Here is a listing of the most commonly asked questions about the WC Program and the answers to these questions.
What is the Worker’s Compensation Program (WC)?
If an employee sustained an occupational injury or illness as a result of their working environment, WC law entitles an employee to payment for all medical costs that may result. If that occupational injury or illness causes a disability (time off from work certified by a physician), an employee will be entitled to full (standard) pay per 22 GCA §9104(j). All work injury leave must be accompanied by a doctor’s certification.
How do I get my benefits?
If an employee sustained an occupational injury or illness as a result of their working environment, the employee must report to his or her supervisor immediately! Timely and proper reporting of any occupational injury or illness will facilitate an employee’s benefit payments promptly.
What happens if the employee is killed on the job because of an occupational injury or illness?
The maximum for a Death Benefit is $100,000. Of the $100,000, up to $3,600 will be utilized for funeral expenses (receipts required), and the remaining balance will be distributed to the qualified dependents.
What do medical benefits entail?
WCC will pay the following costs resulting from an occupational injury or illness:
- Medical, surgical or hospital care,
- Prescribed items, such as medication, crutches, prosthetic devices, etc.,
- Authorized off-island treatment.
Who selects the doctor? (Government of Guam employees only)
All employees are required to go Guam Memorial Hospital Authority (GMHA) for their initial medical treatment (per 17 GAR Division 2 Chapter 10 §10107(b)). All subsequent referrals for treatment must be authorized by WCC for line agencies.
What do death benefits entail?
Death benefits are payable to qualified surviving dependents of an employee who dies because of an occupational accident or illness. The amount will vary according to the number of qualified dependents, but not to exceed the AWW of $375.00. Compensable at the maximum amount possible of $100,000.
Up to $3,600 in actual burial costs may also be paid. If there are no qualified dependents, no compensation will be paid.
Total cash payments for any one occupational injury, illness, or death cannot exceed the aggregate total of $100,000.
Note: If a widow or widower is a beneficiary, please know that if the widow or widower remarries that the death benefits will cease. If children are also beneficiaries, they will keep their death benefits until the day before they turn 18 years of age.
What injuries to employees are covered?
The law covers all occupational injuries and occupational diseases arising out of and in the course of employment, such diseases or infections as naturally or unavoidably result from such injuries, and death resulting there from. No compensation is payable, however, if the injury was caused solely by the intoxication of the employee, or by his willful intention to injure or kill himself or another.
When can the employer controvert a claim?
The employer can controvert a claim by filing form GWC-207 (Notice of Controversion), if the employer has substantial evidence to the contrary that the occupational injury, disability or death did not rise out of, and, in the course of their employment.