Workers Comp Information
Coverage
1) Does workers' comp insurance cover long-term illnesses and diseases?
Your injury does not have to be caused by an accident to be covered by workers’ compensation . As an employee, you can receive compensation for repetitive stress injuries, including carpal tunnel syndrome and back pain that are caused by overuse or misuse over a long period of time. A worker who has sustained a documented repetitive motion injury is entitled to workers’ compensation benefits according to the benefit schedules in their state’s workers’ comp statutes.
You may also be compensated for some illnesses and diseases that are the gradual result of work conditions, including heart conditions, lung disease and stress-related digestive problems.
2) Are on-the-job injuries covered by workers' compensation even if I was at fault?
Most on-the-job injuries are covered, regardless of fault. The workers’ compensation system is designed to provide benefits to injured workers, even if an injury is caused by the employer's carelessness or the employee's own carelessness (if the employee tripped because of clumsiness or was not paying attention while operating heavy equipment, for example). Mere carelessness or even recklessness is rarely enough to take the claim out of the realm of workers’ comp.
The tradeoff for receiving these guaranteed benefits is that the employee cannot sue the employer for negligence. Workers’ compensation hearings, if necessary, are normally administrative proceedings that take place in a separate court system. However, there are some limits to workers’ compensation being an “exclusive remedy.”
Coverage may be denied in situations involving self-inflicted injuries, injuries suffered while an employee is committing a crime or injuries suffered when an employee's conduct violated company policy, like a policy against drug use or drinking on the job.
3) If I was drunk or on drugs when the accident occurred, can I be denied benefits in a workers' compensation case?
In most cases, injuries that happen because an employee is drunk or using illegal drugs are not covered by workers' compensation insurance.
4) Do I have to be injured while actually working in order to qualify for workers compensation benefits?
Yes. As long as your injury is job-related, it's covered. For example, you'll be covered if you are injured while traveling on business, doing a work-related errand or even attending a required business-related social function (for instance, playing flag football at a company-sponsored picnic). In general, you will not be covered for injuries sustained while traveling to or from work, during your lunch break or while playing a basketball game with your work friends on your day off. To recover, you must be injured within the scope of the employment relationship.
5) If my injury is permanent, am I entitled to a workers’ comp settlement?
You are entitled settle all or part of your workers’ compensation claim, but you probably want to be very careful to leave medical benefits open for future treatment. Settlements are voluntary and will be reviewed by a compensation judge to make sure they seem fair. If you are offered or are interested in a settlement of your claim, it is best to contact an experienced workers’ compensation attorney to make sure your rights are protected. |