Navajo Nation Workers Comp: What does it cover?

By John Christian Hopkins
Diné Bureau

WINDOW ROCK — The Navajo Board of Election Supervisors continued looking into the possibility of joining the Nation’s worker’s compensation program.

The NBOES has long displayed an interest in insurance coverage, and Thursday Pat Begay, a claims analyst for the worker’s compensation department, gave them a crash course in his department’s duties.

“We handle paper cuts, we handle death on the job; we handle fractures, amputations and everything in between,” Begay said.

The central theme of his office is that the injury must have occurred on the job, he said. To that end, a lot of the job — there are three claims investigators in the department — is to determine the scope of work for each insured department or office and then ascertain whether the injury occurred in what would be considered normal work activity.

An office worker would be insured for accidents or injuries in the office, but not while driving to or fro, Begay explained.

There are exceptions, he added. A police officer is considered to be on call at all times, so he or she could be covered for an injury occurring while driving to work, or leaving it, Begay said.

The different between worker’s comp and risk management is as simple as flesh and blood.

Risk management covers equipment, worker’s comp is for personnel, he said. In the case of an accident, for example, the vehicle might qualify for insurance under risk management; the driver for worker’s compensation, he explained.

Various tribal offices and entities are covered by worker’s comp, including Diné Power Authority, elected chapter officials, Navajo Tribal Utility Administration, Kayenta Township commissioners and NAPI employees.

“We don’t get salaries, we only get per diem’s,” NBOES Vice Chairman Jonathan Tso said. Could election board members still qualify for worker’s comp, Tso asked.

The NBOES members could be covered, but the Navajo Election Administration would have to apply for their coverage, Begay said.

Departments pay a percentage of their salaries toward worker’s compensation coverage, Begay said. The pay-out rate now is 66.6 percent of the insured party’s salary, he added.

Because NBOES members don’t get a salary, how would their worker’s comp rate be calculated, Tso asked.

Where there is no weekly salary, his office would probably use the minimum wage as a guide, Begay said.

“Worker’s compensation is all about medical,” Begay said. “We try to remain as resourceful as we can.”

Pay-outs can vary, depending on the severity of the injury, Begay said. There are, for example, different classifications for fractures, such as compound, spiral and oblique, Begay said.

The maximum pay-out for a death claim is $5,000, or $2,500 for disfigurement, Begay said.

After an injury, the worker has up to one year to file a claim, Begay said.

“One part of worker’s compensation is safety. We always want to encourage safety,” Begay said.

Chapters pay a rate of 1.08 percent of their payrolls for worker’s comp coverage.

“It’s very reasonable,” Begay said.