Workers compensation rules

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Workers' compensation is a state mandated insurance program that provides benefits to employees who suffer job-related injuries and illnesses. Each state has its own laws and programs for workers' compensation.  In general, an employee with a work related illness or injury can get  workers' compensation benefits regardless of who was at fault, the employee, the employer, a coworker, a customer, or some other third  party.  

No! As long as your injury is job-related, it's covered. For example,  you will be covered if you are injured while traveling on business, doing a work-related errand, or even attending a required  business related social function.

Workers' compensation covers most work related injuries but not all. Generally, workers' compensation does not cover injuries that happen because an  employee is intoxicated or using illegal drugs. Coverage may also be  denied in situations involving:

1. injuries suffered while a worker was committing a serious crime.
2. injuries suffered while an employee was not on the job.
3. injuries suffered when an employee's conduct violated company policy.
4. self-inflicted injuries (including those caused by a person who starts a fight)

Your injury need not be caused by an accident like a fall from a  ladder—to be covered by workers' compensation. Many employees receive  compensation for injuries resulting from overuse or misuse over a long period of time, such as repetitive stress injuries or chronic back problems. You may also receive benefits for some occupational diseases that are the gradual result of work conditions (such as heart conditions, lung disease, and stress related digestive problems) or infectious illness that you contracted as a result of  exposure at work (like COVID-19 from the coronavirus). There are special rules for workers' compensation eligibility for occupational illnesses.

Workers' compensation does pay hospital and medical expenses that are necessary to diagnose and treat your injury. But it also provides disability payments while you are unable to work (typically, about  two-thirds of your regular salary). Depending on the state and the  injury, it may also pay for rehabilitation, retraining, and other benefits.

No! First of all, not all employers are required to have workers' compensation coverage. State laws vary, but an employer's responsibility to provide coverage usually depends on how many employees it has, what type of business it is, and what type of work the employees are doing.  Second, every state excludes certain types of workers. Although these exclusions vary, they often include farm workers, domestic employees and seasonal or casual workers.

States have different rules about who gets to choose the treating doctor in workers' compensation cases. In some states, you have a right to see your own doctor. Other states require that you request this in writing before the injury occurs. More typically, however, an injured worker must initially go to a doctor or medical provider network that the employer designates.Y our treating doctor's report will have a big impact on the benefits you receive. Keep in mind that doctors who are paid by employers or insurance companies may have a conflict of interest. For instance, that business relationship may motivate some company doctors to minimize the seriousness of an injury or to identify it as a preexisting condition. Depending on the rules in your state, you might be able to change treating doctors in your workers' compensation case if you're unhappy with the one you were sent to or chose on your own.

Usually, No! As a general rule, you're limited to the benefits you receive through workers' compensation, which means you can't sue for damages  like pain and suffering or mental anguish. But some states allow you to  sue your employer in very limited circumstances, including when your employer intentionally hurt you or didn't have legally required workers' compensation insurance.   Fill out the free online quote form  or contact us HERE.