Get the Most from Your Healthcare Workers’ Comp

workers comp for healthcare facilities
By: 
Mordechai Kamenetsky
Last Updated: 
March 13, 2023
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Workers’ compensation insurance is integral to any industry. 

It ensures that workers (employers and employees alike) are taken care of in the event of an injury, accident, or illness associated with the workplace. That’s valuable regardless of the work someone does. Accidents can happen in any job. 

However, this coverage is particularly vital for medical providers and staff. Healthcare workers’ comp means workers are covered for the unique challenges and hazards that come with working in the medical field. 

No two days are alike in medicine and things happen quickly. All it takes is a slip of the hand, a twist in the wrong direction, or not noticing a spill on the tile floor for an accident to happen.

Table of Contents

What Hazards Do Healthcare Workers Face? 

Healthcare is a physically demanding job, more so than many people realize. 

Medical workers spend most of their shifts on their feet and physically interacting with patients. Shifts tend to be long, too, and 12-hour shifts aren’t uncommon. 

Long, difficult shifts leave them more prone to health issues and accidents. Packed schedules with little time off make healthcare workers’ comp even more important. 

Changes in the workplace ease the burden, but employees need healthcare workers' compensation insurance coverage and care when those changes aren’t possible or the unexpected happens. 

Some of the most common injuries healthcare workers face include strains, sprains, slipped discs, and other injuries associated with lifting and moving patients. Handling patients is part of the job for most healthcare workers and preventing injuries entirely isn’t possible. 

There are tools and safety training options available that teach healthcare workers safe lifting practices and train them to use tools designed to ease the burden of patient handling, though. 

In other industries, workers’ comp claims typically deal with injuries occurring on the job, but that’s different for healthcare workers’ comp, too. 

workers comp for healthcare facilities

Doctors, nurses, medical assistants, and many other healthcare employees are routinely exposed to biological hazards as part of their routine, meaning a higher instance of comp claims related to illness. Viruses, bacteria, bodily fluids, and more - healthcare workers deal with all of it and then some. 

During unprecedented events like the Covid-19 pandemic, medical providers and staff see a sharp increase in workplace-related illness. It’s estimated that illness-related healthcare workers’ comp claims increased nearly 250% in 2020 due to the pandemic. 

It’s difficult to imagine a time when medical providers were more important to society than at the height of the pandemic. Workers’ comp for healthcare workers eases the burden on the medical employees everyone relies on. 

To recap, medical staff and providers commonly face: 

  • Slipped discs
  • Back injuries
  • Strains
  • Sprains
  • Infectious diseases
  • Infections
  • Broken bones

What Does Healthcare Workers’ Compensation Insurance Cover? 

Workers’ compensation offers several different benefits. Even if every claim doesn’t require the use of every benefit, having them offers peace of mind. They’re there if and when they’re needed. 

Healthcare workers’ comp covers: 

medical cost

Medical Costs - Medical costs range from short-term diagnostic and care requirements to long-term (even lifelong) coverage. States regulate workers’ compensation differently, meaning there are variations in the timeframe for drawing benefits.

However, workers’ compensation covers medical expenses as long as the treatment is related to the original injury or illness or until the patient accepts some sort of settlement that ends liability.

Medical costs are anything from doctor’s appointments and medication to reasonable mileage reimbursement. 

lost wages

Lost Wages - Like medical costs, states regulate wage reimbursement differently. Depending on location, an employee may receive reimbursement beginning after five days of missed work, after a week, or whatever period is set by state regulations.

The amount of reimbursement differs and depends on the extent of injury and state rates. Generally speaking, employees will receive around two-thirds of their average weekly wage.

Those suffering total impairment or disability as a result of their workplace injury or illness receive a higher payment, typically. 

Funeral and Death Benefits

Funeral and Death Benefits - The thought of healthcare workers losing their lives as a result of a workplace illness or accident is tragic. Unfortunately, it happens.

Healthcare workers’ comp pays out funeral expenses to cover burial costs and, in most cases, offers a death benefit to surviving spouses or dependents of the deceased.

In some cases, those payments last for the rest of the spouse’s life. Workers’ compensation offers peace of mind for medical staff in multiple ways - they receive the care they need and know it will be passed to their loved ones, too. 

What information does the insurance company need? 

The need for healthcare workers’ comp is clear, but how do you obtain coverage? 

Many medical positions are high-risk (for some obvious and not-so-obvious reasons) and underwriters need a lot of information to give accurate rates and coverage.

Employers understandably seek to keep premiums as low as possible, too. Below are a few tips about how insurance companies determine rates and what employers can do to streamline the process. 

Class Codes 

Insurance companies use an equation combining payroll information and class codes to determine rates. Class codes are set by the NCCI (National Council on Compensation Insurance) and designate the amount of risk for each position. 

Class codes, like most aspects of workers’ comp, vary a bit by state. The most common class codes for healthcare are: 

  • 8824 - Retirement Living Centers: Health Care Employees
  • 8824 - Assisted Living Facilities, ALF: Health Care Employees
  • 8824 - Nursing Homes, SNF: Health Care Employees
  • 8826 - Retirement Living Centers: All Other Employees
  • 8826 - Assisted Living Facilities, ALF: All Other Employees
  • 8826 - Nursing Homes, SNF: All Other Employees
  • 8831 - Veterinary
  • 8832 - Physician & Clerical
  • 8832 - Dentist & Clerical
  • 8832 - Health Clinic or Urgent Care
  • 8833 - Hospital: Professional Employees - This code includes employees of public or private hospitals as well as asylums or sanitariums. 
  • 8835 - Home, Public, And Traveling Healthcare - All Employees
  • 8835 - Companion Care
  • 8835 - Home Health Care / Home Health Aide
  • 8835 - Personal Care Provider
  • 8842 - Group Homes - All Employees & Salespersons, Drivers

8832 is one of the most-used class codes for medical employees and it does include clerical employees (meaning comp code 8810 does not apply to clerical workers in this industry). 

Nursing staff is usually classified depending on location (8823 for doctor’s offices and 8824 for nursing homes), though underwriters may decline to insure nursing staff assigned to correctional facilities and some hospitals. 

Nursing Homes  

Underwriters look for certain information pertaining to nursing homes. Any outside vendors or subcontractors working with the nursing home need to provide COIs stating they have workers’ compensation coverage. 

Nursing staff for nursing homes is classified under the 8824 comp code (whereas in other healthcare settings, they are 8832). Non-healthcare nursing home staff use the 8826 class code. 

Additionally, if staff provides non-emergency transportation to patients it is classified differently, and employers must pass that information on to underwriters. 

Group Homes

Insurance companies typically want to know patients’ ages and conditions in group homes. 

For example, are the patients usually ambulatory or do they require assistance and frequent handling? If patient lifting is involved, are the staff properly trained in safety procedures? 

Safety Training 

Insurance companies and underwriters look for adequate safety training when they build a plan (or decide whether to insure at all). 

Safety training is critical in reducing the number of injuries and illnesses among healthcare workers, especially staff frequently involved in patient handling. Safety training includes (but isn’t limited to) correct lifting procedures, either with a Hoyer lift or two workers.

 Employers should send any formal safety training procedures or programs to insurance underwriters. 

Does Workers’ Comp Cover Home Care?

home health care worker

The short answer is - yes. Healthcare workers’ comp does include workers' compensation for home health aides and similar professions. There are a few specific things to keep in mind about home healthcare workers’ compensation insurance, though. 

  • Plenty of agencies employ nurses and aides as 1099 employees (rather than W2 employees) and those 1099 employees must be included in home health workers' compensation insurance policies.

    Exemptions or waivers from 1099 employees are not admissible, and the workers must be covered, either by an employer’s policy or by providing COI showing coverage elsewhere. 
  • If workers provide transportation (to the grocery store, for example), underwriters often need MVRs (motor vehicle records) to prove safe driving habits.

    Agencies should consider not hiring employees with poor driving records, as it could affect their home healthcare workers' compensation insurance. 
  • 24-hour shifts are common in home health, but those extended shifts are high risk in workers’ compensation for home healthcare policies. 
  • Pennsylvania makes a distinction between medical, professional, and nursing home health employees (classed 0942 in PA) and companionship-oriented home health aides (classed as 0943). A policy can list both, but payroll is separate and clear records are necessary. 

Get the Best Healthcare Workers’ Comp Insurance 

The healthcare industry is brimming with high-risk positions, but coverage for medical providers and staff is not just recommended - it’s a necessity. 

Kickstand Insurance is ready to help get the workers’ compensation coverage that healthcare employees deserve. 

Get a quote in minutes for workers’ comp for home healthcare, nursing homes, clinics, and more.

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Note: The information provided in this blog is intended for general informational purposes only and is not a substitute for professional legal or insurance advice. Laws and regulations regarding workers' compensation insurance are complex and vary by state and by specific circumstances. Therefore, readers are encouraged to consult with a qualified legal or insurance professional to obtain advice with respect to any particular issue or problem they might have.

Mordechai Kamenetsky

Mordechai Kamenetsky, co-founder and lead agent of Kickstand, is recognized as an expert in workers' compensation. He is passionate about helping small businesses manage risks and lower their workers' comp costs. In his articles, he educates readers and clients on the intricacies of workers' comp insurance.

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