“Workers’ Compensation” refers to a system of laws that describe specific benefits to which injured employees are entitled, and the procedures for obtaining those benefits. Each state has its own workers’ compensation laws, which are contained in statutes and vary from state to state. In addition, there are special workers’ compensation laws for federal government employees, and others for workers in specific industries such as railroad employees.
Under the law in most states, every business must have some form of workers’ compensation insurance to cover injured employees. Filing a workers’ compensation claim is similar to filing an insurance claim; It is not a lawsuit against an employer, but rather a claim for benefits.
The Purpose and Effect of Workers’ Compensation Laws
Workers’ compensation laws are designed to ensure that employees who are injured on the job receive fixed monetary compensation, without having to litigate their claims against their employers. In this way, workers’ compensation is an important safety net for employees when they are injured on the job, or as a result of their work.
Most workers’ compensation laws also provide employers and co-workers with a certain level of protection, by limiting the amount that employees can recover from their employers, and by prohibiting (in most cases) employees injured people sue their co-workers. In essence, workers’ compensation is a no-fault system where the negligence of the injured worker himself (or the negligence of his employer or co-workers) is not called into question; rather, the injured employee is simply covered for his work-related injuries.
Therefore, workers’ compensation is an “exclusive remedy” for the injured worker with respect to a work-related injury, unless he or she can point to a third party who contributed to his or her injuries. For example, because workers are often injured by products or machinery they use on the job, they can, and often do, seek compensation from the manufacturers of such products.
Third Party Claims – Employers Can Recover Payment
Employers are generally not directly involved in their employees ‘third-party claims, and such claims take place in civil actions, rather than in the workers’ compensation system. In most cases, however, an employer can recover its workers’ compensation payments and recovery obligations that an injured worker obtains from a lawsuit against a third party. In some states, the worker’s compensation insurer and the employer may bring the employee-initiated lawsuit and try to protect your rights to recover the amounts.
In other states, the employer is awarded a lien against the employee’s recovery. In those states, the employer and insurer must wait until the employee has made a recovery, at which point they affirm the lien and the employee must then return money that duplicates the workers’ compensation benefits previously received or receivable.
Workers’ compensation benefits claims vs. civil lawsuits
Workers’ compensation is generally considered a substitute for a claim by an employee against his employer. In exchange for not suing the employer in court, employees are entitled to workers’ compensation benefits, regardless of who was at fault for the accident or injuries. Most employees are automatically entitled to workers’ compensation, but at the same time, the employer is automatically protected from most employee claims.
Types of injuries covered by workers’ compensation
For a work-related injury, an employee may be eligible for compensation for any of the injuries listed below:
- Pre-existing conditions that the workplace accelerates or aggravates. Examples may include a back injury, although the employee didn’t notice pain from the injury until later.
- Injuries caused during breaks, lunch hours, and work-sponsored activities (such as a company picnic) and on-the-job injuries caused by company facilities, such as a chair in the company dining room.
- Diseases such as lung cancer, if contracted by exposure to toxins at work as a result of normal working conditions.
- Injuries resulting from mental and physical strain caused by increased work tasks or work-related stress. In some states, this includes employees who develop a disabling mental condition due to job demands and constant harassment from a supervisor.
Injuries not covered
However, there are some injuries that may not be covered by workers’ compensation. State courts are divided as to whether an employee can recover from an injury sustained during horseplay on the job. Many states do not grant benefits to a person who is injured while intoxicated or who deliberately injures himself. Additionally, an employee who is injured while traveling to or from work is generally not entitled to benefits unless the employer has agreed to provide the worker with transportation, to pay the employee’s cost for the trip to work, or if the travel is required while fulfilling your duties.
If a worker leaves the employer’s premises to run a personal errand and is injured, they may not be entitled to workers’ compensation benefits. However, if an employee is injured while returning from company-sponsored education classes, or going to the bathroom, visiting the cafeteria, taking a coffee break, or leaving a non-smoking office to smoke a cigarette, and Injury, workers’ compensation boards and courts typically recognize that employers benefit from these “non-business” conveniences of employees, and often award compensation.
The scope of workers’ compensation coverage
Workers’ compensation coverage varies by state and occupation. For example, some states exempt certain categories of workers, such as agricultural employees, domestic employees, and independent contractors, from their workers’ compensation systems. Other states require coverage only if the employer employs a minimum number of employees.
Hire an Attorney for Workers ‘Compensation Coverage or Workers’ Compensation Issues
To determine if your employees are entitled to workers’ compensation benefits, you should contact an experienced business and commercial attorney in your area. Also, keep in mind that if your employees are not covered by workers’ compensation, they may be able to file a civil lawsuit against you and / or your company.