What Is Workers' Compensation Law?

Occupational safety is a significant focus in most workplaces, but accidents can and will happen. Work-related injuries would be costly for employers and their employees if not for workers’ compensation insurance. The workers’ compensation system remedies injured workers without requiring employers to pay out of pocket for a work injury.

Workers’ compensation insurance law is state-specific and usually handled through state agencies, making it complicated to understand. The following is a brief overview of this area of law and how to know when workers’ compensation benefits apply to you.

What Is Workers’ Compensation Insurance?

Workers’ compensation insurance is accident insurance coverage that protects employers and injured employees from job-related injuries and financial loss. Employers pay the insurance providers to cover their injured employee’s medical expenses.

With proper workers’ compensation coverage, no deductions are made from the employees’ paychecks. If an employee is unable to work at their full earning capacity due to their work-related injuries, they may receive permanent partial disability benefits, temporary total disability benefits, or permanent total disability benefits depending on their condition.

An employee may receive vocational rehabilitation services through workers’ comp in order to return to work or transition to another role. Workers’ compensation claims can be filed by the employer, the injured employee, or the doctor treating the employee.

Requirements for Claiming Workers’ Comp

Workers’ compensation insurance is accident insurance that protects employers and employees from injury-related financial loss.

When a workplace injury requires medical treatment, benefits are paid out by a private insurance carrier or state-run workers’ compensation programs. Two primary requirements must exist for a worker to be eligible to receive workers’ compensation benefits:

Requirement 1: The Injured Person Must Be an Employee

Most workers either qualify as employees or independent contractors. Employees can receive medical benefits through workers’ compensation programs, but independent contractors cannot, so all parties must understand how the determination is made.

The inquiry into whether someone is an employee is usually fact-specific, which means the result turns on the specifics of your situation. Generally, though, you need to look at the degree of control and independence in the relationship. Factors to be considered include whether:

• The company controls how the worker does their job
• The company provides necessary supplies
• The company dictates when and how the worker is paid
• There are written contracts
• The work performed is a crucial aspect of the business

No one factor will dictate whether a worker is an employee, and there is no magic number of factors that means the worker must be considered an employee.

Requirement 2: The Injury Must Be Work-Related

The general rule is that if an employee was injured while doing something for the benefit of their employer, then their injury is work-related. There are some situations where this rule applies easily, like if they hurt their back while lifting things on the job. However, there may be situations where it’s not clear if the employee’s injury really happened during the course of their employment.

Lunch Breaks

An employee injured off-site while picking up lunch likely won’t be able to receive workers’ compensation benefits unless they are also picking up lunch for their boss. If an employee is injured while eating on the employer’s premises (in a break room, for example), that is more likely to be covered.

Cumulative Injuries

Some occupational diseases or injuries result from prolonged exposure to chemicals, excessive stress, or repetitive motions. It is often challenging to prove that injuries of this nature are work-related, so employees will want to speak with a lawyer about the best way to approach their case. Additionally, stress-related illnesses are not covered by workers’ compensation benefits in every state.

Misconduct

Employee misconduct that leads to an injury is not necessarily a bar to receiving workers’ comp disability benefits. Whether the employee is covered depends on the jurisdiction and the extent of the misconduct. However, an employee will usually not be covered if they were drunk or using illegal drugs when injured.

Should I Talk To a Workers’ Comp Lawyer?

Workers’ compensation cases require a lot of document-gathering and navigation of administrative agencies. You might need medical records to prove an injury or contracts to show whether someone was an employee or independent contractor. If you’re an employer, you might need guidance about purchasing workers’ comp and what’s required. Because this area of law is state-specific, it will be helpful to talk to someone who knows the rules you must follow.

An effective lawyer will have experience in state law and dealing with the insurance company. They’ll be able to anticipate potential problems with your case and advise you on how to approach them. They will also keep track of deadlines and file all the paperwork with the necessary courts and agencies, giving you one less thing to worry about.

Workers’ Comp Lawyer FAQs

Below are some common questions you might want to consider when meeting with an attorney for the first time.

1. What are your attorney’s fees and billing options?
2. Can I work while receiving workers’ compensation?
3. What wage replacement benefits am I entitled to under my state’s workers’ compensation statutes?
4. Am I entitled to either temporary or permanent disability benefits?
5. How do I prove my injuries occurred in the course of employment?
6. What does workers’ comp pay for?
7. Am I required to purchase workers’ comp insurance for my employees?

Finding the Right Attorney for Your Needs

Visit the Super Lawyers directory to find a lawyer who practices workers’ compensation law in your area.