Have you been injured on the job? Then you deserve workers’ compensation! Here is the process to applying for it, and everything else you need to know.
It’s never easy to think about, but it’s important to prepare for the worst—especially in the workplace.
If you are injured on the job, you may be entitled to workers’ compensation. Each state holds different laws governing injury compensation. Each company practices different policies and procedures in this respect.
Workers’ compensation is a form of social insurance that pays benefits to employees who become injured or disabled as a result of working.
In essence, it is a wage-replacement system. If you are unable to work, you receive a percentage of your wage tax-free. The actual amount paid depends on many factors.
For this reason, it is important to retain an experienced disability lawyer who can advise you of your rights and entitlements.
Keep reading to learn everything you need to know about worker’s compensation.
Basics of Workers’ Compensation
Most states require businesses to carry workers’ compensation insurance. These policies vary based on state law, the type of work performed, and the size of the company payroll. You can also supplement your employer coverage with your own private income insurance.
Most companies purchase policies from private insurance companies. There are also state-funded programs available.
Unlike other forms of non-working insurance, workers’ comp is tax-free. In most cases, the injury must result from work. This differs from outside situations preventing you from working.
This is where workers’ comp varies from other forms of unemployment insurance. Disability insurance covers injuries not sustained while working but impede you from working.
In some cases, workers can take paid sick days on medical leave if they did not receive a monetary reward.
When monetary claims are rewarded, the payout can depend on many factors. Benefits can include:
- Medical fee coverage
- Lost wages (including back pay)
- Living expenses
- Rehabilitation costs
- Re-training costs to return to work
- Funeral expenses and death compensation to family members, if applicable
Furthermore, states like Massachusetts serve as no-fault states. This means you can be eligible for benefits even if you caused the injury yourself.
Each company has different workers’ comp policies and procedures, and compensation laws vary by state.
Why Workers’ Comp Over Litigation?
It’s critical to note that by accepting this benefit, you enter the “compensation bargain” where you waive the right to sue your employer.
This can be good for the injured person, as it provides guaranteed compensation. There is no need for a lengthy legal process in which you could potentially walk away with nothing. Furthermore, if the case goes to litigation, the burden of proof is on you to show your employer is responsible.
Workers’ comp is also good for the employer, as they avoid a potentially costly lawsuit that requires legal fees even if they win the case.
There are some exceptions where you can override and sue for damages anyway:
- Intentional harm to an employee caused by employer/coworker
- Defective products causing injury
- Exposure to toxic substances
- Suits against third-parties, including vendors, subcontractors, etc.
Some unique types of employees and businesses are exempt from workers’ comp laws, depending on the state.
This has become a hot topic in the media over the past few years. Companies like Uber and Lyft have battled to avoid providing these benefits to their employees. They deem them “independent contractors,” thus not subject to such protections.
What Qualifies for Workers’ Comp?
Workers’ comp laws are not always black-and-white. There can be more explicit examples from a one-time injury, as well as more complicated situations.
One example of this is a repetitive strain injury. These cases are difficult to navigate. They require a greater burden of proof to ensure the injury resulted directly from workplace conditions.
Repetitive strain injuries tend to be more common in the hand but can also appear in the knee, back, or hips. It is best to contact a lawyer if this applies to you to determine the viability of your claim in this situation.
Other workplace injuries can include:
- Physical injuries resulting from a one-time incident (broken bone, laceration, etc.)
- Repetitive stress injury (RSI) from a long-term working condition (knee or back damage, etc.)
- Work-induced psychological injury
- Medical conditions exacerbated by workplace conditions
There can also be work-related injuries that occur when away from the office or worksite. During the COVID crisis, many office-based employees are working from home. Surprisingly, there is still the possibility of injury while working remotely.
What Do I Do if I Am Injured on the Job?
Not everything that happens on or near the job site falls under the jurisdiction of workers’ comp. A piece of equipment injuring a construction worker at a job site would be covered. An employee getting into a car accident on their way to work would not.
In any type of injury case, it is important to contact a lawyer to review your options and ensure your well-being. If you do have a legitimate workers’ comp case, time is of the essence.
Exact laws vary by state, but in Massachusetts you have up to four years to file a claim after a workplace injury. Of course, the sooner you act, the more information is readily available and, thus, the quicker award of benefits.
If you think you could be ready to return to work, some states allow for a 28-day trial period to assess readiness to return. After the trial, benefits can be reinstated if you do not feel ready to continue working. The compensation process does not need to start over.
Report Your Injury Immediately
In the case of workplace injury, the employee should contact their supervisor as soon as possible. They will create an incident report with the date, time, and details of the situation.
Again, the exact procedure depends on state laws. Your supervisor should collect the necessary information, including:
- Your personal information
- The details surrounding the incident
- Any witness testimony
- Security/camera footage, if available
- Company and insurance policies/procedures
The key to a smooth workers’ comp process is to gather as much information as possible.
It’s imperative to seek medical attention as soon as possible and to keep a copy of the detailed medical report. This includes any prescriptions, reports, charts, tests/labs, diagnoses/prognoses issued, etc.
Be sure you closely follow directions and prescriptions from medical professionals. This includes follow-up visits, physical therapy sessions, etc.
This ensures there is no later claim that you exacerbated the injury with your own actions/inactions.
Be sure to document and keep your supervisor apprised of developments in your injury.
Consult an Attorney
After reporting your injury to the company and consulting a medical professional, getting a lawyer to help is key. This ensures you know your rights, and that your employer does not take advantage of you.
If the case does end up in court, the cases often become emotionally-charged. Even if you are on good terms with your employer, they may not have your best interests in mind.
An attorney can advise you of the best course of action and help to maximize your claim.
In the initial consultation, the attorney will go over all the facts of your case. This includes the nature and circumstances surrounding the incident, and your employment history.
The lawyer will estimate how much compensation you could expect based on these factors.
If your employer has denied your workers’ comp claim, or otherwise treated you unfairly, your attorney can file a legal claim.
What if Your Employer Contests the Claim?
After you file a claim, your company may dispute it as they want to keep their incident rates down to lower insurance premiums. If disputed, the state workers’ compensation evaluation board will investigate.
A state-designated doctor will then evaluate the injured employee.
While this doctor is impartial, they are not subject to doctor-patient confidentiality protections. The employer can sue anything the injured employee says against them. This includes anything to suggest the injury is fake, less severe than claimed, or not work-related.
The board may rule the claim is not valid or not covered. In these cases, the employee can appeal. These cases are often contentious and difficult to navigate—making an attorney essential.
The world of workers’ compensation can be complicated.
With laws varying from state-to-state and based on the nature of work, the layperson may have a hard time determining their rights as an employee.
Contacting a lawyer is the best course of action to identify your options.
In Massachusetts, free consultations are available to lay out the case, discuss options, make a plan, and answer questions.
Contact an experienced attorney today for a free consultation!