Workers’ compensation policies cover most jobs and positions, though certain employees cannot recover if they are injured at their job.
There are several possibilities, including, but not limited to:
- Federal government employees;
- Independent contractors (except for work that is particularly risky or inherently dangerous);
- Depending on the state where you live, business owners may be able to recover if their workers’ compensation coverage includes them;
- Housekeepers or nannies working in private homes
- Interns and volunteers
Workers’ Compensation Benefits
Typical workers’ compensation benefits include:
- Replacement income
- Medical expenses
- Long-term or lump sum pension if you are permanently unable to work
- Temporary disability pension while you are unable to work
Workers’ Compensation Requirements
Complying with workers’ compensation requirements requires:
- You must be an employee of your employer (not an independent contractor).
- It must be a work-related injury
Workers’ Compensation Claim Processing
In order to receive workers’ compensation, you must follow several steps.
The following must be done:
- Report your injury to your employer as soon as possible. Some states require notice within 2-30 days of the injury. Work-related injuries and illnesses must be reported as soon as you become aware of them.
- Follow your doctor’s instructions and get medical treatment.
- Make a claim with your employer’s insurance company. Your employer must provide forms for insurance claims.
- Throughout the entire process, keep all copies of the paperwork.
Workers’ Compensation Covers What Types of Injuries?
Employees are entitled to workers’ compensation benefits regardless of whether the injury was caused by their employer or by themselves. Workers’ compensation covers injuries that are work-related.
The following types of injuries are typically covered:
- Repetitive stress injuries
- Illnesses or diseases that are a gradual result of work conditions
- Traumatic physical injuries
- Repeated trauma injuries
- Mental injuries – when associated with physical injury
- Occupational diseases
Can I Get Workers’ Compensation Benefits if I Have Already Recovered Actual Damages for My Injury?
Workers’ compensation cannot be recovered if you have already sued your employer for damages. Bypassing the judicial review process, workers’ compensation allows employees to recover compensation for injuries sustained on the job without having to fight their employers in court.
However, in most states, you can recover both workers’ compensation benefits as well as damages arising from a personal injury lawsuit only if your employer engaged in willful, deliberate, or intentional conduct that caused your injury.
Workers’ Compensation Doesn’t Cover What Types of Injuries?
The majority of workers’ compensation plans do not cover certain job-related injuries.
State laws may or may not include the following, depending on where you live:
- When you are under the influence of drugs or alcohol at work, you can cause injuries to yourself;
- Injuries that you suffer in the course of committing a crime or engaging in illegal conduct at work;
- Getting into a physical fight with a coworker or trying to gain access to an area that is off-limits to employees can result in injuries.
What Types of Employment Practices Are Not Covered?
Workers’ compensation covers a wide array of employment fields. Still, it often does not extend to claims brought against an employer based on the practices of the employer, which might include claims for discrimination, harassment, or wrongful termination.
At Trial, How Are Medical Expenses Proven?
It will be necessary for you to present all of your medical bills that support the amount you are claiming at trial. You may also need a treating physician or an expert witness to testify as to the reasonableness of the cost of your medical expenses.
What Are Some of the Most Common Workers’ Compensation Issues?
Workers’ compensation attorneys deal with several recurring issues on a regular basis. Failure to file a claim on time is one of the most common workers’ compensation issues that require the assistance of a workers’ compensation attorney. States vary on how long an injured worker has to file a claim, but the standard period is usually around 30 days.
Workers who fail to file within the prescribed time frame may lose their right to receive workers’ compensation benefits. The worker whose claim is denied may have to pay out-of-pocket for medical expenses and could lose their job or income. It may be necessary for the worker to hire an attorney and take the matter to court if a dispute arises.
An employer may accuse a worker of faking an injury as another common workers’ compensation issue. If an employer successfully makes such an argument, the insurance company may deny the claim. The lawyer can assist the worker in gathering evidence that proves that the worker was injured on the job, that their injury is real, and that they deserve compensation.
Lastly, one issue that frequently arises in workers’ compensation claims is the possibility that an employer may retaliate against the worker by terminating them, docking their pay, denying them a promotion, or scheduling them to work fewer hours. Firing a worker is illegal simply to file a workers’ compensation claim. A termination based on this reason is known as a retaliatory discharge.
The employee may sue their employer for retaliatory discharge in such a case. A workers’ compensation attorney can help increase a worker’s chances of winning and receiving monetary compensation if they file a retaliatory discharge lawsuit.
Should I Contact an Attorney Who Specializes in Workers Compensation?
If you are injured on the job, you should first file a workers’ compensation claim. Suppose you are denied complete relief there but believe you are entitled to it. In that case, a workers’ compensation lawyer specializing in workers’ compensation will be able to advise you of your rights and of any and all relief to which you are entitled.
A workers’ compensation attorney can interpret the laws in your area, calculate the damages in your case, and determine the correct amounts and types of benefits you should receive in connection with a workers’ compensation claim.
Additionally, a workers’ compensation attorney can provide you with information about your rights under the law, help you prepare your claim, and ensure that you receive the maximum benefits possible.
Also, workers’ compensation attorneys can discuss the pros and cons of filing a workers’ compensation claim and can recommend your best course of action. They can also suggest the next steps you should take if they determine there are better options for handling your case.
Workers’ compensation lawyers can also speak with insurance companies on your behalf to find out why a certain claim was rejected and how to appeal the decision. Despite the insurance companies’ best efforts to avoid paying for a claim, a skilled and knowledgeable workers’ compensation lawyer can make it much easier.
Before submitting your claim, you may also want to have a workers’ comp lawyer review all documents. There can be issues even in the most straightforward cases. In some cases, if there was an error in your application and you failed to correct or amend it, you may receive fewer benefits than you would have if you had consulted a workers’ comp lawyer first.
Additionally, some states limit the number of times you can collect workers’ compensation benefits. A workers’ compensation lawyer can also provide this information to you.