Understanding Workers' Compensation
If you have suffered some sort of injury or contracted some sort of illness while on the job, you can receive benefits if you qualify for workers' compensation. Workers' compensation is a state-mandated insurance program that provides compensation for almost anyone who suffers some form of job-related injury. There are some basic rules and information that you need to know in order to determine if you qualify for workers' compensation.
Are All On-the-Job Injuries Covered Under Workers' Compensation?
Even though workers' compensation is designed to provide benefits to injured workers even if their injuries were caused by their own or their employer's carelessness, not all injuries will qualify. For example, if an employee is intoxicated or using illegal drugs at the time of the injury, his or her injuries will not be covered. Coverage can also be denied if the injuries are:
- Self-Inflicted
- Suffered While the Employee Is Committing a Crime
- Suffered While the Employee Is Not on the Job
- Suffered While the Employee Is Violating Company Policy
Even injuries that occur off-site can qualify for benefits provided they are work related. An injury that occurs while you are traveling on business, for example, would qualify.
Am I Covered by Workers' Compensation?
While almost all workers are covered by workers' compensation, each state excludes various types of workers from coverage. Among those who could be excluded are:
- Business Owners
- Independent Contractors
- Household Domestic Staff in Private Homes
- Farm, Maritime, and Railroad Workers
- Unpaid Volunteers
It's a good idea to refer to your state's workers' compensation law to see which specific exclusions apply in your area. If you are a federal employee, you will be excluded from any state workers' compensation plan. However, you are eligible for similar benefits under a separate federal law.
What Sort of Benefits Will I Receive?
Workers' compensation can provide you with replacement income, pay for your medical expenses, and even provide you with on-the-job training and job placement assistance, if necessary. Generally, though, the benefits are relatively modest. If you are out of work while recovering from your injuries, you'll receive two-thirds of your average wage tax-free. If you are permanently unable to return to the work you did prior to your injuries or are unable to do any work at all, you might qualify for long-term or lump-sum benefits. The payment amounts for permanent injury benefits depend on the extent and nature of your injuries. These benefits can take some time to process, though, so if you have a claim to report, you should contact your local workers' compensation office as soon as you can.
Who Provides Treatment for My Injuries?
While many states allow you to go to your own doctor, it is more likely that you will be referred to a medical professional who is paid for by your employer. This doctor's report will play a significant role in determining the benefits you will receive. Keep in mind, though, that the doctor may minimize the seriousness of your injury or identify it as a preexisting condition in order to secure more business from your employer. Tell the doctor if you have previously suffered a significant injury or have a chronic condition. Don't give an itemized list of aches and pains because this can negatively impact your benefits. You might have the right to request a physician of your own, depending on your home state, and if the injury is serious enough, you are entitled to a second opinion.
Can I Sue My Employer over a Work-Related Injury?
If you want to bypass the entire workers' compensation process and sue your employer, you can do so provided that your injuries are the direct result of some recklessness or even intentional action from your employer. If you are able to sue your employer, you'll be eligible to receive recompense for the full range of damages, including punitive, pain and suffering, and mental anguish.