Workers’ compensation is a state-mandated insurance program which provides compensation to employees who experience job-related injuries. An employee who is injured while on the job is guaranteed benefits, regardless of who was at fault for the injury. In return for workers’ compensation benefits, employees generally forfeit their right to sue their employer in court for damages for their injuries. In this way, the rules governing workers’ compensation are very different when compared to other personal injury issues.
Some of the most common examples of what workers’ compensation benefits cover include, but may not be limited to:
- Replacement income;
- Medical expenses;
- Long-term or lump sum pension, if you are left permanently unable to work; and/or
- Temporary disability pension while you are unable to work.
In order to satisfy workers’ compensation requirements, you must be an actual employee of your employer. What this means is that you cannot be considered an independent contractor. Additionally, your injuries have to be work related.
When thinking of a workers compensation claim, it is generally assumed that the employee is still working for their employer. Although this is often the case, some injuries do not materialize until after an employee has been terminated from their job. As such, there are specific circumstances in which an injured employee can still recover workers compensation benefits after termination.
When Can I Recover Workers Compensation Benefits After I’m Fired?
There are several steps you must follow in order to receive workers’ compensation, which may vary by industry as well as state. Generally speaking, you must do the following:
- Promptly report your injury to your employer. It is important to note that some states require notice within 2-30 days following the injury. If your injury or illness develops over time, you must report it as soon as you determine that it was in fact caused by your work;
- Receive medical treatment and adhere to the doctor’s instructions. It is important to note that if you do not follow the doctor’s instructions, and further aggravate your injury, your workers compensation claim payout may be reduced or denied;
- File your claim with your employer’s insurance carrier using the insurance claim forms that your employer must provide to you. Typically, you may contact human resources for assistance with obtaining and filling out the necessary forms; and
- Save all copies of paperwork throughout the entirety of the process.
When a worker is attempting to recover their workers compensation benefits once they have been fired, it can sometimes be considerably difficult for many different reasons. In order to recover your workers compensation benefits once you have been terminated, you must prove the following elements:
- You suffered an actual physical injury or disability, whether temporary or permanent;
- The injury occurred in the course and scope of your employment; and
- The injury would not have occurred, if you had not been at that job.
If an injured worker is successful in showing that they should recover workers compensation benefits after they have been fired, they can generally recover the following:
- Cost of medical and disability expenses;
- Attorney’s fees and court costs;
- Vocational rehabilitation expenses; and
- Interest on any amount not forthcoming.
The employer may also face various penalties, such as being required to restructure their safety plan.
What Are Some Legal Issues Associated with Recovering Workers Compensation Benefits?
There are many legal issues associated with workers compensation settlements. One such issue involves what is and is not covered by workers compensation. Workers’ compensation is intended to provide benefits to injured workers, regardless of whether the injury was the fault of the employer or the employee. As long as the injury is work-related, it is generally covered under workers’ compensation.
Some examples of the most common injuries covered by workers compensation include:
- Repetitive stress injuries;
- Illnesses or diseases that gradually result due to substandard work conditions;
- Traumatic physical injuries;
- Repeated trauma injuries;
- Mental injuries when they are associated with physical injury; and
- Occupational diseases.
However, there are several types of injuries which remain uncovered by worker’s compensation:
- Self-inflicted injuries, which includes injuries sustained when you cause a fight;
- Injuries resulting from the commission of a serious crime or illegal action;
- Injuries caused when your conduct violates company policy;
- Injuries experienced while intoxicated, or under the influence of illegal drugs; and
- Injuries in which the employee was acting in a reckless manner.
Other legal issues generally involve who is and is not covered by workers compensation. There are several classes of workers who are not entitled to workers’ compensation benefits, including:
- Business owners;
- Independent contractors;
- Federal employees, as determined under the state’s scheme;
- Domestic employees in private homes;
- Farm workers;
- Maritime workers;
- Railroad employees; and
- Unpaid volunteers.
It is important to note that workers compensation laws can vary by state. Additionally, workers compensation does not cover claims that are brought against an employer based on the employer themselves. This includes claims for discrimination, harassment, and/or wrongful termination.
Finally, you generally cannot recover workers compensation if you have already taken your employer to court and recovered damages for your injury. Workers compensation was intended to bypass the process of judicial review, and thereby enable employees to recover money for injuries that they suffered on the job without having to fight their employer in court.
However, most states will allow you to recover both your workers compensation benefits as well as any damages arising out of a personal injury lawsuit. This would only be if your employer engaged in willful, deliberate, or intentional conduct; and, your injury was a direct result of that conduct.
Are There Any Defenses?
When an injured worker is attempting to prove that they were injured on the job, but the injury did not appear until after they were fired, there are many defenses available to an employer or their insurance carrier. These include, but may not be limited to:
- The worker’s injury was not compensable, given a workers compensation statute;
- The injury did not actually occur in the course and scope of their employment;
- An unreasonable amount of time passed between when the employee was fired and when the injury allegedly appeared; and/or
- The injury was caused by the employee’s own intentional conduct.
As previously mentioned, workers compensation is a specific type of personal injury law. As such, it is helpful to mention some of the defenses commonly used in other personal injury claims:
- Comparative or contributory negligence;
- Assumption of risk;
- Plaintiff did not state a claim;
- Statute of limitations; and/or
- No mitigation of damages.
Do I Need an Attorney?
If you wish to pursue a workers compensation claim, or experiencing issues related to your workers compensation claim, you should consult with an experienced and local workers compensation attorney. As previously mentioned, the laws governing workers compensation can vary from state to state, as well as from industry to industry.
As such, working with a local lawyer will ensure you receive the most relevant legal advice regarding your rights and course of action. An experienced workers compensation lawyer can help you determine how to file your claim and collect evidence, and will also be able to represent you in court, as needed.