Every state has a workers’ compensation statute that requires employers to insure their employees for wage loss and medical benefits when an employee is injured or suffers an occupational disease. That injury or disease must occur or arise in the course of a worker’s employment by an anticipated and foreseeable risk of that employment. The general rule is that an employee who suffered such an injury or disease can obtain workers’ compensation benefits notwithstanding who was at fault. Even if the employee was negligent and caused his or her own injuries, it’s highly likely that benefits are payable. In return for these benefits, employees ordinarily don’t have the right to sue their employer in a civil court of law for damages.
Workers’ compensation is also known as workers’ comp. It can pay a variety of benefits based on the nature and extent of an employee’s injuries. For most injured employees, the benefits that it pays are:
- Necessary medical bills resulting from the occurrence
- Temporary total disability while the employee cannot work as a result of the injury
- Any permanent partial disability
- Not all work injuries are covered by workers’ comp
Remember about the course and scope of one’s employment. Not all injuries that occur at work are covered by workers’ comp. There are exceptions like:
- Intentional self-inflicted injuries
- Injuries resulting from the commission of a crime
- Injuries caused while violating company policy
- Repetitive motion injuries
An injury need not be a sudden and traumatic event to be covered under workers’ compensation. Some conditions that develop over time such as repetitive motion injuries might be covered. For example, carpal tunnel syndrome is a repetitive motion disorder that’s typically covered under workers’ compensation. Some individuals with lung or hearing disorders might also be compensated for an occupational disease.
You don’t have to be at your place of employment to be covered
If an employee is traveling on business or from job site to job site, he or she is likely covered under workers’ compensation. The employee is probably covered when taking a client out for dinner and drinks too, but it’s unlikely that that there would be coverage while out bar hopping alone in another city. An employee on a business trip who arrives in another city and goes directly to their hotel and gets injured there probably suffered a work-related injury. An injury suffered at a company event with mandatory participation would likely be covered too.
Can I be treated by my own doctor?
Some states allow injured workers to be treated by their own doctor and every referral doctor after that. Other states require the employee to be treated by a doctor that the employer refers all other injured employees to.
After a serious accident, some employees are no longer physically capable of fulfilling their job duties. If the employee needs to be trained in another area of employment, the employer is required to pay for that training.
If an employee is killed on the job, the employer is required to pay a lump sum death benefit to the dependents of the deceased person plus funeral and burial expenses.
Employee lawsuits for injuries
In nearly all cases, workers’ compensation is the employee’s sole and exclusive remedy for an injury that occurred at work. An exception arises if the employee was injured by somebody else who wasn’t the employer or a co-employee. That’s known as third party liability, and a civil lawsuit against that third party is permitted. The injured person can also pursue a workers’ compensation claim at the same time.
Some employers aren’t cooperative with injured employees, and some workers’ compensation insurers routinely deny temporary disability and medical payments. Some company doctors refuse to recognize disabling injuries too. Workers’ compensation laws are very complex. Injured employees need to educate themselves about their rights and the applicable laws. After that, they should give strong consideration to retaining a knowledgeable and experienced workers’ compensation attorney to pursue full and fair benefits for them.