Workers' Compensation Resources

You may be entitled to workers' compensation benefits if you are injured on the job. Workers' compensation benefits include wage loss, medical, vocational rehabilitation, and more. However, navigating the workers' compensation system can be difficult without the proper guidance.

Workers' compensation programs are state-specific. Your state's workers' compensation laws may differ from those of neighboring states. Every state, except Texas, requires all private employers to carry workers' comp insurance. You'll need the appropriate forms for your state to apply for workers' compensation benefits.

See the FindLaw Workers' Compensation section for more information about workers' compensation. There, you can find more in-depth information, including:

• Which wage-loss benefits may be available to you
• Medical benefits and vocational rehabilitation
• Your employer's obligations
• How to report work-related injuries
• How to file a claim for workers' comp benefits
• Which injuries qualify for workers' comp benefits
• FAQs about workers' compensation
• What happens if the worker's compensation insurance company denies your claim
• Workers' compensation and self-employment

This article overviews workers' compensation benefits. It also provides a list of resources to help you learn about the claims process.

Workers' Compensation at a Glance

Workers' compensation is a specialized area of law. States regulate their own workers' compensation systems. This section only discusses general rules and guidelines. Workers' comp laws vary from state to state.

If you have suffered a work-related injury, consider contacting a workers' compensation lawyer. They can provide more specific information about your options.

No-Fault System

Workers' comp is a no-fault system. Workers' compensation represents a policy agreement between workers and their employers. It is designed to provide benefits to injured employees. It also prevents civil litigation between employees and employers. Without workers' compensation, injured employees and their employers would flood the courts.

Employees who suffer an injury at work can receive workers' compensation benefits. The employee does not have to prove their employer was at fault or caused their injury. All the employee needs to show is that the injury arose from and in the course and scope of their employment.

In exchange for these benefits, the employee agrees not to sue their employer in civil court. The employer is thus protected from a potential lawsuit. The employer must provide benefits to the injured employee, even if the employee is at fault.

As with most areas of law, there are exceptions to the general rule. For example, suppose an employer's misconduct caused the employee's injury. The employee could file a civil lawsuit rather than a workers' comp claim. If the employee injures themselves due to intoxication, their claim may be denied. Depending on your state, there may be exceptions to the general rule that can affect your case.

Types of Injuries

There are several types of injuries covered by workers' compensation. These injuries are classified as:

• Acute injuries
• Repetitive use injuries
• Occupational diseases

An acute injury occurs from a specific incident. If an employee for a roofing company falls off a ladder and breaks a bone, that's an acute injury. Repetitive use injuries occur over a period of time. For example, if a nurse's shoulders wear out throughout a 30-year career, that could be a repetitive use injury.

Repetitive use injuries can be difficult to prove as work-related. There often is no specific incident the employee can point to as causing the injury. However, employers and insurers often accept repetitive use injury claims.

Occupational diseases include respiratory illnesses stemming from workplace exposure. For example, asbestosis is an occupational disease. Some states now consider post-traumatic stress disorder (PTSD) a workplace injury. Other states do not allow any compensation for nonphysical injuries or pain and suffering.

Work-Related Injuries

To qualify for workers' compensation benefits, the injured worker typically must show the injury:

• Arose out of their employment for the employer
• Occurred in the course and scope of their employment

Litigation often arises regarding these two elements. For example, consider an employee who drives to and from job sites many times daily.

Suppose an employee is injured in a car accident while driving from one job site to another. The injury likely arose out of their employment while performing their job.

But what if the injury occurred while driving from a job site to a restaurant for an unpaid lunch? In that case, the workers' comp insurance carrier may dispute the claim.

Not every injury sustained while working qualifies the employee for workers' compensation benefits. You may still have a personal injury claim if you suffered a personal injury that does not entitle you to workers' compensation benefits.

A personal injury case can be very complex. Such a case may involve the Occupational Health and Safety Administration (OSHA). There may be a breach of occupational safety. Consider contacting a personal injury attorney near you for more information. They can explain personal injury law and your legal rights regarding a potential personal injury lawsuit.

Types of Benefits

Workers' compensation cases generally allow for up to five different benefit types. Either the employer or the workers' compensation insurance company pays these benefits. The following benefits are generally available:

• Wage benefits are indemnity benefits paid to injured employees for lost wages due to a work injury. They are provided if an employee is entirely off of work. They are also provided if the employee cannot work their regular hours due to a work injury. Wage benefits are based on the employee's average weekly wage before the injury.
• Medical benefits pay for the employee's medical bills associated with medical care for their work injury. These benefits include physical therapy, chiropractic care, surgical consultations, and surgery.
• Vocational rehabilitation helps return the employee to the workforce. The goal of vocational rehabilitation may differ depending on the injury. Some employees may need a work hardening program to return to their date-of-injury job. Other employees may qualify for a retraining program if they cannot return to their position. Typically, a vocational rehabilitation expert will create a vocational rehabilitation plan. The plan will set out the plan's goals.
• Permanent disability benefits provide benefits to employees who cannot return to work. These benefits consider the employee's expected future earnings had they not suffered the permanent disability.
• Death or dependency benefits go to the family of an employee who died due to a work-related injury.

General Workers' Compensation Resources

Injured workers have various rights and obligations. The following resources can provide you with general information about workers' comp.

• The Office of Workers' Compensation Programs (OWCP) administers four major disability compensation programs. These programs provide replacement wage benefits, medical treatment, vocational rehabilitation, and more. The OWCP provides state-by-state information on workers' comp programs. If you have suffered an injury at work, consider contacting your state's agency.
• FindLaw's Directory of Qualified Workers' Compensation Attorneys provides attorneys who work on workers' comp cases in your area. These attorneys can provide you with information about medical bills and medical expenses. They can advise if your on-the-job injury qualifies for workers' comp benefits.
• FindLaw's Workers' Compensation Law by State article provides information on each state's workers' comp laws.

Industry-Specific Resources

Some industries see higher employee injury rates than others. These industries include mining, construction, and manufacturing. If you work in a specialized industry, there may be specific workers' compensation programs for which you qualify. The following links provide some, although not all, of these programs.

• The Division of Energy Employees Occupational Illness Compensation (DEEOIC) handles workers' compensation and medical benefits for employees of the Department of Energy, its agencies, contractors, subcontractors, and more. It provides information about available benefits and how to file a claim.
• The Division of Longshore and Harbor Workers' Compensation (DLHWC) ensures prompt and correct payment of workers' compensation benefits under the Longshore and Harbor Workers' Compensation Act. You may qualify for the program if you sustained an injury while performing work on navigable water (or adjoining areas like a dock or pier). Injured workers can learn more about their legal rights and how to file a claim on the DLHWC website.
• The Division of Coal Mine Workers' Compensation (DCMWC) administers claims filed by coal miners. This program compensates miners who develop pneumoconiosis (black lung disease) from coal mining. It also benefits surviving family members of miners who died from black lung. The website provides step-by-step information about filing a claim.
• The Federal Employers Liability Act (FELA) benefits injured railroad employees. FindLaw's step-by-step guide provides general information about FELA claims.
• The Federal Employees' Compensation Act (FECA) provides the equivalent of workers' compensation benefits for public sector employees. The federal government offers different workers' comp benefits to civilian government employees. Such benefits may differ from state-specific workers' compensation programs. The FECA's benefits are comparable to the general benefits states offer. The FECA website offers information about how federal civilian employees can file a claim. It also provides more specific details on what benefits are available.

Coordination of Benefits Resources

• Workers' compensation differs from federal Social Security disability. Disability benefits are available to employees who cannot work due to a personal medical condition. Disability benefits such as short- and long-term disability cover part of your wages. Such benefits do not cover medical costs. You may be entitled to disability benefits while receiving workers' compensation benefits. Additionally, if a dispute exists about whether an alleged work injury qualifies you for workers' comp benefits, you may receive disability benefits until the dispute is resolved. You may also receive the benefits simultaneously. In that case, the Social Security Administration may lower your disability benefits.
• Generally, you cannot receive unemployment insurance and workers' comp benefits simultaneously. Workers' comp benefits are for injured employees who cannot work due to their injury or can only work a limited number of hours. Unemployment insurance is for individuals who cannot get employment. However, if you lose your job while injured, you may be entitled to unemployment insurance. You are usually not eligible for both unemployment and workers' comp at the same time.
• Workers' comp is generally exempt from taxation by the Internal Revenue Service (IRS). There may be a small benefit reduction exception. If you settle your workers' compensation case, an attorney can provide legal advice on settlement language that exempts your settlement award.

Get Legal Advice About Your Workers' Compensation Claim

If you have questions about your claim or want to find out whether you should sue your employer, consider contacting a workers' comp attorney. A lawyer can provide you with information about the following:

• An evaluation of your workers' compensation case
• What to do if the insurance carrier denies your claim for benefits
• Whether your injury is compensable
• An injured worker's legal rights
• Your state's workers' compensation laws

Even the most straightforward injury can lead to considerable obstacles. State law requires most employers to provide fair compensation for workplace injuries and illnesses. A skilled workers' comp lawyer can help preserve your rights and fight for your entitlement to benefits.