What Is a Workers Compensation?

Regardless of work or position, employees who get injured while doing the company’s job are eligible to get Workers compensation benefits. And yes, this continues while they recuperate from the injury or illness acquired. While the claim process is pretty much straightforward, there are a number of specific guidelines (more on this below) used in determining whether an injury or illness qualifies for the said compensation. There are also various procedures that the employee needs to follow in order to file a proper claim. Contrary to popular belief, this compensation is nothing similar to a lawsuit filed against an employer. It is rather a request for benefits akin to that of an insurance claim.

The Significance of Workers Compensation Law

The Workers compensation laws are specifically crafted to guarantee that employees receive fixed monetary or support whenever they get injured or ill. And it is also meant to file claims without them having to litigate anything against their employers. Hence this compensation is deemed an important safety net for workers whenever something bad happens to them as a result of performing tasks or job.

It is worth noting that most, if not all, of these laws are also there to provide employers a certain level of protection. This is usually done by providing a limit to the amount an employee can get from their employees and, in most cases, prohibit injured workers from ever suing the company. By essence, Workers compensation is merely a no-fault system, where an injured worker’s own negligence – or the negligence of the co-worker or employer – is not considered an issue. Rather, the injured employee is simply meant to receive financial coverage for his/her work-related injuries or illnesses.

Hence Workers compensation is often coined an “exclusive remedy” with respect to an injury or illness obtained from work unless a third party is involved or contributed. For instance, employees are likely to be injured by the company’s very own products or machinery, and thus they may seek compensation. However, employers are not meant to be directly involved in any third-party claim of their respective employees. These claims rather take place in civil actions, instead of involving the Workers compensation system. There are cases, though, where employers can provide such compensation to their employees despite the involvement of a third-party.

In most states, both the insurer and employer of the compensation can enter into a lawsuit commenced by employees and find a way to protect their right to recuperate the sums. There are also states that allow employers to give a lien against their employee’s recovery. This is where the insurer and the employer must wait until the employee reaches a successful recovery, a point they can easily assert the lien. From there, the employee is required to pay back monies which are consistent to the Workers compensation benefits previously acquired or acquirable.

Difference Between Workers Compensation Benefit Claims and Civil Lawsuits

Workers compensation is typically considered an apt substitute for a lawsuit against a certain employer or company. In order to prevent an employee from suing an employer, he/she is entitled to the said compensation, and this does not fall under any fault for the injury or illness. Before this compensation’s conception, employees were given no choice but to file a lawsuit so they can acquire compensation. Nowadays, employees are automatically given with Workers compensation and, at the same time, the employer gets protected from any form of employee lawsuit.

It is important to remember, however, that even after filing a Workers compensation claim, an employee may still be able to bring a lawsuit for certain reasons. For starters, if the employee is injured by someone other than the employer, he/she is likely to proceed with a lawsuit. The same thing can happen if the injuries or illnesses are acquired through a defective product or faulty equipment.

The Scope of the Compensation’s Coverage

Workers compensation and its coverage still vary by state and, more importantly, by occupation. For example, some states exempt certain types of workers from the compensation system, including, but not limited to, agricultural, domestic, and independent (contractors). Others require coverage if and only if an employer employs a minimum number of employees or workers. Note: If a person is not covered by the compensation, he/she may be able to proceed with a civil claim against an employer or third party, whichever is applicable.

The Types of Expenses the Compensation Covers

Benefits are given to survivors (i.e. immediate family members) of employees killed on the job

Medical care provided for the injury or illnesses

Permanent Injuries Compensation

Retraining Costs

Replacement Income

If an employee files or claims a Workers compensation, he/she is no longer eligible in suing an employer. And this kind of compensation does not necessarily cover any sort of pain or suffering.

As for wage replacement, it is mostly two/thirds of a worker’s average wage, though there is sometimes a fixed maximum amount that the benefit will not go beyond. It is safe to say that the compensation is modest, especially that it is not taxed. So, as long as an employee was earning a fair wage, he/she should have not any issue whatsoever. The wave replacement eligibility starts immediately once a few days of work are missed due to the existence of a certain injury or illness.

Long-Term and Permanent Injuries

Apparently, Workers compensation is the kind of insurance that covers both long-term and permanent injuries. Hence it is not limited to any incidental accident. It even covers illnesses or problems that develop over a long period of time of doing similar injurious activities. An epitome here is the carpal tunnel syndrome (more about this below) or back problems acquired from repetitious and strenuous movements.

While most types of employees are automatically covered by this compensation, most states commonly practice the exclusion of some workers, such as:

• Business owners
• Casual workers
• Private home employees
• Farmers and farmhands
• Maritime employees
• Railroad workers
• Volunteers

Since employees working in the federal government are already compensated under the federal Workers compensation insurance program, they are – and will always not be – covered by the state-level compensation. There are even states that do not enforce this compensation on employers that have fewer (usually 3 to 5) employees working for them. Again, this largely varies from one state to another.