From construction work to nurses, many jobs in the country present a high risk of injury to employees. Laws on workers’ compensation are designed to protect employees from economic losses caused when they are injured or contracted a work-related illness. While the rules and procedures related to workers’ compensation vary from state to state, almost all states have some version of the same basic laws that govern claims related to the subject.
How does compensation for work accidents work?
In many states, employers are required to offer workers’ compensation compensation coverage, but in some, they are exempted from those with less than a certain number of employees. The employer pays insurance directly and is generally prohibited from requiring the employee to pay the cost of coverage. As with most other types of insurance, benefits are paid when a valid claim is filed and the criteria established by state law are met.
Claims for workers’ compensation
Most state laws aim to expedite the process of filing claims for workers’ compensation. However, these claims must pass certain tests that vary by jurisdiction and type of work. Some of the most common tests to determine if a claim is valid are the following:
- The presence or absence of drugs or alcohol in the employee’s body at the time of the accident
- If the employee violated the company’s security policies and procedures
- If the injured party was an employee of the company at the time of the incident
- If the injury or illness really occurred at work
The employer’s duty to provide workers’ compensation compensation coverage extends to providing training, appropriate equipment and safety information. The employee’s duty to follow and use this training is sometimes considered a key element for the acceptance or rejection of the claim.
What does compensation for accidents at work cover?
The benefits of workers’ compensation usually cover medical costs and a percentage of wages not received as a result of the injury or illness, in most cases, not subject to taxes. Benefits may be limited to a specific amount of time or may be extended if the employee requires more comprehensive services, such as occupational rehabilitation or training for another. Coverage, requirements to file a claim and filing times vary by state.
What does not cover compensation for accidents at work?
Among other things, workers’ compensation compensation generally does not cover:
- Injuries suffered outside the company’s facilities or the time loaned to the company
- Injuries or illnesses that arise as a result of the consumption of drugs or alcohol in the company’s facilities or during the time loaned to the company
- Pain and suffering as a result of the injury or illness
It is possible that certain classes of workers are not covered by the workers’ compensation law in a given state, for example:
- Maritime workers
- Independent contractors
- Undocumented Workers
Can an injured worker sue his employer?
If workers’ compensation is accepted, the benefits do not cover pain and suffering. During the litigation, however, there is the possibility of receiving compensation for punitive and other damages.
Most states allow injured workers to file a lawsuit against their employer, but the worker generally cannot claim the benefits of workers’ compensation if they initiate legal action. In some cases, a lawyer who specializes in workers’ compensation can help the worker receive the benefits that were unfairly denied.