The answers to commonly asked questions from employers and injured employees
The Alabama Legislature passed Alabama’s first workers’ compensation laws in 1919. Unsurprisingly, a lot has changed since then.
As a result of more than 100 years of legislative changes and court decisions, Alabama’s workers’ compensation laws can be a little confusing. With that in mind, we’ve provided accurate and up-to-date answers to some of the most common questions about workers’ compensation in the Cotton State
Employee workers’ compensation questions
What laws govern workers’ compensation in Alabama?
Workers’ compensation is governed by the Alabama Workers’ Compensation Act. The full text of the Act can be found in Title 25 of the Code of Alabama.
The Alabama Department of Labor’s Workers’ Compensation Division is responsible for the administration of the Alabama Workers’ Compensation Act. Injured employees can find a lot of helpful information on the division’s website, including required forms and coverage information.
What is the first thing I should do if I’m injured on the job?
First and foremost, you need to call an ambulance if you require immediate medical assistance. Although medical treatment must typically be pre-authorized by your employer in order to be covered by workers’ compensation insurance, there is an exception for necessary emergency treatment.
Once you’ve taken care of your immediate health needs, you should notify your employer.
Alabama Code 25-5-78 requires that you provide your employer with written notice of your workplace injury within 5 days after the occurrence of the injury.
The failure to provide notice within 5 days will result in the denial of your workers’ compensation claim unless you can prove that you were prevented from providing notice by reason of physical or mental incapacity. In that case, if written notice isn’t provided within 90 days, your claim will be denied.
What kinds of injuries and illnesses are covered by workers’ compensation?
Most injuries and illnesses (other than those that are self-inflicted) are covered by workers’ compensation insurance as long as the injury or illness “arose out of” your employment.
Generally speaking, an injury arises out of your employment if:
- There is a relationship between the employment and the accident,
- The injury occurs within the period of employment,
- The injury occurs at a place where the employee may reasonably be, and
- The injury occurs while the employee is fulfilling the duties of their employment or is engaged in something incidental to their duties.
An injury is NOT considered to have arisen out of your employment if it occurred at work but would have occurred anywhere. For example, if you have a stroke due to a hereditary genetic disorder, you probably won’t be eligible for workers’ compensation benefits because the stroke could have occurred anywhere.
Workers' compensation covers both traumatic work injuries and occupational work injuries:
- Traumatic work injuries are those injuries that result from a 1-time accident at work (e.g., suffering a back injury as a result of a fall from construction scaffolding).
- Occupational injuries occur over a period of time (e.g., repetitive movement injuries).
How do I file a workers’ compensation claim?
Providing written notice of your injury to your employer is considered “filing a workers’ compensation claim.” It is then the responsibility of your employer to file a First Report of Injury Form (also known as “WCC Form 2”).
It’s a good idea to respectfully stay on top of your employer to make sure they file the WCC Form 2. If your employer refuses to do so, we strongly recommend contacting an Alabama workers’ compensation attorney or the Alabama Workers’ Compensation Ombudsman Program as soon as possible.
What workers’ compensation benefits are available?
Injured workers in Alabama can receive 3 types of workers’ compensation benefits:
- Reasonable and necessary medical expenses (doctor visits, hospital bills, prescriptions, crutches, physical therapy, etc.)
- Wage loss benefits
- Death benefits for certain dependents
Wage loss benefits are calculated according to the nature of the injury, with injuries falling into 1 of 4 categories:
|Temporary partial disability (TPD)||Temporary total disability (TTD)||Permanent partial disability (PPD)||Permanent total disability (PTD)|
|If you're able to return to part-time or light-duty work while you're recovering but earn less than your normal wages, you may be eligible for temporary partial disability (TPD) benefits. TPD benefits are two-thirds of the difference in your average weekly wages (subject to an ever-changing statutory maximum). TPD benefits cannot exceed 300 weeks.||If you're temporarily unable to work, you may be eligible for temporary total disability (TTD) benefits. TTD payments are two-thirds of your average weekly wages (subject to an ever-changing statutory maximum).||If you suffer a permanent injury but are still able to work in some capacity, you may be eligible for permanent partial disability (PPD) benefits. Your award will be based on the permanent impairment rating assigned to you by your doctor, as well as a state schedule that lists degrees of impairment based on loss of use of certain body parts. PPD benefits cannot exceed 300 weeks.||If you're totally and permanently disabled, you may be able to receive two-thirds of your average weekly wages (subject to an ever-changing statutory maximum).|
Can I select my healthcare provider?
In Alabama, your employer is permitted by law to select your treating physician. The right of your employer to select your treating physician begins on the date you provide your employer with the notice of your injury (not the date your workers’ compensation claim is filed or approved).
Although your employer has the right to select your treating physician, you can request a list of 4 other physicians if you're unhappy with the physician selected. However, you’re typically only allowed to change physicians once.
Does medical treatment require pre-certification?
Alabama Department of Labor Administrative Code 480-5-5-.08 lists the services that require pre-certification. The list is not all-inclusive. From a practical standpoint, all medical treatment can and probably should be pre-certified. The carrier and provider may mutually agree to procedures that will not require pre-certification.
Can I hire an attorney to help with my workers’ compensation claim?
Although it’s not required, you have the right to hire an attorney to help with your workers’ compensation claim. An attorney is particularly important if you expect that your employer will be difficult or if your workers’ compensation claim is ultimately denied.
Interestingly, Alabama doesn’t have a court process available to hear workers’ compensation disputes. This means that if you wish to appeal your decision, you must:
- File a lawsuit with the Alabama district court, or
- Attempt to resolve the dispute with the help of the Ombudsman.
What if I was injured, but my employer doesn’t have workers’ compensation insurance?
If you’re injured at work and your employer doesn’t have workers’ compensation insurance, you may still be able to receive compensation. Your legal options depend on whether your employer was supposed to be carrying workers’ compensation insurance at the time of the injury:
- Your employer is supposed to have workers’ compensation insurance but doesn’t. Most employers in Alabama are required to carry workers’ compensation insurance. If your employer doesn’t have insurance coverage (and should), you can contact the Alabama Department of Labor Workers' Compensation Ombudsman Program. Legal action may be taken against the employer, and the employer may be forced to provide you with twice the amount you would have received through insurance.
- Your employer is not required to have workers’ compensation insurance. If your employer isn’t required to carry workers’ compensation insurance, you might still be able to receive compensation by filing a personal injury lawsuit against the employer. Keep in mind that, unlike a workers’ compensation claim, you’ll need to prove that the employer was negligent or acted willfully in order to recover damages.
Employer workers’ compensation questions
Am I required to carry workers’ compensation insurance?
The Alabama Workers’ Compensation Act requires almost all employers who regularly employ 5 or more employees (full or part-time) to have workers’ compensation coverage.
Employers who are exempt from carrying workers’ compensation coverage include:
- Employers in the business of constructing single-family, detached residential dwellings
- Employers of domestic employees (e.g., housekeepers)
- Employers of farm laborers
- Employers of casual employees (e.g., temporary workers performing work that is not part of the employer’s regular business)
Employers who are required to carry workers’ compensation coverage have 3 ways to meet the requirement:
- Purchase insurance from an approved commercial workers’ compensation carrier,
- Provide coverage through a group self-insured fund, or
- Individually self-insure (if qualified)
What’s the penalty for not carrying workers’ compensation insurance?
If you are required to carry workers’ compensation insurance and fail to do so, you’ll be liable for 2 times the amount of compensation that would have otherwise been payable for injury or death to an employee. In addition, you may receive criminal penalties, including fines, jail time or both.
What should I do if an employee is injured at work?
When an employee is injured at work, they’re required to provide you with notice of the injury (typically within 5 days). Once notice is provided, you must complete and file a First Report of Injury Form. This form includes information about the injury, how it occurred and the employee’s wages.
Can I be sued in lieu of a workers’ compensation claim?
A workers’ compensation claim is generally the sole remedy for an employee who suffers a work-related injury. There are, however, a couple of important exceptions in Alabama.
- First, an employee can reject workers’ compensation coverage. If an employee rejects coverage before the injury occurs, the employee may be able to pursue a civil lawsuit against the employer.
- Second, if an employee is injured through the “willful misconduct” of the employer, the injured employee can file a civil lawsuit against the employer.