All states require businesses to carry workers’ compensation insurance, also known as workman’s comp. Workers’ comp protects employees who suffer a work injury or illness and pays related medical expenses and cash benefits, regardless of who was at fault. It’s not a fail-proof system, however, and there are times you need legal representation to protect your rights.
Note: Federal employees are covered under the federal workers’ compensation system.
What are the eligibility requirements?
Workers’ compensation laws vary from state to state. There are specific requirements that must be met to be eligible to draw workers’ compensation benefits.
- Your employer carries workers’ compensation insurance. Requirements vary based on the number of employees, type of business, and work employees perform.
- You are an employee. Employee covers full- and part-time employees, seasonal workers, and temporary employees, excluding independent contractors and volunteers. Domestic workers, farm laborers, or undocumented workers may not qualify.
- You were injured during the performance of your job-related duties. This isn’t always cut and dried. Injuries that occur off the worksite but in connection with the job fall into a gray area.
What are workplace injuries?
Private industry reported slightly more than three million nonfatal workplace injuries and illnesses in 2013, according to the latest numbers released by the U.S. Bureau of Labor Statistics. Workplace injuries and illnesses commonly result from falls, repetitive motion injuries, manual materials handling, slips and falls, and motor vehicle accidents.
- Falls are a common occupational hazard for construction workers, resulting in broken bones, spinal cord injuries, traumatic brain injuries, and even death. Causes include defective equipment, unsafe work conditions, and carelessness.
- Repetitive motion injuries result from performing the same movement over and over again for an extended period of time, resulting in bursitis, carpal tunnel, and tendonitis. These are the most commonly reported workplace injury.
- According to the U.S. Bureau of Labor Statistics, more than one million workers suffer back injuries, accounting for one out of every five manual materials handling work-related injuries or illnesses. Back injuries result from carrying, holding, lifting, lowering or placing loads.
- Slips and falls are not compensable under workers’ compensation, unless a hazardous condition at the time caused the fall. These can cause broken bones, head injuries, or musculoskeletal injuries.
- Injuries sustained in a motor vehicle accident are compensable if the employee was engaged in work-related business. However, employees are not compensated for injuries sustained commuting to and from work, except in special circumstances.
What do you do after an injury
You need to notify your immediate supervisor immediately after you are injured at work. The reporting requirements vary from state to state. Failure to report a workplace injury or illness within the state-mandated time frame may result in forfeiture of your right to file a workers’ compensation claim.
Once your employer is notified, they are required to ensure you receive all necessary medical attention. In addition, employers must notify their insurance carrier and file a claim with the state workers’ compensation board.
What benefits are you entitled to
Workers’ compensation covers all medical expenses necessary for diagnosing and treating an employee workplace injury or illness, including doctor appointments, prescriptions, surgery, and durable medical equipment. Employees are also entitled to vocational rehabilitation benefits if unable to return to their pre-injury job.
Workers’ compensation benefits compensate employees for lost wages while off work. The benefit amount is typically two-thirds of an employee’s weekly wage. There are four types of disability benefits.
- Temporary total disability. Employees receive temporary total disability benefits while off work for a limited amount of time.
- Temporary partial disability. Employees receive temporary partial disability benefits if able to perform light job duties until they are able to return to work at the same level of employment.
- Permanent total disability. Employees receive permanent total disability benefits if they are permanently and totally disabled and unable to return to work. The employee may also be eligible to receive Social Security disability payments.
- Permanent partial disability. Employees receive permanent partial disability benefits if the complete or partial loss of the body or body part partially impacts their ability to work.
- Death benefits. Families are entitled to receive death benefits when an employee is killed on the job as compensation for the loss of financial support.
What are your legal rights
Workers’ compensation does not cover personal injuries or punitive damages, which an injured employee may be entitled to. In certain circumstances, employees injured on the job can file a lawsuit in civil court to recover additional damages. Therefore, it’s important for injured employees to understand their legal rights.
- In a majority of states, employees can recover damages if their employer specifically and directly harms them. Alabama, Georgia, Indiana, Maine, Nebraska, New Hampshire, Pennsylvania, Rhode Island, Virginia and Wyoming are the exceptions.
- Injured employees can file a personal injury lawsuit against their employer in civil court if they do not carry workers’ compensation insurance. You must prove that your employer was at fault for the on-the-job injury.
- If a workplace injury results from a defective machine or piece of equipment, the employee can sue the manufacturer. The manufacturer would be responsible for damages.
- Workers exposed to toxic substances can suffer from cumulative long-term effects include cancers, neurological damage and lung diseases. Employees can file a toxic tort claim against the manufacturer.
- When a third-party causes the workplace injury or illness, the employee can file a personal injury lawsuit against that person.
What to look for in a personal injury lawyer
It’s important to choose a personal injury lawyer who has your best interests in mind. During your initial consultation, ask: What is their background and experience? What is their assessment of your case? Can they handle your case at this time? What do they charge? This is your opportunity to interview the attorney to ensure they are the right one for your case.
The workers’ compensation system operates smoothly most of the time. However, there are times you need a workplace injury lawyer to guide you through the claims process. Without the proper guidance, you may not receive all you are entitled to.
If you need a personal injury attorney, LegalZoom can help. Get a free personal injury evaluation with an independent attorney and discuss your case options.
Find out more about Personal Injury