Workers' Compensation - FAQ
Did You Know?
Each of us has a 20 percent chance of becoming a person with a disability and a 50 percent chance of having a family member with a disability.
What is Workers' Compensation?
Workers' Compensation is insurance that your employer is
required by law to carry to help you in case you are
injured on the job or become ill due to your job.
How do I know whether I am covered by workers' compensation?
Determining whether or not you are covered by workers' compensation can sometimes be quite complicated. Generally, however, there are two main factors that determine your status: first, whether you are an employee, and second, whether your injury occurred as a result of your employment. It should be noted that neither of these factors is an absolute guarantee that you will be covered by workers' compensation. For example, depending on the state, some employees (for example, agricultural workers) are not covered by workers' compensation. Also, if you were intoxicated at work or intentionally injured yourself, you might not be covered by workers' compensation. When in doubt, you should contact an experienced workers' compensation attorney, who can advise you of your rights.
What is a workers' compensation injury?
Any injury or illness that occurs due to employment is considered a workers' compensation injury. Under workers' compensation law, you will receive help if you are injured no matter who was at fault. Some types of workers' compensation injuries are: broken/fractured bones, back problems/pain, knee problems/injuries, grip loss, heart attacks, hypertension, wrist injuries (carpal tunnel syndrome), burns, shoulder pain, neck pain, headaches, etc. You may be entitled to benefits even if you are still working.
Who pays workers' compensation benefits?
In most states, employers are required to purchase insurance for their employees from a workers' compensation insurance carrier. In some states, larger employers who are clearly solvent are allowed to self-insure, or act as their own insurance companies. When a worker is injured, his or her claim is filed with the workers' compensation carrier, or the self-insuring employer, who pays medical and disability benefits according to a state-approved formula. It is noteworthy that some smaller companies (with fewer than three or four employees) are not required to carry workers' compensation insurance at all.
What should I do if I get injured on the job?
Immediately report your injury to your employer.
If, before your injury, you gave your employer
written notice of the name and address of your personal
physician, you can go to that physician for treatment
immediately after an injury. If you did not notify your
employer about your physician, your employer is responsible
for arranging for your treatment. If your employer fails
to refer you to a doctor after being notified of your
injury, you may choose your own doctor.
Furthermore, your employer will provide you with a claim
form on which you must describe your injury and how,
when, and where it occurred. Return the completed form
to your employer.
Contact an attorney that handles Workers' Compensation
cases in your area.
What Injuries are covered by the Workers' Compensation Act?
In simplest terms, if your work causes you an injury, irritates an existing medical or physical condition or causes an illness, the law entitles you to workers' compensation.
A physical or medical condition that already exists (a heart condition, diabetes or even a high school sports injury) does not affect your eligibility for benefits.
For example, a man who for years had a problem with his right knee because of a football injury is eligible for workers' compensation if the job makes his knee problem worse.
Work that irritates an existing disability or causes a disabling injury entities you to benefits.
Employers who deny you workers' compensation because of a prior back problem, a preexisting heart condition or other reasons either do not know the law or are not telling you the truth.
What is a work-related disease or illness?
Long term exposure to chemicals, dust, fumes, solvents and various compounds may cause a serious illness or disease or irritate an existing medical or physical condition. A liquid you use readily today may be tomorrow's cancer causing chemical.
How much does it cost me?
There is no charge to you. If you qualify for workers' compensation, all approved medical bills
will be paid in addition to any temporary or permanent disability compensation you're entitled to. Furthermore, if an attorney handles your case, generally they will not charge you anything unless they make a recovery for you.
How does this affect my own health insurance?
Workers' compensation is separate from personal health care insurance. Workers' compensation insurance covers work-related injuries and illnesses. There is no deductible-all approved medical bills will be paid. It is important to let the treating doctor know if your injury is work related.
Do I have to be injured at my workplace to be covered by workers' compensation?
No. As long as your injury is job-related, it's covered. For example, you'll be covered if you are injured while traveling on business, doing a work-related errand or even attending a required business-related social function.
If I'm injured do I have to file a claim form?
Yes. As soon as you can after your injury,
tell your supervisor that you have been hurt. Your employer
will provide you with a claim form on which you must
describe your injury and how, when, and where it occurred.
Return the completed form to your employer, who will
send it to us. We will then get in touch with you to
explain the benefits you will be receiving.
Can I lose my job because of a workers' compensation injury?
The law prohibits your employer from discharging or discriminating against you because of your workers' compensation injury. If you believe you have been discriminated against because of your injury, you should discuss your rights with a Workers' Compensation attorney.
What other benefits am I entitled to other than Workers' Compensation?
You may be entitled to state disability insurance benefits (SDI). If you have paid into this fund,
the state provides temporary disability benefits. Though
normally paid for non-industrial illness or injury,
if your employer's Workers' Compensation insurer refuses
to pay your benefits, the State of where you live may
pay them to you. You may also be entitled to these benefits
if the insurer stops paying your benefits even though
your treating doctors feel you are unable to return
to work and are still temporarily disabled.
If the Workers' Compensation Appeals Board judge later determines that you were entitled to
Workers' Compensation benefits from your employer's
insurer during the time your were receiving SDI, your
employer's insurer will have to reimburse the State
for the benefits paid to
you.
Do I need an attorney?
You have the right to be represented by an
attorney of your choice in connection with your work-
related injury. Your attorney will assist you in seeing
that your benefits are properly protected.
Your employer or your employer's insurance company will
be advised and represented by individuals experienced
in Workers' Compensation cases and you should have an
attorney experienced in handling Workers' Compensation
representing you.
There is no filing fee for filing an application with the Workers' Compensation Appeals Board.
Attorney's fees for representing an injured employee
are determined by the Workers' Compensation Appeals
Board judge and are paid out of the settlement or award.
These are
usually a percentage of the monetary recovery awarded
to the injured employee. They may range from 10% to
20% of the award, depending on the complexity of the
case and time involved.
Are there Consultation Fees to have my case reviewed by an Attorney?
Usually, attorneys do not charge for consultations in Workers' Compensation matters.
Time limits
Workers' compensation laws provide some time
limits for claiming compensation benefits. Generally,
proceedings must begin within one year from the date
of injury. It is very important
that you act promptly so a not to risk losing your benefits because you waited too long.
Who pays workers' compensation benefits?
In most states, employers are required to purchase insurance for their employees from a workers' compensation insurance company -- also called an insurance carrier. However, in some states, smaller companies (with fewer than three or four employees) are not required to carry workers' compensation insurance. In some states, larger employers who are clearly solvent are allowed to self-insure, or act as their own insurance companies. When a worker is injured, his or her claim is filed with the insurance company -- or self-insuring employer -- who pays medical and disability benefits according to a state-approved formula.
What if my employer tells me not to file a workers' compensation claim or threatens to fire me if I do?
In most states, it is a violation of the workers' compensation laws to retaliate against an employee for filing a workers' compensation claim. If this happens, immediately report it to your local workers' compensation office.
Will I get fired if I file a claim?
NO. Employers are forbidden from terminating or discriminating against any employee who has filed employment a workers compensation claim. However, there are some employers that refuse to obey the law. Further, the employer is not required to hold open a job indefinitely while an employee in unable to return to work. In general, the smaller the company, the shorter the length of time that an employer will be able to hold open a job for an injured employee.
Can I ever sue my employer in court over a work-related injury?
Yes. If you are injured because of some reckless or intentional action on the part of your employer, you can bypass the workers' compensation system and sue your employer in court for a full range of damages, including punitive damages, pain and suffering and mental anguish. We strongly recommend that you consult with an attorney before you sign any papers related to your Workers' Compensation claim. YOU MAY BE ENTITLED TO MONETARY COMPENSATION.
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