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Workers' Compensation Overview

From construction work to nursing, many jobs across the country have a high risk of injury for employees. Workers’ compensation laws are designed to protect employees from financial losses caused when they are injured or contract illnesses on the job.

Most states have similar workers’ compensation rules and procedures, but each state is different. When it is time to find a lawyer to help you with your worker’s comp case, find an experienced worker’s compensation lawyer in your state.

How Does Workers’ Compensation Work?

Employers in many states are required to provide workers’ compensation coverage to employees, but some states exempt employers that have less than a certain number of employees. The employer pays for workers’ compensation insurance directly and is generally prohibited from requiring the employee to pay for the cost of coverage.

Employers can purchase worker’s compensation insurance through different providers depending on the state. For example, employers in New York can get insurance through a commercial provider or state fund. Approved companies can also be self-insured.

Like most other types of insurance, benefits are paid out when a valid claim is filed, and the claimant is determined eligible for wage benefits and payment for medical expenses.

Eligibility and the process for filing for workers’ comp vary by state. For example, if a worker in Connecticut suffers from an occupational disease, they file their claim through the Connecticut Workers’ Compensation Commission. An injured employee in Wyoming goes through the state agency, the Department of Workforce Services.

Understanding Workers’ Compensation

Most state laws are intended to streamline the process of filing workers’ compensation claims. However, these claims must pass certain tests that vary depending on the jurisdiction and type of work. Some of the more common tests for whether a claim is valid include:

  • The presence or absence of drugs or alcohol in the employee’s body at the time of the accident
  • Whether the employee violated company safety policies and procedures
  • Whether the injured party was an employee of the company at the time of the incident
  • Whether the injury or illness occurred on the job or in the course of employment

The employer’s duty to provide workers’ compensation coverage to employees also extends to providing them with proper safety training, equipment and information. The employee’s duty to follow and use this training is sometimes considered a key element in whether a claim is accepted or denied.

What Does Workers’ Compensation Cover?

Workers’ compensation benefits typically cover medical treatment and a percentage of wage replacement arising from a work-related injury or illness. Medical benefits may be limited to a specific amount of time or be enhanced if the employee requires more comprehensive medical care or rehabilitation services. Average weekly wage benefits can also be limited to a specific time or extended for vocational rehabilitation or training for a new job. Workers’ comp coverage, claim requirements, and filing windows vary by state.

What Doesn’t Workers’ Compensation Cover?

Among other things, workers’ compensation typically does not cover the following:

  • Injuries sustained off company time or premises
  • Injuries or illness arising from drug or alcohol consumption on company time or premises
  • Intentional injuries
  • Pain and suffering arising from the illness or job-related injury

Certain classes of workers may not be covered under workers’ compensation law in a given state, including:

  • Farmers
  • Maritime workers
  • Independent contractors
  • Business owners
  • Volunteers
  • Undocumented workers

Can an Injured Worker Sue an Employer?

The workers’ compensation program is based on a no-fault system. The benefit of the workers’ compensation system is that an injured worker can get benefits even if the employer was not negligent. However, it generally means that the worker cannot later file a personal injury claim against the employer.

If workers’ compensation is accepted, benefits do not cover damages for pain and suffering. However, if the employer intentionally or recklessly caused the worker’s injuries, the employer may be able to file a personal injury lawsuit for additional damages.

You can sue an employer for improperly denying benefits. Some employers or insurance companies may improperly deny a worker’s injury claim. If your employer is challenging your claim, you can talk to a workers’ compensation lawyer who can help to make sure you get the benefits you are owed.

What Other Benefits Are Available After a Workplace Injury?

An injured worker may be eligible for additional benefits after they have exhausted their workers’ compensation benefits. If the worker cannot find a job, they may qualify for unemployment insurance benefits. If the worker is disabled by the injury, they may be eligible for short-term or long-term disability benefits.

Workers’ comp provides benefits for a temporary total disability or a permanent partial disability. If the worker suffers permanent total disability injuries, they may be eligible for permanent disability benefits. To qualify for disability benefits, the worker has to meet the requirements for Social Security disability. If the worker dies in a workplace accident, the dependents may be able to receive survivor benefits.

Get Advice From an Experienced Workers’ Compensation Attorney

This article is intended to be helpful and informative. But even common legal matters can become complex and stressful. Making the wrong decisions in a workers’ comp claim could even expose you to workers’ comp fraud. A qualified workers’ compensation lawyer can address your particular legal needs, explain the law, and represent you in court. Take the first step now and contact a local workers’ compensation attorney to discuss your specific legal situation.

Speak to an Experienced Workers’ Compensation Attorney Today

This article is intended to be helpful and informative. But even common legal matters can become complex and stressful. A qualified workers’ compensation lawyer can address your particular legal needs, explain the law, and represent you in court. Take the first step now and contact a local workers’ compensation attorney to discuss your specific legal situation.

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