Worker's compensation is designed to get employees swift medical and financial attention for a work-related injury or illness.
It's designed to benefit both the employer and employee while keeping the matter from ending up in court.
The concept of workers comp benefits sounds simple enough, but the law has many gray areas.
Workers comp eligibility requirements vary, sometimes drastically, from state to state.
If you’ve suffered a work-related injury or become sick because of conditions at your workplace, you may wonder if you are eligible for workers’ compensation benefits.
In the article below, we will discuss how to qualify for worker's compensation.
Table Of Contents
- What Is Workers Compensation?
- How Do I Qualify for Workers Compensation?
- Who is Not Covered by Workers' Compensation?
- Worker's Comp Statute Of Limitations
- Is It Worth Getting a Workers Comp Attorney?
What Is Workers Compensation?
Workers comp benefits provide medical expenses and medical care, lost wages, and rehabilitation costs to employees who are injured or become ill “in the course and scope” of their job.
Worker's compensation also pays death benefits to families of employees killed on the job.
Individual states mandate compensation coverages, and the wage and medical benefits vary by state.
Workers’ compensation is social insurance because it relies on a social contract between management and labor.
Business owners who offer workers comp benefits to their employees are generally protected from civil suits from their injured workers.
How Do I Qualify for Workers Compensation?
You Must Be an Employee
The first step to qualifying for worker's compensation benefits is that you have to be an employee of the business.
For the most part, only official employees may file claims against an employer’s worker's compensation insurance.
The employee can't be an independent contractor or volunteer when they are injured.
To be considered an employee, you must be hired to work without a designated end date, provided a regular hourly wage or salary, and have taxes withheld from your paycheck.
Part-time or seasonal employees are also eligible for workers’ compensation.
Temporary workers who suffer a job-related injury are usually covered by the temp agency they work for and not by the company where they are placed.
Your Employer Must Have Workers' Compensation Insurance
All businesses with employees must have worker's compensation insurance because of a 70-year-old federal law.
Businesses pay premiums, and the benefits are managed by the employer’s private insurance company or a worker's compensation fund run by the state.
Always be sure your employer is covered by worker's compensation insurance.
You can visit the U.S. Department of Labor’s website to learn about the agency that oversees workers comp in your state.
From there, you can also find your employer’s liability limits in a compensation claim for work-related injuries and illnesses.
If your employer doesn’t have worker's compensation insurance, you will need to file a worker's comp lawsuit with the help of a worker's compensation attorney.
But even if your employer is insured, always be careful before you sign off on the offered compensation.
Once you've agreed and signed a settlement offer, you can't sue if your paid-out benefits prove insufficient for your workplace injury.
It's always good to speak with a workers comp attorney about your injury.
The Injury Must Be Work-Related
A worker's compensation injury must occur at work to qualify for compensation benefits.
Even when not the result of the employee’s misconduct, accidents on the job are covered.
So are repetitive stress injuries where a body part breaks due to the cumulative effects of job-related duties, like typing on a keyboard causing carpal tunnel syndrome or injuring your back lifting heavy objects.
Worker's compensation will also cover illnesses resulting from work or working conditions.
For example, exposure to hazardous materials can trigger allergic reactions or asthma, and asbestos exposure can lead to mesothelioma.
Loud noises in the workplace can cause hearing loss.
Courts have also established that injuries linked to emotional or mental stress are also compensable injuries.
Proving emotional injuries isn't easy, and states have different concepts about what qualifies as stress.
But if you are injured during your commute or lunch break, you likely won't be entitled to worker's compensation benefits.
The Employer Should Regularly Have At Least Three Employees
If you are one of only two employees, your employer may not be subjected to your state's worker's compensation laws.
That means if you are injured on the job, you still may not have a valid worker’s compensation claim.
But in these situations, your employer will not be protected by the exclusive remedy provision of the Workers’ Compensation Act.
That means you may be able to sue your employer if their negligence was the cause of your injury.
Who Is Not Covered By Workers' Compensation?
Business Owners, Sole Proprietors, and Partners
Most of the time, business owners, sole proprietors, and business partners aren't covered by workers' compensation insurance.
But in some states, business owners, sole proprietors, and partners can be covered by workers' compensation if they pay to get workers' comp insurance and pay the premiums.
Volunteers
Volunteers are not considered employees so they aren't covered by workers' compensation insurance.
However, some organizations purchase workers' comp insurance to cover their volunteers.
Some exceptions do exist to this general rule.
For example, volunteer firefighters are covered by workers' compensation, as are any volunteers requested by a firefighter or police officer to assist in an emergency.
Independent Contractors
Independent contractors generally aren't covered by workers' compensation insurance.
The distinction between an employee and a general contractor matters greatly when a worker is injured on the job.
Some employers try to classify an injured worker as an independent contractor to avoid paying for their worker's compensation benefits.
Worker's Comp Statute Of Limitations
Each state will have its own statutes of limitations for worker's compensation claims.
The deadline could vary depending on your type of injury as well.
Typically, the statute of limitations for filing a workers’ comp claim is one or two years from the date of the injury.
Employees are usually required to notify their employers within 30 to 45 days of the injury, but the sooner, the better.
If you wait too long to notify your employer, you can jeopardize your ability to receive workers’ comp benefits.
You can notify your employer with a formal letter or email detailing the work injury.
Or you can do it informally, such as mentioning wrist pain caused by typing all day.
As an injured employee, always err on the side of caution and submit a written notification of the incident detailing the nature of the ailment and when, how, and where it occurred.
Is It Worth Getting a Workers Comp Attorney?
Determining whether an injury is work-related or not can be complicated.
If your injuries do not qualify for workers’ compensation, you may have other legal options.
If your work-related injuries qualify, you still may be eligible for additional compensation.
And your insurance company makes a profit by paying out as little as possible in workers’ compensation claims.
So, even if you are eligible to receive workers’ compensation, it is essential to consult with an experienced workers’ compensation law firm.
A compensation attorney or injury lawyer will help ensure that all of your rights are protected and that you get the medical care you deserve if you have a compensable injury.
If you have suffered any type of injury or sickness that is work-related, a work injury lawyer at Helping The Hurt can help.
They will help you understand workers’ comp laws, explore your legal options, protect your rights, and file any necessary claims on your behalf.
If you need our help with a workers comp injury, please schedule a Free Consultation with Helping The Hurt today.
References:
https://www.insureon.com/blog/what-counts-as-a-workers-comp-claim
https://vanasselaw.com/workers-compensation-faq/what-benefits-am-i-entitled-to/
https://www.rsinjurylawyers.com/library/georgia-workers-compensation-benefit-eligibility.cfm
https://workerscompensationexperts.org/injury/benefits/eligibility-and-requirements/
https://www.disabilitysecrets.com/resources/what-jobs-arent-covered-workers-compensation.htm
