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Wage replacement benefits; Medical treatment; Vocational rehabilitation; Other benefits. Form D-2 – Brief Description Of Your Rights and Benefits If You Are Injured On The Job.Injured workers have a duty to disclose their current residential address to the Commission and to report any changes of address as they may occur. Form D-2 Brief Description of Rights and Benefits. Failure to report a work-related injury within 90 days of the accident may disqualify you from receiving benefits. Benefits. A guide for injured workers. Workers' compensation insurance coverage provides covered employees with income and medical benefits if they sustain a work-related injury or illness. 2. Our Pledge to Employees. If you are injured on the job, you have certain rights, benefits and responsibilities. I'm hurt on the job?