Workers' Compensation Benefits Explained
When you go to work, you trust that you are safe. However, sometimes accidents will happen. You might suffer a workplace injury or even an occupational disease. It's important to understand the workers' compensation system in your state.
This article provides a brief overview of workers' compensation benefits.
What are workers' compensation benefits?
Workers' compensation is a type of insurance. It provides workers' compensation benefits to workers who get hurt on the job. These benefits can include medical treatment, reimbursement for medical bills, and disability benefits. Benefits can even include death benefits for dependents if the worst happens. These benefits are designed to cover a range of costs experienced by the injured worker.
The federal government does offer its own workers' compensation insurance for federal employees. However, each individual state has its own workers' compensation insurance program. State laws govern workers' compensation insurance. For example, the South Carolina Workers' Compensation Act outlines the system in that state.
Employers usually purchase workers' compensation insurance from an insurance company. The cost of this insurance is called a premium. It is based on factors like the kind of work done and the company's safety record. Some larger companies may be self-insured. This means they pay for workers' compensation benefits directly.
In most situations, injured employees receive workers' compensation insurance, no matter who was at fault for the injury. These workers comp benefits act as a type of insurance. Benefits preclude the employee from suing their employer for the injuries covered.
Be sure to check your own state's workers' compensation benefits laws by referring to the appropriate office in your state on the State Workers' Compensation official page of the U.S. Department of Labor website.
What accidents are not covered by workers' comp?
Workers' compensation insurance is designed to cover work injuries. The range of injuries and situations covered is broad, but there are limits. Compensation may be denied if:
- Injuries happened because a worker was intoxicated or using illegal drugs
- Injuries occurred while a worker was committing a serious crime
- Injuries happened while a worker was not on the job
- Injuries were self-inflicted, like if a worker started a fight
States can impose drug and alcohol testing on the injured employee and can deny the employee workers' compensation benefits if such tests show the employee was under the influence at the time of the injury. Most of these situations will be uncovered during the investigation. The investigation happens after a workers' comp claim is submitted.
What types of expenses does workers' compensation insurance cover?
Workers' compensation can cover a variety of expenses related to a work-related injury. Although the payments are usually modest, workers' compensation insurance covers:
- Medical Treatment: This includes doctor visits, surgery, medication, medical care, and other treatments.
- Disability Benefits: If an injured worker can't work, either temporarily or permanently, they may receive disability benefits. Those with impairments may be eligible for either temporary total disability or permanent disability benefits.
- Rehabilitation Costs: If an injured worker needs rehabilitation, workers' compensation may pay for it. This might include costs for retraining.
- Death Benefits: If a worker dies as a result of a workplace injury, their dependents may receive death benefits.
Wage replacement payments are usually about two-thirds of the worker's average weekly wage. The eligibility for wage replacement begins immediately after a few days of work are missed because of a particular injury or illness. You may have to be taken off work by doctors approved by the worker's comp system or your employer. Those doctors may also decide when you can return to work, either for light duty or full duty.
Remember that if a person collects workers' compensation benefits, they cannot sue the employer. Workers' compensation benefits do not cover pain and suffering.
Does workers' compensation cover long-term and permanent injuries?
Yes. Workers' compensation can cover long-term and permanent injuries. These may include permanent partial disability, where a worker is partially but permanently impaired, or it might include permanent total disability, where a worker can't work at all due to their injury. Examples of this may include carpal tunnel syndrome or back problems from repetitious movement. Some workers are exposed to injurious chemicals or substances over time, and the effects may not be known for years.
For more information, visit FindLaw's What Types of Injuries are Compensable Under Workers' Compensation? page.
Who is covered by workers' compensation?
Workers' compensation insurance covers most types of employees. Workers' compensation covers most full-time and part-time workers, including minors who are legally allowed to work. The specifics can depend on state laws and the company's workers' comp insurance.
States commonly exclude some workers from coverage, such as:
- Independent contractors
- Business owners
- Employees of private homes
- Farmworkers and farmhands
- Maritime employees
- Railroad employees
- Casual workers
Because employees of the federal government are covered under the federal workers' compensation insurance program, they are not covered by state workers' comp.
Some states do not enforce the workers' compensation program on employers with fewer than three to five employees. This varies from state to state.
Can I sue my employer for a work injury?
If workers' compensation covers you, you usually can't sue your employer for a workplace injury. The idea of workers' compensation is to provide benefits without going to court. Workers' compensation was created as an alternative to filing a personal injury lawsuit. There may be an exception, such as if your employer intentionally hurt you.
In some states, however, you may still be able to sue your employer for any reckless or intentional action of your employer that caused your injury. Other states may allow a wrongful death lawsuit if an injury results in the employee's death. In general, if you choose to do this, you will waive your right to workers' compensation.
If you are successful, the court may award a broad range of damages. This might include punitive damages, medical expenses, lost wages, pain and suffering, and mental anguish.
Can my employer fire me for filing a workers' compensation claim?
No. It is generally illegal for an employer to fire an employee for filing a workers' compensation case. This is considered retaliation, and most states prohibit retaliation by law. If an employer does retaliate against an employee for filing a workers' compensation claim, the employer should be reported immediately to the local workers' compensation office.
Learn About Your Benefits From an Experienced Workers' Comp Attorney
Understanding workers' compensation can be complicated, as there are many rules. Dealing with an insurance carrier can also be difficult. If you've been injured on the job and your employer disputes your workers' comp claim, you will likely need legal help.
A workers' compensation attorney can help you understand your legal rights. They can help make sure you get the medical benefits you deserve. Attorneys will help you navigate the workers' compensation system and investigate your workers' compensation coverage. They are skilled in workers' compensation law and can provide valuable legal help.
An experienced workers' compensation lawyer can provide peace of mind for your claim.
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Meeting with a lawyer can help you understand your options and how to best protect your rights. Visit our attorney directory to find a lawyer near you who can help.
Contact a qualified workers' compensation attorney to make sure your rights are protected.