General Information About Workers’ Compensation
This page provides answers to the following questions:
1. What is workers’ compensation?
2. What types of injuries are covered?
3. What types of injuries are generally not covered?
4. What types of illnesses are covered?
7. Will my workers’ compensation case go to court?
8. Can I be fired for filing a workers’ compensation claim?
9. Where can I find more information?
1. What is workers’ compensation?
The workers’ compensation system evolved quickly after the turn of the 20th century in this country. Along with the industrial revolution came bigger, faster, and more complex machinery, and many more work place hazards. Congress passed the Workers’ Compensation Act for federal employees in 1908. Each state has now passed workers’ compensation laws providing both replacement income and medical expenses caused by injuries that occur on the job, as well as occupational diseases or diseases specifically caused by something unique to the workplace. While the workers’ compensation program is national, the states are responsible for implementing it, which means that every aspect, from who is eligible to the process of filing claims, varies according to the laws of the state in which you live.
These laws were initially put in place to balance the rights of workers and employers and provide a basic good for society as a whole, as a way to settle differences quickly and privately. Both the employer and employee give up some legal rights under the workers’ compensation laws of the various states. The employee gives up the right to go to court and sue his employer for on-the-job injuries which, in some states, could be for unlimited amounts of damages (although many states have passed laws capping the amount of damages). Instead, the worker is entitled to receive a certain recovery, based upon fixed maximums set by the various states.
In return, employers give up the right to challenge the employee’s negligence, if any, which may have contributed to the injury or illness. The workers’ compensation systems are considered “no-fault” systems. Employers finance the system primarily through insurance premiums, although in some states, companies are allowed to self-insure, which means that they pay all claims themselves.
2. What types of injuries are covered?
For a work-related injury, you may be eligible for compensation for any of the injuries listed below:
- Any physical injury on the job, which can include exposure to dust, toxins, hearing loss caused by workplace and repetitive motion injury – such as carpal tunnel.
- Preexisting conditions that the workplace accelerates or aggravates. Examples may include a back injury, even though you do not notice the pain from the injury until later.
- Injuries caused during breaks, lunch hours, and work-sponsored activities (such as a company picnic), and at-work injuries caused by company facilities, such as a chair in the company lunchroom.
- Injuries resulting from mental and physical strain brought on by increased work duties or work-related stress. In some states, this includes employees who develop a disabling mental condition because of the demands of the job and a supervisor’s constant harassment. Mental distress caused by something other than an initial physical injury is sometimes excluded from workers’ compensation completely, however, depending on your state.
3. What types of injuries are generally not covered?
There are also a number of cases where these injuries are not eligible, such as the following situations:
- self-inflicted injuries (including those caused by a person who starts a fight);
- injuries suffered while a worker was committing a serious crime;
- injuries suffered while an employee was not on the job;
- injuries suffered when an employee’s conduct violated company policy; and
- injuries suffered when an employee was intoxicated.
4. What types of illnesses are covered?
Diseases contracted by exposure to toxins at work as a result of normal working conditions.
5. What if someone is killed on the job? Can the employee’s survivors receive workers’ compensation benefits?
Yes. The FECA provides compensation for survivors of employees who are killed. Although workers’ compensation coverage varies from state to state, generally employees’ survivors are eligible to receive workers’ compensation benefits.
6. I was injured when a machine at work malfunctioned. Even though I cannot sue my employer, what about the manufacturer of the machine?
There are a few exceptions to the rule that workers compensation is your exclusive remedy for a work-related injury or illness. If your injury was caused by the negligence of a third party, someone other than your employer or a coworker, you are free to sue that person for damages.
For example: If your injury was the result of a machine malfunction, and that malfunction was caused by the manufacturer’s negligence you are eligible for workers’ compensation and you can sue the manufacturer responsible for the machine malfunction. Another example would be if someone ran a red light and hit the company truck you were driving while making deliveries for your employer.
You are eligible for workers compensation and you can sue the person who caused your injury. In addition, your employer can sue this negligent third party in order to recover the workers compensation benefits he is required to pay to you. Your employer could also join in your lawsuit and seek reimbursement of his benefit obligations out of your damage award. Most states require employees to notify their employers if they intend to sue a third party.
7. Will my workers’ compensation case go to court?
An employee making a workers’ compensation claim will never see a jury, because that is one of the rights waived in the workers’ compensation system. Workers’ compensation systems are administrative in nature, and cases are usually ruled on by administrative law judges. Many workers’ compensation claims, however, are settled before a hearing is needed.
Often, what the parties disagree about and require the administrative law judge to settle, is the amount adequately compensates for the nature and extent of any permanent disability. Some states allow lump sum settlements for permanent disability, and others allow weekly payments.
8. Can I be fired for filing a workers’ compensation claim?
No. Workers’ compensation laws in almost all states prevent employers from disciplining workers for filing a workers’ compensation claim. It does not even matter if the claim is eventually thrown out; your employer is not allowed to retaliate. If your employer does discipline, discharge or fire you, you have a case against your employer as long as the disciplinary action was related to your filing a workers’ compensation claim.
9. Where can I find more information?
At our site’s listing of state government agencies, you can find the contact information and web links for the agency in your state which oversees the workers compensation program in order to obtain further information about the laws in your state concerning workers compensation benefits.
© 2015 Workplace Fairness