You may think that the odds of encountering a workplace injury are small, but no one is exempt from the risk of a workplace injury. Every seven seconds, a worker is injured on the job. In one recent year, private industry employers reported 2.8 million nonfatal workplace injuries and illnesses.
An injured worker and their family often face a loss of income and enormous medical bills. Although your job is important, you shouldn't have to risk your health, safety, and financial well-being for the sake of your job. The intent of workers' compensation insurance (also known as workman's comp, work comp, or worker's compensation) is to provide injured employees with a way to receive money for work-related injuries..
If you have suffered a workplace injury or illness, you need information about workers' compensation as soon as possible. Reach out to an experienced workers' compensation lawyer at Dolman Law Group Accident Injury Lawyers, PA, with a successful track record in filing workers' compensation claims and recovering workers' compensation benefits.
Our workers' comp lawyers can review your case, answer your questions about workers' comp insurance and the claims process, and help you obtain the benefits you deserve. Don't wait, contact our law firm for a free consultation today.
The Purpose of Workers' Compensation
The idea of workers' compensation has been around for centuries. However, it began in the United States when Congress passed the Employers' Liability Acts of 1906 and 1908. Today, most states require employers to carry work comp insurance for full- or part-time employees.
Workers' comp claims provide injured workers with a way to pay medical bills and other expenses during their recovery from a workplace accident. A workers' comp claim can include lost wages, treatment expenses, disability payments, and costs associated with rehabilitation and retraining. Individual states administer the workers' compensation system, which is financed by compulsory payments made by the employer.
There are trade-offs to this system. A workers' compensation lawyer can help an injured employee receive payments quickly, but the payments are usually capped. The employer may avoid a lawsuit but still must provide benefits through its workers' compensation insurance company, even if the employer was not at fault.
Keep in mind that workers' compensation is different from unemployment income and disability insurance. Workers' comp law applies only when the worker gets injured or dies while at the workplace or performing job-related duties. However, unemployment income and disability insurance are paid regardless of whether the injury occurs within or outside the workplace.
Workers' compensation also differs from health insurance. Health insurance covers injuries and illnesses that are not job-related. A knowledgeable workers' compensation lawyer can explain the insurance coverage that applies to your situation.
Types of Injuries
Injuries suffered during the performance of job duties, including injuries that occur at an off-site location (for example, during business travel), are usually covered. However, injuries that are caused by employee misconduct, injuries that occur outside the scope of work, and injuries caused by “acts of God” are not covered.
Some of the occupations most likely to cause injuries include:
- Service jobs and first responders (including firefighters and police officers),
- Transportation and shipping,
- Manufacturing and production,
- Installation, maintenance, and repair.
If an employee has been injured, the employer or insurance carrier may request that a qualified doctor examine the worker. Failure to agree to medical examinations can affect workers' comp claims.
Common workers comp injuries include:
- Overexertion - Lifting or lowering heavy objects, repetitive movements such as a wrist injury caused by typing.
- Contact with objects and equipment - Being struck, caught, or crushed by objects, equipment, or collapsing structures.
- Slips, trips, and falls - Most of these happen on greasy, wet, or snowy walkways.
- Electrocution - A high-voltage electric shock can lead to serious injuries. Victims may suffer from cardiac arrest, nerve damage, organ damage, brain injuries, and burns. Workers such as electricians, construction workers, utility workers, and crane operators may suffer electrocution injuries.
- Respiratory illness related to the use of chemicals - Exposure to dangerous chemicals like lead, asbestos, pesticides, benzene, cadmium, beryllium, mercury, silica, paint, solvents, and acids may result in respiratory illness.
Which Injured Workers are Eligible to File a Workers' Compensation Claim?
It is not always clear who is covered by workers' compensation. A worker's status usually relies primarily on whether they are an employee and whether the injury occurred as a result of their employment.
You must be an employee of a company that has (or should have had) workers' compensation insurance. Even if you are a seasonal or part-time employee, you are eligible. Some categories of workers are exempt from workers' compensation requirements. Many state laws list specific types of employment excluded from workers' compensation coverage. These often include part-time domestic workers, such as maids and nannies. Also, part-time maintenance workers or gardeners employed in the home may be excluded.
You aren't eligible to file a workers' comp claim if you are an independent contractor, freelancer, or consultant. You should talk with a workers' comp attorney if you have been injured at work and believe you have been misclassified as an independent contractor.
Although some organizations provide workers' compensation insurance for volunteers, volunteers generally are not covered.
To be eligible, you must have been injured at work or as a result of job-related duties. That means you must have been injured at the worksite or while performing work that is related to your job. For example, if you have a car accident unrelated to your job or are injured performing chores at home, workers' compensation probably does not apply. On the other hand, if a worker gets injured while operating a forklift on the job or falling from scaffolding, the workers' compensation law probably does apply.
The Federal Employment Compensation Act (FECA) covers employees of the federal government, including employees of the executive, legislative, and judicial branches. The main exception is military personnel. It provides benefits such as compensation for wage loss, medical expenses, and payment to dependents of employees who die from work-related injuries or diseases. FECA also provides vocational rehabilitation for partially disabled employees returning to work.
The Workers' Compensation System and Subcontractors
Any subcontractor that uses employees is required to have its own workers' compensation policy. If you are a subcontractor working for another company, you need to know that the IRS and the individual states have different criteria for determining whether a subcontractor is an independent contractor or an employee. Therefore, even subcontractors that qualify as independent contractors for purposes of taxes may still be considered employees under state criteria.
How Does the Workers' Compensation Claim Process Work?
Individual states regulate workers' compensation. Therefore, the workers' compensation process can vary depending on the employee's location. If a worker suffers a personal injury on the job, there is a limited period of time to submit paperwork to receive a workers' compensation settlement. When a worker is hurt on the job, both the injured worker and the employer must fulfill certain requirements, or the claim could be denied.
When an injury occurs, the employer must:
- Provide the employee with the appropriate paperwork and guidance
- File the claim with the insurer
- Comply with state law for reporting work injuries
The employee must:
- Provide the employer with a detailed notification of the injury.
- File a formal workers' compensation claim
Workers' compensation provides payment for the cost of medical treatment, wage loss benefits, and financial compensation for permanent disability. Some states also provide benefits such as vocational retraining and return-to-work programs. Some states allow the surviving dependents to receive workers' compensation benefits if a worker dies on the job or due to an occupational disease.
There are several different types of workers' compensation benefits. The most common types include:
- Medical care: This includes the cost of medical care such as emergency treatment, hospital stays, doctor visits, nursing care, medical diagnostic tests, medication, physical therapy, and durable medical equipment (like crutches and wheelchairs).
- Rehabilitation: Most states provide some type of vocational rehabilitation to workers who are unable to return to their previous job due to an on-the-job injury. Some also provide psychological rehabilitation if a worker has suffered a work-related mental injury.
- Cash benefits: If you are partially or totally disabled, you may be entitled to workers' compensation cash benefits for your lost wages. If you return to work, but your injury causes you to earn less than what you made before the injury, then you may also be entitled to reduced earnings benefits.
- Death: If an employee dies due to a work-related injury, death benefits are paid to the worker's spouse, minor children, and other dependents. Burial costs are also covered.
While you don't need to prove negligence, the tradeoff is that workers' compensation benefits are typically capped by law. The payment amount decreases over time as the employee heals and begins to resume their job duties. Insurance companies, however, may exaggerate the degree to which they are not liable. A workers' comp lawyer at Dolman Law Group Accident Injury Lawyers, PA, can ensure that you recover as much compensation as the law allows, not a lowball offer the insurance company is trying to force you to accept.
An Experienced Workers' Compensation Attorney Can Explain Your Legal Options
Workers with a valid workers' compensation claim are guaranteed various benefits. In exchange, workers are prohibited from suing the employer in court for negligence. However, the employee can file a personal injury lawsuit if the employer intentionally caused the worker's injuries. In that case, the injured worker may be awarded damages for pain and suffering, punitive damages, and other tort damages not available through a workers' compensation claim.
In some situations, the injury or illness is indisputably work-related, and the claim is paid. If the claim is contested, the matter will be decided by a workers' compensation law judge. Also, the parties are encouraged to work out a settlement. However, if the parties are unwilling or unable to agree on a settlement, the injured worker and their attorney may decide to go to trial, sometimes called a workers' compensation hearing.
For example, if there is a disputed issue, such as whether the injury occurred at the workplace or during the performance of job duties, there may be a hearing. Even if the employer or insurance carrier is withholding benefits because they maintain that the injury is not job-related, the injured employee may be eligible for disability benefits. These payments will be deducted from future workers' compensation awards.
Generally, in a workers' compensation case, no one is determined to be at fault, and the amount of compensation is not affected by the potential fault. However, the claim may be affected if the injury is the result of the worker's drug or alcohol use or the intent to injure themself or another person.
In some situations, an injured worker may choose to receive a lump sum, called a settlement, instead of continuous benefit payments. There are pros and cons to both options. However, accepting a settlement means that you are giving up the right to future benefits, which may not be in your best interest if complications develop later.
Reaching a settlement agreement can be difficult. You want to receive the compensation you deserve, but the insurance carrier wants to offer the lowest possible amount. If you decide to seek a settlement, an experienced work comp lawyer can negotiate the best possible settlement on your behalf. Settling a claim is voluntary, so if you are not happy with the amount offered, you can refuse it. Some states allow a settlement to include a stipulation that the company will not pay extra benefits for the same injury in the future.
How Long Do Injured Workers Have to Report an Injury?
You must meet the deadlines for reporting the injury and filing a workers' compensation claim required by your state to qualify for recovering workers' compensation benefits. Some states require the incident to be reported in 30 days or less, but you should report your injury as soon as possible. Your employer then has no more than seven (7) days to report the injury to their insurance company. After that, you should receive an information brochure within three (3) days.
How Our Workers' Compensation Lawyers Can Help You
Although workers' compensation laws are meant to provide injured workers with fast relief, the long and complicated claim process can create a lot of stress in your life.
If you were injured at work and want to file a claim as soon as possible, consult a workers' comp attorney at Dolman Law Group Accident Injury Lawyers, PA. In addition to making sure you file all the necessary forms and meet the deadlines, our experienced attorneys will know how to gather the evidence needed to support your case, engage in productive negotiations with the insurance company, and represent you in any litigation. If you can't agree on a good settlement, our attorneys prepare for and can represent you at the hearing or trial.
For more information or to schedule a free case evaluation, call Dolman Law Group Accident Injury Lawyers, PA, at 833-552-7274 (833-55-CRASH) or contact us online.
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