning her to the wall. Her back was injured more severely than my NY friend's. After all was said and done, she only got $7,000 in a lump sum.

[mjfrombuffalo[$]]

[not a lawyer and don't play one on TV]

Companies pay into Workman's Comp programs run by the states. Companies in some states can opt out of Workman's Comp but must have their own insurance setup to cover worker injuries on the job. Cheaper for the companies to do it this way IF they have a trend of few injuries on the job. That may be the difference, but this is based on a 10-minute portion of a lecture in Non-Profit Administration II class last semester.

[poseidon]

I'm not a lawyer, nor do I play one on TV, either.

However...

I am an insurance adjustor and for five years I did handle Worker Compensation claims in both Colorado and Utah.

A business owner could be excluded from Worker Compensation benefits in Colorado (sorry, don't remember if Utah had the same rules). He or she could still be injured on the job, it's just that Work Comp wouldn't pay for it -- a health insurance policy would pay for the injuries.

Worker Compensation kicks in any time you are injured on the job -- and it doesn't have to be job-related. If you're horsing around (the term that insurance carriers use really is horseplay) and hurt yourself, you are still covered by Worker Compensation benefits. If, however, you were injured on your lunch hour and you were taking your lunch off-premises (and for the sake of argument, you weren't in a company-owned or company-leased vehicle), then you would not be covered by Worker Compensation benefits.

I have never heard the distinction of OTJI versus WC.

The only thing that I can think of is I think that in order to qualify for Worker Compensation insurance, a company must have at least three employees (and, of course, be paying premiums for the insurance).