Workers' Compensation in the United States
Workers compensation insurance is a type of financial coverage for U.S. employees who have sustained an injury or become ill while performing their regular work duties. Each state has its own separate workers comp program, and the workers compensation laws and procedures may differ across the country. In general, a combination of state and private insurance companies pay the employee's weekly work compensation benefits and his or her health care costs. Note that an employer cannot refuse to hire you or terminate your employment if you have previously filed a claim. To prevent such occurrences, some state workers comp commissions implement additional injury trust funds that cover employers in the eventuality that the worker's injury reoccurs.
The workmans comp insurance package is purchased by the employers, and it provides protection to both parties, as neither the employee nor the employer is considered to be at fault in a workers comp case. Therefore, employees who are receiving workers compensation insurance benefits do not have the right to bring legal charges against their employer. Some employers will, however, contest the employee's workmans comp claim. In such cases, workers can engage a workers comp lawyer to assist them with their case. Even if your claim is not disputed, an attorney can still help you file your work compensation application.
Read the below sections to review the workers comp qualification criteria and learn how to submit your workers compensation insurance claim:
- How do I qualify for work compensation?
- How do I apply for workers' compensation?
- Types of workers comp benefits
How do I qualify for work compensation?
To qualify for workers compensation insurance in the U.S. you must have either been injured or contracted an illness at your place of work as a result of your or your employer's carelessness. Note that not all on-the-job injuries are covered under the workmans comp program. For example, you do not qualify for workers comp coverage in situations involving injuries that were sustained:
- While you were committing a crime.
- While you were not at your place of employment.
- When your behavior was in violation of company policy.
- When you were the instigator of an altercation with a colleague.
You will not receive work compensation benefits for injuries that were self-inflicted as well. In addition, your workmans comp claim will be denied if your injury resulted from your alcohol or drugs intoxication.
How do I apply for workers' compensation?
The workers comp application process may vary across the country, as the implementation of workers compensation laws and policies are overseen by separate workmans comp authorities on a state level. Regardless of your location in the U.S., you can nevertheless apply for workers compensation insurance by filing a claim with your state's workers comp board. The entire procedure may, however, include additional steps. Therefore, if you sustain a work-related injury you must complete the following tasks in order to obtain your work compensation benefits:
- Get urgent treatment for your injury (if required).
- Notify your manager of your injury as soon as possible.
- Inform your local workmans comp agency of your situation.
- Fill out the necessary workers comp claim forms
- Deliver the paperwork to your employer, so he or she can submit them to his or her insurance carrier.
- Submit any additional documents to your state's work compensation board.
Note: You must report your injury and file your request within a limited timeframe, which varies from state to state.
If your employer or his or her insurance company does not object your workmans comp claim, you will be instructed on how to supply your health care bills and any additional documents. However, if your claim is challenged, you can consult with a workmans comp lawyer on how to proceed.
Types of Workers Comp Benefits
Depending on the policies of your state work compensation commission, you may be eligible for workers comp benefits that cover other medical needs, aside from diagnosis and treatment of your injury. As the purpose of the workers compensation insurance coverage is to reimburse you for lost wages, you will generally be eligible for weekly disability cash benefits and rehabilitation payments. The payable amount of disability benefits depends on whether your injury is total or partial and permanent or temporary.
Furthermore, workmans comp programs also cover long-term medical conditions that were the result of your work activities, such as carpal tunnel syndrome. Your family members can be protected by workmans comp if a tragedy occurs while completing your work obligations.