From construction work to nursing, many jobs across the country have a high risk of injury for employees. Workers' compensation laws are designed to protect employees from financial losses caused when they are injured or contract illnesses on the job. While workers' compensation rules and procedures vary from state to state, nearly every state has some version of the same basic laws that govern workers' compensation claims.
How does workers' compensation work?
Employers in many states are required to provide workers' compensation coverage to employees, but some states exempt employers that have less than a specified number of employees. The employer pays for this insurance directly and is normally prohibited from requiring the employee to pay for the cost of coverage. Like most other types of insurance, benefits are paid out when a valid claim is filed and the criteria under state law are met.
Workers' compensation claims
Most state laws are intended to streamline the process for filing workers' compensation claims. However, these claims must pass certain tests that vary depending upon the jurisdiction and type of work. Some of the more common tests for whether a claim is valid include:
- The presence or absence of drugs or alcohol in the employee's body at the time of the accident
- Whether the employee violated company safety policies and procedures
- Whether the injured party was an employee of the company at the time of the incident
- Whether the injury or illness actually occurred on the job
The employer's duty to provide workers' compensation coverage to employees also extends to providing them with proper safety training, equipment and information. The employee's duty to follow and use this training is sometimes considered a key element in whether a claim is accepted or denied.
What does workers' compensation cover?
Workers' compensation benefits normally cover medical costs and a percentage of lost wages arising from the injury or illness, in most cases on a tax-free basis. Benefits may be limited to a specific amount of time, or they may be enhanced if the employee requires more comprehensive services such as occupational rehabilitation or training for another. Coverage, claim requirements and filing windows vary by state.
What doesn't workers' compensation cover?
Among other things, workers' compensation typically does not cover:
- Injuries sustained off company time or premises
- Injuries or illness arising from drug or alcohol consumption on company time or premises
- Pain and suffering arising from the illness or injury
Certain classes of workers may not be covered under workers' compensation law in a given state, including:
- Maritime workers
- Independent contractors
- Business owners
- Undocumented workers
Can an injured worker sue an employer?
If workers' compensation is accepted, benefits do not cover pain and suffering. During litigation, however, there is the possibility of awards for punitive and other damages.
Most states allow for an injured worker to file a lawsuit against an employer, but the worker generally cannot claim workers' compensation benefits if legal action is taken. In some cases, a workers' compensation lawyer can help the worker in receiving benefits that were improperly denied.
The information on this page is meant to provide a general overview of the law. The laws in your state and/or city may deviate significantly from those described here. If you have specific questions related to your situation you should speak with a local attorney.
Additional Workers' Compensation Articles
- Workplace Injuries do not Discriminate Between Legals and Illegals
- Obesity as a Work-Related Injury Covered by Workers' Compensation
State Workers' Compensation Articles
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota