If you experience a work-related injury or occupational disease, you may be eligible for workers compensation. With some exceptions, most workers are entitled to protection under workers compensation laws which vary from state-to-state. Workers compensation covers most job-related injuries. Workers compensation alleviates the difficulty and complexity of settling differences between employers and employees and provides assurance that the employee will once again be made whole. To learn more about workers' compensation, read below:
- What is workers' compensation?
- What types of injuries are covered?
- What types of injuries are generally not covered?
- What types of illnesses are covered?
- What if someone is killed on the job? Can the employee's survivors receive workers' compensation benefits?
- I was injured when a machine at work malfunctioned. Even though I cannot sue my employer, what about the manufacturer of the machine?
- I was injured in a car accident on the way to work while driving the company car. Can I receive workers' compensation benefits?
- Will my workers' compensation case go to court?
- Should I hire a workers' compensation lawyer?
- Can I be fired for filing a workers' compensation claim?
- Where can I find more information?
1. What is workers' compensation?
Workers compensation is a program that provides benefits to certain workers or their dependents who suffer a work-related injury or disease. Workers’ compensation benefits may include
- wage replacement,
- medical treatment,
- vocational rehabilitation, and
- other benefits
The workers' compensation system evolved quickly after the turn of the 20th century in this country. Along with the industrial revolution came bigger, faster, and more complex machinery, and many more work place hazards. Congress passed the Workers' Compensation Act for federal employees in 1908. Each state has now passed workers' compensation laws providing benefits for workplace injuries and illness.
While the workers' compensation program is national, the states are responsible for implementing it, which means that important aspects of the program vary according to the laws of your state.
These laws were initially put in place to balance the rights of workers and employers and provide a way to settle differences quickly and privately. Both the employer and employee give up some legal rights under the workers' compensation laws of the various states. The employee gives up the right to go to court and sue his employer for on-the-job injuries which, in some states, could be for unlimited amounts of damages (although many states have passed laws capping the amount of damages). Instead, the worker is entitled to receive a definite award, based upon fixed maximums set by the various states.
In return, employers give up the right to deny responsibility due to potential negligence by the employee that may have contributed to the injury. The workers' compensation systems are considered "no-fault" systems. Employers finance the system primarily through insurance premiums, although in some states, companies may self-insure, which means that they pay all claims themselves.
2. What types of injuries are covered?
There are four different types of work-related injuries that qualify for workers’ compensation. You may be eligible for compensation for any of the injuries listed below:
- Any physical injury on the job, which can include exposure to dust, toxins, hearing loss caused by workplace and repetitive motion injury - such as carpal tunnel.
- Preexisting conditions that the workplace accelerates or aggravates. Examples may include a back injury, even though you do not notice the pain from the injury until later.
- Injuries caused during breaks, lunch hours, and work-sponsored activities (such as a company picnic), and at-work injuries caused by company facilities, such as a chair in the company lunchroom.
- Injuries resulting from mental and physical strain brought on by increased work duties or work-related stress. In some states, this includes employees who develop a disabling mental condition because of the demands of the job and a supervisor's constant harassment. Mental distress caused by something other than an initial physical injury is sometimes excluded from workers' compensation completely, depending on your state.
3. What types of injuries are not covered?
In some cases, injuries that occur at work are not covered by workers’ compensation, they include:
- self-inflicted injuries (including those caused by a person who starts a fight);
- injuries suffered while a worker was committing a serious crime;
- injuries suffered while an employee was not on the job;
- injuries suffered when an employee's conduct violated company policy; and
- injuries suffered when an employee was intoxicated.
4. What types of illnesses are covered?
Diseases contracted by exposure to toxins at work are covered by workers’ compensation. The Disease must have been contracted under normal working conditions.
5. What if someone is killed on the job? Can the employee's survivors receive workers' compensation benefits?
Yes, the Federal Employees’ Compensation Act (FECA) provides compensation for survivors of federal civilian employees who are killed. Although workers' compensation coverage varies from state to state, generally employees' survivors are eligible to receive workers' compensation benefits.
6. I was injured when a machine at work malfunctioned. Even though I cannot sue my employer, what about the manufacturer of the machine?
There are a few exceptions to the rule that workers compensation is your exclusive remedy for a work-related injury or illness. If your injury was caused by the negligence of a third party, someone other than your employer or a coworker, you are free to sue that person for damages.
For example: If your injury was the result of a machine malfunction, and that malfunction was caused by the manufacturer's negligence you are eligible for workers' compensation and you can sue the manufacturer responsible for the machine malfunction. Another example would be if someone ran a red light and hit the company truck you were driving while making deliveries for your employer. You are eligible for workers compensation and you can sue the person who caused your injury. Your employer can sue this negligent third party to recover the workers' compensation benefits he is required to pay to you. Your employer could also join in your lawsuit and seek reimbursement of their obligations out of your damage award. Most states require employees to notify their employers if they intend to sue a third party.
7. I was injured in a car accident on the way to work while driving the company car. Can I receive workers' compensation benefits?
Yes, if an employee is injured while traveling to or from work and the employer has agreed to provide the worker with the means of transportation, or pay the employee's cost of commuting, or if travel is required while performing their duties, then the employee can receive workers' compensation benefits. This can be a complicated legal issue, so it may be best to contact an attorney who regularly represents employees in workers' compensation cases for more information.
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8. Will my workers' compensation case go to court?
An employee making a workers' compensation claim will never see a jury. The right to a trial in court is one of the rights waived in the workers' compensation system. Workers' compensation systems are administrative in nature, and cases are ruled on by administrative law judges. Many workers' compensation claims are settled before a hearing is needed.
One issue that parties may have difficulty settling is how much compensation is enough when a worker has suffered a permanent disability. This issue may need to be decided by an administrative judge if the parties cannot settle on how much is enough to compensate someone for a lifetime of disability. Some states allow lump sum settlements for permanent disability, and others allow weekly payments.
9. Should I hire a workers' compensation lawyer?
While it is not required, hiring a workers' compensation lawyer is advisable. A workers' compensation lawyer has expertise in the field and knows how to get through all the forms and do things right the first time to prevent a denial of your claim. Not only will a lawyer make getting your compensation easier, but it can also help you recover by reducing stress.
If you're worried about the cost of a lawyer, many lawyers will speak with you about your situation for free or for a small fee before you decide to hire them or not. Workplace Fairness can help you find a lawyer who practices regularly in workers’ compensation.
10. Can I be fired for filing a workers' compensation claim?
No, workers' compensation laws in almost all states prevent employers from disciplining workers for filing a workers' compensation claim. It does not matter if the claim is eventually thrown out; your employer is not allowed to retaliate. If your employer does discipline, discharge, or fire you, you have a case against your employer as long as the disciplinary action was related to your workers' compensation claim.
11. Where can I find more information?
Visit Filing a Workers’ Compensation Claim in Your State to get information about how to file. Find contact information for your state’s government agency in charge of workers’ compensation at our State Government Agencies page.
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