A vital safety net for millions of laborers, factory workers and countless other jobs
Workers' compensation is a vital safety net for millions of laborers, clerks, factory workers and countless other jobs. Many of these occupations carry inherent risk to life and limb, and despite the best efforts of employers, workers, insurance companies and regulators, accidents and injuries do occur on the job.
Before the creation of a dedicated system nearly a century ago, injured workers would often find it difficult to obtain treatment for their injuries and compensation for lost wages.
Today, insurance for work injuries is a requirement for most employers. This essentially means the employer accepts financial liability for any on-the-job injuries – from a slip and fall to carpal tunnel syndrome – even if the incident was the worker's fault. In exchange for this coverage, workers cannot hold the employer liable for pain and suffering except in the most severe cases.
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Workers' compensation laws were set up to make sure that workers who suffer workplace injuries are appropriately compensated. The idea is to get your medical bills paid and to provide a percentage of your weekly salary so you don't have to file a lawsuit against your company (though you still can file a lawsuit in many states, however. We'll cover this later).
Workers' compensation is a really important safety net for most workers. It provides you with a certain amount of financial protection, but the employer gets a good deal as well; the laws limit how much you can get from your company, and the laws usually prevent you from suing your co-workers.
Workers' compensation is basically a no-fault set up.
That is, if you are hurt on the job, it is generally not a matter of determining if you were at fault or if the employer was at fault. You simply receive treatment for your medical bills and part of your salary through the workers' compensation program to which your employer belongs.
Enjuris tip: The idea of workers' compensation is to get your medical bills paid and to provide a percentage of your weekly salary so you don't have to file a lawsuit against your company. You still can file a lawsuit in many states, however.
Exclusive remedy for most workers' comp cases
Usually, workers' compensation is your exclusive remedy for a job-related accident – that is, unless you can prove that a third party caused your injury. For instance, if you work on an assembly line and your hand is mangled in a machine that malfunctioned, you could in theory sue the manufacturer of that machine.
Employers usually stay out of these types of third-party claims, and these actions are civil lawsuits, not workers' compensation claims.
Some states will allow the worker's compensation insurance company and the employer to join a lawsuit that you filed against a third party. This allows the companies to recover the funds that they must pay you in worker's compensation benefits. Other states may allow the employer to get a lien against the amount you recover in the third-party lawsuit.
Injury sustained when you are doing a personal errand off of company property.
Horseplay at work that results in an injury.
Some states will not provide benefits to a person who was hurt while intoxicated; however, if the employer provided alcohol at a company-sponsored event, you should speak to a workers' compensation attorney about this scenario.
Workers' compensation does not cover your pain and suffering. So, if you have very serious injuries, you may look at filing a personal injury lawsuit. This can be difficult to do, but there are exceptions.
For instance, if you think your employer intentionally caused your injury, you may be able to file a lawsuit instead. The most common reasons for this are:
Intentional infliction of emotional distress
And, as noted earlier, if you were hurt on the job and you think a third party is to blame, you can sue that party.
What to do if you are hurt on the job
The process for filing a workers' compensation claim will be similar regardless of the state you are in. The time limit within which you must bring a claim may differ, for example. So, be sure to check your state's specific laws, which, again, can be found here.
Report your injury
You have a certain number of days after your injury to report it to your company. You must report the injury in writing; a verbal communication is not enough. If you are seriously hurt and cannot report it, your relative or friend should do it for you.
Seek medical care
Your company should have a list of healthcare professionals that can be used under their workers' compensation coverage. Select a provider from this list. Use them as your treating physician for your workers' compensation claim and all of your accident-related injuries
Employer files claim with insurance
Your employer has a certain number of days to tell their insurance company about your injuries. If your injuries are very severe and you miss several days of work, your company may need to report the accident to the state.
The insurance company must make a decision within a certain timeframe after being informed of your injuries. The company will either accept or deny the claim. Common reasons for denied claims are lack of information or the insurance company believes your injuries weren't work-related. Get a definitive answer from the insurance company.
Denied? Talk to an attorney
If your workers' compensation claim is denied, you should talk to an experienced workers' compensation attorney immediately. He or she can determine if you have a strong case for appeal.