Work accidents make up a large percentage of the cases seeking compensation for injury that are filed each year in the U.S. The term “work accident” usually refers to a one-time only event in a person’s place of work that causes the person injury. Thus, such conditions as repetitive stress injury or musculoskeletal disorders are sometimes considered chronic conditions rather than the result of accidents.
Some common work accidents include the following:
- Slip and fall;
- Catastrophic falls from scaffolding and other structures;
- Heavy lifting accidents;
- Accidents involving tools;
- Electrocutions and burns;
- Injuries caused by spills of toxic liquids, or contact with harmful chemicals; or
- Injuries sustained in accidents specific to certain trades, such as welding and painting.
Of course, other types of injuries are also possible.
How Are Work Accidents Remedied?
All states except Texas require most businesses to have workers’ compensation insurance. This is a specialized type of insurance that provides compensation to employees when they are injured on the job. A business that does not have workers’ compensation insurance to cover its employees might be fined and subjected to other penalties by the state in which it operates.
The business could also end up paying unexpected costs associated with an injured employee out of its own funds The states that have workers’ compensation laws have an exclusive remedy provision. This provision means that workers’ compensation is the only remedy available to injured workers, and it prevents employees from also making other kinds of claims against their employers in the event they are injured on the job.
The premiums that a business must pay for its workers’ compensation insurance are calculated based on its gross annual payroll. The higher its payroll expenses, the higher its workers’ comp insurance premiums are. Workers’ comp insurance premiums are also influenced by a number of other factors, such as a company’s claims history, the requirements of its employees’ roles, the type of business it is, and the law of the state in which it operates.
Workers’ compensation is a form of insurance that compensates workers who are injured on the job. It offers the worker compensation for lost wages, the cost of medical care and the cost of rehabilitation therapy, if it is necessary. A worker who is injured on the job is required by law to turn to the workers’ compensation system and give up their right to sue their employer for the tort of negligence.
The benefit to the worker is that they are guaranteed coverage by the workers’ compensation system, and they do not have to prove that their employer was in any way negligent. They must only prove that they were injured within the course and scope of their employment.
What Kind of Damages Can a Worker Recover in the Workers’ Compensation System?
Another feature of the workers’ compensation system is that damages for pain and suffering and punitive damages for an employer’s intentional misconduct are generally not available through a claim for workers’ compensation.
While the injured worker does not have the right to recover damages for pain and suffering and punitive damages, they are protected by the system from the risk of an employer becoming insolvent and incapable of providing any kind of damage award or being driven to bankruptcy by having to pay out huge awards for pain and suffering. The system prevents the possibility of a bankrupt employer, and thus it ensures that compensation is available to injured workers.
Workers’ compensation insurance provides employees with money awards to cover lost wages directly related to the accident as well as compensation for permanent physical impairments and medical expenses. While the exact details of what workers’ compensation insurance offers vary in the different states in the U.S., provision might be made for weekly payments in place of wages. So, it may function much like a type of disability insurance.
Or, a plan might offer compensation for economic loss, both past and future, as well as reimbursement or payment of medical expenses. In this regard, it functions much like a health insurance policy. It may also offer benefits payable to the dependents of workers who are killed in the course and scope of their employment.
The payments made to replace a worker’s lost income usually amount to less than the person’s full salary. The most generous insurance policies pay about two-thirds of the worker’s gross income, i.e. income before taxes are paid, but these payments for lost income are usually not taxable by the state or federal governments.
Workers’ compensation laws in some states also protect employers and colleagues of an injured worker by limiting the amount an injured employee can recover from an employer. Also, states’ workers’ compensation laws generally eliminate any liability on the part of co-workers for most accidents, if their negligence may have contributed to causing the incident.
Who Is Eligible for Workers’ Compensation?
In most states, independent contractors are not eligible for workers’ compensation. So contract workers in the so-called “gig economy” have no right to submit a claim for workers’ compensation, even if they are injured while on the job. Reportedly, in 2020, about 17 million Americans worked full-time as independent contractors and more than 34 million worked part-time or occasionally as contractors.
As noted above, Texas is the only state that does not require any of its businesses to have workers’ compensation insurance. Some states require all businesses to have it, while others require businesses with 3 to 5 or more employees to have it.
Of course, in some states, exceptions and waivers are available, and workers’ compensation laws differ from state to state. The basic concept is, however, the same in all states except Texas. It is that a person injured on the job must turn to the workers’ compensation system for a remedy and may not file a civil suit for negligence. And the workers’ compensation system should provide them with a remedy.
In many states, businesses that can show that they have sufficient funds to cover their potential workers’ compensation liabilities may insure themselves. This means that they do not have to buy insurance, but rather pay any claims for workers’ compensation from their own resources.
Each state has its own workers’ compensation board, a state agency that oversees the state’s workers’ compensation program and resolves disputes. Administrative law judges handle workers’ compensation claims. They conduct hearings for claims that are not settled and hear appeals if either side is dissatisfied with the outcome of a claim and wants to appeal a judge’s decision.
An employer may challenge a claim because the employer suspects insurance fraud. An employee may falsely report that they were injured on the job when in fact they were injured elsewhere. Or, an employee may exaggerate the severity of an injury, or even invent an injury they do not have at all. In fact, the National Insurance Crime Board says organized criminal gangs of crooked physicians, attorneys, and patients profit from submitting and supporting false claims to medical insurance companies for workers’ compensation and other benefits.
The federal government has a workers’ compensation program for federal employees, longshore and harbor workers, and energy employees. The federal Black Lung Program handles death and disability claims for coal miners and their dependents.
How Is a Work Accident Claim Filed?
The rules for applying for workers’ compensation vary by state, but usually, a worker with a job-related injury or illness should do the following after being injured on the job
- Write down the details of the injury or illness, take photos if possible, and record the names of witnesses if possible;
- Maintain a journal of how the injury affects their lifestyle and their daily activities;
- Keep records of all medical care they receive;
- Report the injury or illness to their employer. The employer may require the employee to fill out a form. An employee wants to get a copy of all paperwork submitted as part of their claim.
- The employer should then file the claim with their workers’ compensation insurance company.
The worker can follow through with the employer’s insurance company to make sure a claim was filed. If the claim is denied, the worker can appeal the decision with their state’s workers’ compensation board.
Do I Need a Lawyer to File a Work Accident Claim?
Work accidents can involve a wide range of injuries and legal issues. In order to be certain that you get the compensation to which you are entitled for your injury, you may want to enlist the help of an experienced workers compensation lawyer in your area. .
Your attorney can review the facts of your work-related injury case and help you file a claim with your employer. In the event of a legal dispute, your attorney can directly represent you during negotiations and hearings or other legal proceedings.