Workers’ compensation is a state-mandated insurance program that provides compensation to employees who are injured while on the job. An employee who is injured on the job is guaranteed benefits regardless of who was at fault for the injury.
However, in return for workers’ compensation benefits, employees generally forfeit the right to sue their employer in court for damages for their injuries. This is one example of how the rules governing workers’ compensation are considerably different than for other personal injury matters.
In general, workers’ compensation benefits include:
- Replacement income;
- Medical expenses;
- Long-term or lump sum pension if you are permanently unable to work because of the injury; 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; meaning, not an independent contractor. Additionally, your injuries must be work related, and your employer must be covered by workers compensation.
There are several steps that you must follow in order to receive workers’ compensation. You must:
- Promptly report your injury to your employer, as some states require notice within 2-30 days following the injury. If an injury or illness results over time, you must report it as soon as you realize that it was caused by your work;
- Obtain medical treatment and follow the doctor’s instructions;
- File your claim with your employer’s insurance carrier. It is important to note that your employer must provide insurance claim forms; and
- Save all copies of all paperwork throughout the filing process.
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 employer’s or the employee’s fault. What this means is that as long as your injury is work-related, it is covered under workers’ compensation.
Some examples of the most common injuries covered by workers compensation include:
- Repetitive stress injuries;
- Illnesses or diseases that are a gradual result of work conditions;
- Traumatic physical injuries;
- Repeated trauma injuries;
- Mental injuries when they are associated with physical injury; and
- Various occupational diseases.
Workers’ compensation provides for nearly every type of injury that may occur at the workplace. However, several types of injuries remain uncovered, such as:
- Self- inflicted injuries, including injuries sustained when causing a fight;
- Injuries resulting from the commission of a serious crime;
- Injuries caused when your own conduct violates company policy;
- Injuries received while intoxicated or under the influence of illegal drugs; and
- Injuries in which you as an employee were acting in a reckless manner.
Additionally, several classes of workers are not entitled to receive workers’ compensation benefits. The following are employees that are not covered by workers’ compensation:
- Business owners;
- Independent contractors;
- Federal employees, 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. An example of this would be how in California, workers compensation laws may differ from Texas workers compensation laws.
What Is The Workers Compensation Statute Of Limitations?
If you have a workers compensation claim, you must file it within a specific time frame, which is known as the statute of limitations. Each state has its own statute of limitations for workers compensation; as such, you should check the laws of the state in which you live. However, the best policy is to file your claim as soon as possible.
The general time frame in which to file a workers compensation claim is between 30-90 days, although it may be less. Exceptions to this rule will extend the filing period, examples of which include:
- The injury resulted in a coma;
- Traumatic injury which requires immediate but prolonged treatment; and/or
- Quarantine resulting from a contagious illness.
It is important to note that exceptions to the statute of limitations involve the employee not being physically able to file a claim. Additionally, remember that the above must have occurred due to a workplace injury and/or exposure.
However, in instances of occupational diseases, the time frame in which to file differs. Generally speaking, it will begin when you first notice the injury; if possible, you should see a doctor when you notice symptoms in order to have it put into your medical record. An example of this would be Asbestos poisoning, which is often found in construction workers.
What Should I Do If I Have Missed The Statute Of Limitations?
If you have missed the statute of limitations, you may have other options such as a claim of negligence. It is also possible to file a claim or notify the Occupational Safety and Health Administration (“OSHA”), especially if your injury was due to a workplace safety violation.
Filing a complaint with OSHA should be done as soon as possible after noticing the hazard or lack of compliance, so that OSHA can issue a citation in order to correct the issue. OSHA citations may only be issued for current violations, or violations that have occurred within the past 6 months.
Ways of filing a complaint with OSHA include:
- Filing a Complaint Through Fax or Mail: You may visit OSHA’s website and download their complaint form, or request a copy of the form from your local OSHA regional or area office. You would complete and mail back this form to your local OSHA regional or area office. Written complaints should be signed by you or your representative in order to ensure an onsite OSHA inspection;
- Filing a Complaint by Phone: Telephone is another option in filing an OSHA complaint, as OSHA staff can discuss your complaint and respond to your questions. However, if there is a current emergency or serious hazard that is immediately life-threatening, you should call your local OSHA regional or area office immediately so that they can inspect and correct the condition; or
- Filing a Complaint Online: You may file a complaint online by filling out the online complaint form on OSHA’s website. Complaints received online in OSHA-approved states will be forwarded to the appropriate state plan for response. It is important to note that written complaints received by OSHA through mail or fax are more likely to result in an on-site OSHA inspection, than complaints received by phone or online.
When you speak with an OSHA officer, or when you describe your complaint to a lawyer, you should present certain information such as:
- A description of the danger or lack of compliance with OSHA standards;
- Where the danger exists; and
- Whether you have presented the problem to your employer.
It is important to note that as a union member, you may benefit from speaking with your labor union before filing an OSHA complaint. The union may be able to represent you and file an OSHA complaint on your behalf, as they are likely to be in a better position to help defend your claim.
After receiving your complaint, OSHA will decide whether your concern will be investigated or inspected. If OSHA decides to investigate your complaint they will most likely contact your employee, describe the complaint, and simply ask the employer to remedy the issue.
Your employer will have five days in which to comply with OSHA standards and respond to OSHA by:
- Eliminating the hazard;
- Beginning the process of eliminating the hazard; and/or
- Outright denying the accusation.
Do I Need A Lawyer For Help With Workers Compensation And The Statute Of Limitations?
If you need to file a workers compensation claim, you should consult with a workers compensation lawyer. Your attorney can help you understand your legal rights and options, and can help you file a claim with the appropriate agency. Additionally, an attorney will also be able to represent you in court, as needed.