Do I Have a Workers’ Compensation Claim?
Many of us will get hurt on the job. Some of us might even get sick on the job. It happens a lot. Work sites are dangerous. They have materials on them that can infect or disease you. Workers’ compensation pays you back for these harms.
It repays you for lost wages as you recover. It also reimburses you for medical bills. It might even help you get back on your feet. For instance, it can provide for job training if you need new employment.
Lots of people don’t know about all that workers’ comp entails. They don’t when it applies. They don’t know how to apply for it. In the next couple of sections, we’re going to overview that subject. You need to know when you can get the benefits of workers’ comp.
Also, we’ll show you how to report and file a claim. Our lawyers have helped many injured workers. We can save you time and money. Give us a call today to find out if you have a workers’ compensation claim. We can review all of this info in more detail. Then, we can see how it applies to you case!
- The Workers’ Compensation System
- Injuries and Costs in the Workplace
- Fact About Work Accidents and Compensation
- Bringing a Claim for Workers’ Comp
- Do I Have a Claim for Workers’ Comp?
- Additional Workers’ Comp Resources
- Work With a Team With Years of Experience!
The Workers’ Compensation System
Think of workers’ compensation like insurance. Both the federal government and states require companies to pay into it. They make payments periodically depending upon their number of workers. When does it pay out? Workers’ comp covers harms from on-the-job accidents and illnesses.
Each state has its own system. Also, federal workers are covered by the government’s own program. Yet, they’re all kind of like insurance. The choice to adopt an insurance model has some consequences. For one, it requires upfront payments by businesses. Like any premium, this money is lost if not recouped after an injury.
Another consequence is that workers collect regardless of fault. If workers’ comp was more like a legal model, there might be a proceeding to determine fault, but that doesn’t happen here. If a worker got sick or hurt on the job, he or she collects. Finally, the insurance model has a larger consequence on workers’ rights. In some cases, collecting through this system preempts them from being able to sue their employer.
Despite their similarity, many states differ in how they apply this insurance-type workers’ comp system. If you check, you’ll probably find it all spelled out in your state’s laws. Often, they set a schedule for injuries and benefits. Of course, this will be compounded if the harm will last into the future.
Injuries and Costs in the Workplace
Workers’ comp covers a lot of injuries. It’s supposed to fix the damage for the harms that naturally come from work. This can be from carelessness, negligence, or acts of God. Here are some examples of accidents that might qualify for workers’ comp.
- Slip and fall on a wet floor.
- Beam falls on your head.
- Vehicle malfunction that leads to a crash.
There are some things it doesn’t extend to. Each state has some subtle differences. Yet, most states don’t comp you for bills and wounds if you were intoxicated at the time. Being under the influence can bar you from obtaining workers’ compensation. Also, if you intentionally committed the act or inflicted the harm, you can’t recover. Similarly, violating law or business policy might remove you from workers’ comp protection.
If you’re covered by it, what can you get? There are a certain set of expenses that workers’ comp normally reimburses you for.
First, all of the medical bills. Second, any lost income (past or future). Third, job placement if you need to move on. Fourth, disability and suffering for long-term effects. Finally, death benefits to the family if the person dies from the work incident.
As you can see, workers’ comp broadly repays a victim. It covers both tangible and intangible harms. It compensates for past, present, and future injuries.
Fact About Work Accidents and Compensation
- Vehicles, fire, repetition, and slips account for most work accidents.
- Millions of workers are injured each year on the job.
- 1/3 of work incidents required days off to heal. This has a total effect on the economy of billions of dollars.
- Manufacturing, construction, and trade account for most work accidents.
- Insurance and finance have the lowest rate of work injuries.
- Cuts, sprains, sores, and fractures are some of the most common forms of injury for workers.
- Around 5,000 people die on average each year from a work accident.
- Common causes of death on the job are electrocution, falls, object striking, and getting caught between things.
Bringing a Claim for Workers’ Comp
The process for workers’ comp is pretty straightforward. Most states have a similar framework with little variation. For starters, you need to report the injury/sickness to your employer. You’ll normally have about 30 days to do this. Although, check your state. It may be less or more. For instance, in Illinois, you must file a report within 45 days. The quicker you do it, the quicker you can get benefits!
You’ll be encouraged to get medical care. Of course, you should do this. First, though, check to see if you need to visit a particular provider. If you go off network, you may be denied workers’ comp. Some states require you to visit a particular place. Some states also might allow the employer to dictate which kind of provider you see. Other states-like Illinois-allow the worker to decide. In that case, the provider must merely accept the workers’ comp rate.
After you get the care you need, you should file a claim. Your employer should provide you with relevant forms. Some states also require you to file a claim with the workers’ comp agency. If your state doesn’t require this, you’ll only have to deal with that agency if your employer denies the claim. In that case, you’ll go through the relevant state processes.
Once your claim is filed, it will be reviewed by an insurance company. The insurance company will either accept or deny it. It has about 4 weeks to do so. If it takes no action, you might be entitled to benefits automatically. If it approves your claim, you’ll begin getting benefits. If it denies it, you can appeal that decision. It might deny your claim for a variety of reasons. It might be because you used the wrong doctor. It might be because it thought you didn’t get the injury at work. The list goes on and on.
At this point, you need to consult a lawyer about your appeal. This is the general process of workers’ comp. Now, let’s discuss the merits of these claims.
Do I Have a Claim for Workers’ Comp?
Now, we want to discuss the substantive merits of workers’ comp claims. In order to succeed on one, you must suffer an illness/injury while working for an employer. There is a lot built into this definition.
First of all, the company must have paid into the workers’ comp program. Otherwise, you might be stuck pursuing money with the state agency. Let’s talk about the claim itself though. There are some traps you need to avoid.
Remember, you must be an employee. Independent contractors, partners, and business owners don’t fall into this scheme. Also, workers from out of state might lie outside of the system’s protections. Many states exclude certain types of employees too. This list often includes government workers, law enforcement, etc. If you’re one of these workers, you won’t have a comp claim.
Your claim must also connect the illness/injury to the work. You must have suffered it while on the job. This can be easy with a broken bone. It might be harder with carpal tunnel or some random sickness. This should remind you how important it is to seek quick medical care. That’ll help build up a record to use in your claims. Certain circumstances can defeat your claim. Thus, even if you suffered it on the job, your actions might bar recovery. This conduct normally includes illegal actions or those against company policy.
Your claim must show damages. You need to be able to point to things like hospital bills, lost wages, disability, reduced future income, etc. Otherwise, your whole case is moot. You’re not allowed to seek workers’ comp just for the annoyance of the accident. You need tangible costs, intangible suffering, or some other harm. This is standard in lawsuits and applies here.
Note, we didn’t say you needed to prove someone else’s fault. Also, you don’t need to show that you were free of fault. The workers’ comp system is blameless. If you got hurt on the job, you recover regardless of fault. Work is dangerous. Lawsuits are expensive. This system balances these two facts. It repays workers for injuries without bankrupting employers.
Hopefully, this helps you understand the merits of workers’ comp claims. It should help you understand the traps that derail many claims too. If you have any questions, call our offices. We’ve help many injured workers. We can help you too! You might have a workers’ comp claim. Contact us to find out now!
Additional Workers’ Comp Resources
Here are some links you might find helpful if you were hurt on the job.
- Office of Workers' Compensation Programs (OWCP)
- Workers' Compensation Laws by State
- Workers' Compensation Benefits FAQ
Work With a Team With Years of Experience!
Rosenfeld Injury Lawyers can look at your case immediately and see if you have a claim. We’ve worked with many injured workers. We can tell you the best approach to getting compensation. Our team has crafted paths to recovery for lots of sick and hurt employees. We know how to help. Give us a call today to see how you can get back up on your feet again!
Learn more about workers’ comp claims. Read the following articles.