The Workers’ Compensation System is an insurance policy designed to compensate workers who sustain workplace injuries. The insurance coverage offers benefits such as medical treatment and compensation for lost wages and permanent disability. Some compensation programs include retraining and return-to-work programs for workers who have been hospitalized for a long period of time due to extensive injuries. In a case of death, the next of kin and the dependents of the worker receive monetary compensation. The extent of the compensation varies depending on the laws of the state.
Workers who are guaranteed insurance coverage and benefits in case of a workplace injury are not eligible to sue the employer for negligence. The only scenario where litigation is valid is if the employer is directly responsible for the injuries sustained by the worker. As such, the worker cannot claim compensation for tort damages such as pain and suffering damages and/or punitive damages through the Workers’ Compensation Law.
In other terms, the workers’ compensation system is deemed to be an indirect lawsuit against the employer in lieu of filing a direct civil lawsuit against the said employer. It ensures that the worker gets compensated regardless of who should be faulted over the injuries sustained.
Coverage of the Workers’ Compensation Law
The scope of coverage of the workers’ compensation law varies from state to state and by the type of occupation. Generally, most categories of workers are included in the coverage save for a few exemptions in some states. For instance, some states do not include independent contractors and domestic workers. Other states only provide coverage when the employer has reached a minimum threshold of the number of workers. However, if you fall under any of the categories not covered by the workers’ compensation law, you are entitled to file a civil lawsuit against the employer and/or any other involved parties.
Workers’ Compensation Benefits
The benefits provided by the workers’ compensation system are generally static across all states. They include compensation for temporary disability that forces you to stop working, medical coverage for the injuries sustained and compensation for any permanent disabilities. The following is a quick breakdown of these benefits:
· Medical benefits – here, the workers’ compensation ensures that you receive the appropriate treatment for your workplace injury or disease. The treatment is fully paid for by either your employer, the state or your employer’s insurance company. The benefits include surgery, physical therapy, prescriptions and any follow-up visits to the doctor. Furthermore, it covers any prescribed form of treatment with the exception of alternative treatments.
· Temporary disability benefits – if your injury forces to refrain from working for a period of time, you are eligible to receive lost wage benefits for the same period of time. This is generally a percentage of your current wage. The most common standard is two-thirds of your wage although this varies depending on the laws of your state.
· Permanent disability benefits – permanent disability may be differentiated into permanent partial disability and permanent total disability. Depending on the extent of your impairment, the state will pay compensation for the work-related injury. Permanent total disability occurs when the worker cannot return to work under any circumstances due to the extent of the injuries. These include total blindness, partial or full paralysis or the loss of both hands. In this scenario, the worker receives a lifetime pension in regular monetary payments based on the wages they were earning at the time of the injury. Partial disability is determined after a full assessment by a workers’ compensation doctor or the workers’ doctor after which an impairment rating is assigned. This rating determines the monetary compensation the worker receives. It can be paid in a lump sum or in small amounts over time.
· Vocational retraining benefits – Once the worker is cleared to return to work, they are entitled to a vocational retraining in case physical restrictions hinder them from joining the workforce.
Types of Injuries Covered by the Workers’ Compensation Law
A worker is only eligible for compensation by the workers’ compensation if the type of injury sustained is of the following nature:
· Pre-established medical conditions that are aggravated by the workplace environment. Such include pre-existing back injuries and respiratory issues.
· Injuries sustained during a work-sponsored event such as a company outing or sporting event.
· Injuries caused by company facilities whether faulty or not.
· Chronic diseases such as lung cancer if they are spurred by exposure to toxins at work.
· Injuries brought on by physical and mental exertion as a result of overworking or other work-related stresses. In some states, this includes debilitative mental conditions brought on by harassment of the worker by the employer.
Injuries sustained during unauthorized activities at work such as horseplay are not covered by the workers’ compensation law.
In the Event of Injury on the Job:
1. Reporting the injury to your employer should be the first thing to be done. Obtain a written copy of the report and file it in your personal records.
2. Obtain and fill a claim form. Your employer is not obligated to provide any compensation or benefits until the claim has been officially filed to the workers’ compensation insurance company.
3. Seek the services of a workers’ compensation attorney. The seemingly straightforward process can develop complications while underway due to the severity of your injuries. Skilled legal assistance will prove crucial in these times.