What is Workers' Compensation Law?
How to know when this law applies
on December 15, 2016
Updated on November 15, 2022
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 administrative 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.
Workers’ Compensation Law – What You Need to Know
- 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.
Workers’ compensation claims can be filed by the employer, the injured employee, or the doctor treating the employee.
An Overview of Workers’ Compensation Law
Workers’ compensation insurance is accident insurance that protects employers and employees from injury-related financial loss. Employers pay the insurance premiums, and there are no deductions from the employees’ paychecks to cover the costs of medical care. This can be massive peace of mind not only for the person suffering the workplace injury but also for their loved ones and dependents.
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 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: 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.
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.
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.
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.
Common Questions to Ask an Attorney
Below are some common questions you might want to consider when meeting with an attorney for the first time.
- Can I work while receiving workers’ compensation?
- How do I prove my injuries are work-related?
- What does workers’ comp pay for?
- How much does workers’ comp insurance cost?
- Am I required to purchase workers’ comp insurance for my employees?
- What type of attorney fees do you require throughout employment?
Finding the Right Attorney for Your Needs
It is essential to approach the right type of attorney—someone who can help you through your entire case. To do so, you can visit the Super Lawyers directory and use the search box to find a lawyer based on your legal issue or location.
To help you get started, you may want to consider looking for a lawyer who practices workers’ compensation law.
Should I Talk to a 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.