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Workers' Compensation Overview

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Workers' compensation insurance is a "no-fault" insurance system that provides financial assistance to employees who become injured or ill while at work. Workers compensation benefits commonly include medical care, partial wage replacement and death benefits. Employers who carry this insurance are normally immune from personal injury and/or wrongful death lawsuits relating to the illness or injury. However, exceptions apply (e.g., the employer knowingly put the employee in danger) that can leave the employer vulnerable to lawsuits for damages beyond workers' compensation, such as pain and suffering and punitive (to punish the employer) damages.

Workers' compensation involves a complex set of federal, state and local laws. All too often, conflicts arise during the process such as problems collecting benefits, and disputes over valuation of benefits. If you or a loved one has been harmed because of a workplace accident or occupational illness, it is best to have a workers' compensation attorney oversee your case to ensure you receive the benefits that are rightfully yours.

Workers Compensation Injuries

Thousands of people flood emergency rooms every day with scrapes, burns, broken bones, spinal cord injuries, traumatic brain injuries and more as a result of workplace accidents involving:

  • Scaffolding accidents
  • Falling objects
  • Explosions
  • Car accidents
  • Fires
  • Faulty machinery

In addition, scores of workers contract occupational diseases that are the result of long-term exposure to hazardous conditions (e.g., toxic mold) or repeated stress on the body (e.g., heavy lifting). Examples include:

  • Asthma
  • Cancer
  • Hearing loss
  • Back injuries
  • Tendonitis
  • Depression

An injury or illness will fall under the workers' compensation umbrella anywhere or anytime as long as it was within the scope of employment. Furthermore, pre-existing conditions aggravated by a workplace accident or exposure also qualify for workers' compensation benefits. The time limit to file your claim generally starts tolling when you are injured, so it is important to contact a lawyer as soon as possible.

Who Regulates Workers Compensation Insurance?

Workers' compensation insurance for employees of private companies and state and local governments is regulated by state workers' compensation boards. Except for statutory exceptions which vary by state (e.g., business with less than three employees), almost every state requires employers to self-insure or carry workers' compensation insurance through a private insurance company or a state fund. The Department of Labor's Office of Workers Compensation Programs (OWCP) handles workers compensation cases for most employees of the federal government. If you or a loved one suffered a workplace injury or occupational illness, contact an attorney to learn more about workers' compensation insurance.

Workers Compensation Benefits

Workers compensation benefits include all medical expenses related to the injury, though the insurer may choose the treating physician(s). Benefits also include compensation for a portion of lost wages. Replacement of lost wages depends on the type, severity and duration of the injury. There are two types of workers' compensation wage replacement:

  • Temporary Disability. Temporary total disability (often calculated as two-thirds of your average weekly wage) is paid to an employee who cannot work at all during his/her recovery period. However, if an employee can return to work on a limited basis during the recovery period, he/she may receive temporary partial disability, which is often two-thirds the difference between pre- and post-injury wages.
  • Permanent Disability. Permanent disability benefits for employees with a lasting condition are more complex and often include a lump sum settlement award.

In cases involving employees who need to transition into different jobs, workers' compensation may include vocational rehabilitation. Finally, if a family member died of on-the-job injuries, survivors may receive death benefits (lost income and burial expenses).

Workers Compensation Disputes

At any point in a workers' compensation case the employee may have trouble obtaining his/her rightful benefits. Common reasons for disputes include:

  • Denial of claim
  • Valuation of benefits
  • Inability to collect benefits
  • Disagreement of medical assessment

Fortunately, workers' compensation disputes can usually be resolved with phone calls, informal hearings and mediation. If necessary, unresolved disputes can be appealed in state court. If you are filing a benefits claim, you will want a workers' compensation lawyer defending your rights throughout the claims process.

Workers Compensation Litigation

Third parties who contribute to a worker's accident or injury are not protected by workers compensation laws. Accordingly, if a third party's negligence (or intentional action) contributed to your illness or injury you can sue for damages including:

  • Lost income
  • Pain and suffering
  • Punitive damages
  • Loss of enjoyment of life
  • Loss of companionship
  • Wrongful death damages (for survivors)

Furthermore, there are exceptions that can strip your employer of immunity from litigation such as employer retaliation (e.g., firing an employee because he/she filed a workers' compensation claim), or if the employer is underinsured. If you have been hurt or become ill while on the job it is advisable to consult an attorney to make sure all of your legal options are explored.

Workers Compensation Attorney

If you or a loved one has been injured or fallen ill at work, workers' compensation benefits offer invaluable medical care and financial support. Having a workers' compensation attorney on your side is important to ensure your rights are protected from start to finish