questions about workers' compensation

Frequently Asked Questions About Workers’ Compensation

Everyone knows that certain occupations are inherently more dangerous than others—a construction worker faces more potential perils on a day-to-day basis than the typical office worker. Even so, injuries can happen in any workplace and these often bring up questions about workers’ compensation.

So, what legal protection exists for workers who sustain significant injuries while on the job? One valuable program that has been instituted for employees is worker’s compensation. If you’re like most people, you probably already know a little about worker’s compensation, but, unless you’ve gone through the process of applying for these benefits, it’s likely that your knowledge is hazy beyond the basic generalities.

With that in mind, let’s take this opportunity to answer some of the more common questions about workers’ compensation that we get.

Frequently Asked Questions About Workers’ Compensation: The Basics

So what is worker’s compensation, anyway? It’s basically a type of insurance that employers take out. It enables their employees to receive financial benefits from the state in the case of a workplace accident that leaves them incapable of performing their usual duties.

Worker’s compensation is sometimes known as workman’s comp or worker’s comp. Most employers have to carry worker’s compensation for their employees. But, as we will see later on, not every employee will qualify to receive these benefits.

What Kinds of Worker’s Compensation Are There?

Again, we have to emphasize that each state has its own rules and regulations pertaining to the administration of worker’s compensation. There are certain broad trends, however. For the most part, this type of benefit falls into one of four distinct types:

  • 1. Medical: This type of worker’s compensation benefit will cover medical expenses including medication and hospital stays. It may cover medical equipment used by the worker during the period of recovery.
  • 2. Rehabilitative: This type of benefit covers medical therapy intended to enable the worker to recover his or her health and full use of their physical abilities. It also covers training programs that allow the worker to relearn specific skills used at their old job.
  • 3. Disability: This type of benefit falls into various subcategories, depending on whether the injury/illness is temporary or permanent in nature and whether it’s partial or total. The disability benefit gives the worker a reliable income during the period of their absence from the workplace.
  • 4. Death: This type of benefit is intended to compensate the surviving immediate family of a worker who died as a result of a workplace-related illness or accident. Depending on the state responsible for administering the worker’s compensation claim, it may or may not cover funeral expenses.

Also, states have varying standards regarding which kinds of relatives can receive this compensation (e.g., dependent parents may or may not qualify).

Do I Qualify For Worker’s Compensation?

This is the big question. To simplify the matter, we can fairly say that an employee must fulfill all three of the following requirements in order to be eligible for these benefits:

  • 1. The employer of the worker has worker’s compensation insurance (or, if this is not so, is required to carry it).
  • 2. The worker is an employee of the employer.
  • 3. The injury sustained by the worker is related to the responsibilities of their job.

What Kinds of Employees Do Not Qualify?

Independent contractors are usually excluded from qualifying for worker’s compensation as they are technically not true employees of the company. Bear in mind, however, that some independent contractors are intentionally misclassified by their employers. They pull this trick in order to save on payroll taxes and related expenses.

If this is the case, then the employee may qualify once all the applicable facts have been properly reviewed. In addition, agricultural employees, undocumented personnel and seasonal workers are usually exempt as well.

What Kinds Of Accidents Does Worker’s Compensation Cover?

Generally, anything that leads to a serious injury while on the job can qualify an employee for worker’s compensation. The injury does not need to result from a single, isolated incident. For example, repetitive stress injuries (e.g., carpal tunnel syndrome) also receive cover.

Injured personnel can qualify even if it’s determined that they were at least partly at fault for the accident. However, true gross negligence, such as flouting an explicit workplace safety rule or operating machinery while intoxicated, might disqualify an employee from these benefits. Intentionally injuring oneself while on the job is another disqualifier.

How Much Will I Get from Worker’s Compensation?

As we’ve already mentioned, workers’ compensation claims fall into multiple categories. That’s a big factor in determining how much money you will get and how you can expect to get it (e.g., scheduled payments or lump sum).

If the nature of your illness or injury keeps you out of work for a significant length of time—the exact amount of time is another varying factor—then you will likely receive benefits calculated at or around two-thirds of your normal salary, payable for as long as you conform to the qualifications.

How Long Can I Collect Worker’s Compensation?

Assuming that the stricken worker fulfills the requirements—that is, they’re still legitimately sick or injured—they can continue to receive worker’s compensation benefits on an indefinite basis. However, the worker should return to their workplace as soon as they are able. Their refusal to do so may endanger their right to further benefits.

Can I Collect Worker’s Compensation Benefits Even If I Was Injured Outside the Workplace?

This is yet another question that has no simple clear-cut answer. This is partly due to variations in state law and partly because of the ambiguities that sometimes arise in these cases, requiring detailed analysis.

The short answer though is that you probably have cover if you were performing duties for an employer as part of your job responsibilities. For instance, if you were injured in a car accident while on a road trip to pick up office supplies at your boss’s behest, then it’s likely that you qualify for worker’s compensation.

Can I Sue My Employer In Addition To Collecting Benefits?

Essentially, worker’s compensation provides employees with financial benefits. This means they don’t have to turn to the courts to sort through the legal mess often seen in personal injury cases. For that reason, you can generally not sue an employer. There are exceptions, however.

If your employer did not purchase worker’s compensation insurance when required by law, then you can turn to the courts for relief. Additionally, if you can demonstrate that your injury or illness was caused by a third party, such as a workplace visitor from an outside company, then you may be able to sue them.

Can I Choose Which Doctor to See?

Sometimes yes, sometimes no. Much of the time, you will have to see a doctor selected by your employer.

Do I Need to Contact an Attorney If I Have More Questions About Workers’ Compensation?

The short answer is no, but there are definitely cases where it’s best to have a lawyer in your corner. As you’ve probably guessed by now, worker’s compensation isn’t always a matter of black-and-white clarity. There are difficult issues that can arise.

Do you suspect that the severity of your injury has been underestimated by the state? Does the doctor insist that you’re capable of returning to work while you still have lingering physical issues? Is your claim in danger of being denied altogether due to your employer’s misrepresentation of the facts?

Issues such as these do sometimes arise. Therefore, when they occur, it’s best to have an attorney with substantial experience in all aspects of worker’s compensation law.

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