Sick? Injured? How to Tell When You’re Eligible for Compensation

Friday, May 24, 2019, 6:00 AM | Leave Comment

A workers’ compensation attorney often faces an unenviable-yet-vital task: aiding unfortunate employees who have broken their bodies on the job and still must provide for their everyday needs.

To make matters more challenging, it is not at all unusual for many workers to not realize or understand the compensation to which they are entitled under the law.

That makes the counsel of an experienced, knowledgeable attorney an indispensable resource when moving forward from an illness or injury capable of interrupting or even terminating one’s livelihood.

All who find their careers in a holding pattern following work-related bodily harm owe it to themselves to ask a legal professional these basic questions first and foremost.

Sick? Injured? How to Tell When You're Eligible for Compensation

  • Are You Covered by Workers’ Compensation?

    Most states require the majority of employers to carry workers’ compensation insurance, but laws establishing compensation obligations on the basis of the type of work being performed, the nature of the business itself and the number of people employed may vary.

    In most jurisdictions, any employer with even a single employee must maintain coverage, whether purchased on the private market or from a state fund.

    Others begin workers’ compensation coverage requirements when a company hires anywhere from two to five employees. Some permit charities to opt out of workers’ compensation insurance entirely, a few hold construction or agricultural employers to unique sets of requirements and carrying coverage is optional for nearly all private employers, although many opt in and purchase policies regardless. In those instances, employees cannot sue their employer but remain eligible for benefits.

    Making matters even more complex, federal law establishes an entirely separate process for compensating injured railroad or maritime workers.

  • Does it Matter if the Injury was “Your Fault?”

    In a word? No. Even if your own actions indisputably caused the injury, workers’ compensation is a no-fault system in which you remain eligible for benefits as long as you did not intentionally hurt yourself or cause an incident by working under the influence of alcohol or drugs.

    In the latter cases where blatant negligence either contributes to or directly causes an injury, your case may depend on whether or not your employers encouraged or enabled your shenanigans.

    When injuries arise from a physical confrontation between two employees, the primary instigator is usually disqualified from benefit eligibility, but different judges in separate states have decided similar incidents of violence in unique ways depending on the situation’s individual circumstances.

    A workers’ compensation attorney can instill essential clarity and possibly even bend legal nuance in such scenarios and should be consulted with every explicit detail of the case to determine the next course of action following a claim denied based on avoidable violence or horseplay.

  • Are You an “Employee” or an “Independent Contractor?”

    Workers’ compensation laws apply critically disparate standards to employees and independent contractors.

    For legal purposes, an employee carries out an employer’s regular business in a long-term position under the employer’s control and direction using the employer’s tools. Taxes are taken out of the employee’s pay by the employer.

    In stark contrast, an independent contractor uses personally owned tools in the employer’s service on a potentially irregular basis as potentially brief as a single job with recognized highly trained skill.

    Meanwhile, the employer takes out no taxes whatsoever. Most importantly, an employer immediately controls the nature of an employee’s duties through every step of the job.

    An independent contractor falls under no such strict direction. For example, consider how you engage an electrician or plumber. You can tell them to repair wiring or unclog a toilet, but you do not tell them exactly how to get the job done.

  • Do You Fall Under an Exemption?

    It would be easy for many employees to take workers’ compensation for granted as a safety net following a disastrous injury or illness incurred while earning a living.

    Many workers nowadays have never been employed by a company that is not obligated to assume some responsibility for their employees’ ongoing wellness.

    Nevertheless, countless workers would have their otherwise-indisputable claims rejected. They simply fall into one of several employee categories exempt from legal requirements, including migrant and undocumented workers, agricultural laborers and such domestic employees as nannies and caretakers.

    Temp or staffing agencies fall under another interesting category, since they are responsible for insuring the employees they lease to other companies instead of the employers themselves covering temporary workers.

Ultimately, there are two all-important aspects of workers’ compensation coverage to remember above almost all others.

  1. First and foremost, contact an attorney immediately following a job-related injury or illness. Maximizing your entitled benefits under the law may depend on receiving immediate counsel explaining the extent of your rights and realities of your specific, potentially complex case. These nuanced circumstances call for an experienced, well-read legal mind that understands how to make the law work for you.

  2. Second, do not take workers’ compensation laws for granted. Believe it or not, independent contractors and numerous other workers are often simply out of luck and must fend for themselves when their livelihoods break their bodies down. Find out your coverage now before injury finds you so that you know where you stand.

Author BIO

Meghan Belnap is a freelance writer who enjoys spending time with her family. She also enjoys being in the outdoors and exploring new opportunities whenever they arise. Meghan also enjoys researching new topics that help to expand her horizons. You can often find her buried in a good book or out looking for an adventure. You can connect with her on Facebook and Twitter.

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