Are You Eligible for Workers’ Compensation?

by RyanD on September 30, 2013

Workers’ compensation is a type of insurance carried by employers. This type of insurance serves to protect both the employee from financial loss due to injury and the employer from negligence lawsuits. Workers’ compensation pays a wage for missed work because of a work-related injury and also covers medical expenses incurred as a result of injuries on the job. Employers with more than just a few employees are required by law to carry workers’ compensation insurance. Workers’ compensation specifically covers wage replacement, medical costs, vocational rehabilitation, and some other benefits.

When Can People Benefit From Workers’ Compensation?
People can benefit from workers’ compensation insurance when they have been injured on the job. The families of individuals who were killed on the job can also benefit. Because of the nature of payment for missed wages and medical costs, the benefit does not generally exceed benefits that would be gained by staying in good health. Employers also benefit from workers’ compensation because the coverage protects employers from having to pay for the medical expenses and lost wages out of the company’s own budget.  This protection is important for smaller businesses when a very costly injury happens to one of its employees.

What Sorts of Situations Make One Eligible for Workers’ Compensation?
In order to qualify for workers’ compensation benefits, one must satisfy the following five criteria: (1) A claim must be filed within the defined time limit. (2) The worker was a qualified employee at the time of the incident. (3) The incident actually happened, and there was an injury. (4) The worker was working at the time of the injury. (5) Medical evidence proves the injury was a result of the incident.

What Steps Does One Have to Take Before Receiving Benefits?
Before receiving benefits, one must seek medical attention and file a claim. The criteria in the above paragraph must be met in order to be eligible for benefits, but workers’ compensation insurance only pays out on claims that are filed. There is a legal time limit; some states have shorter time limits than others, but the United States Department of Labor requires that the claim is filed within three years of the incident. In certain circumstances this time frame can be waived if written notice was given to the employer about the injury within 30 days of the incident.

How Long Do These Benefits Last?
Workers’ compensation benefits last as long as the individual is eligible. This could be an indefinite period. Workers’ compensation benefits come with regulations; for instance, if the claimant is cleared medically to return to work and refuses to do so, the benefits will cease. Additionally, the individual must comply with the process of seeking and accepting medical treatment in order to maintain benefits.  Sometimes individuals will refuse medical treatment because of the drug test associated with the workers’ compensation medical examinations; by refusing treatment these individuals cannot claim benefits.

Individuals with permanent disabilities from the injury can continue to receive benefits even after returning to work. Individuals with complete disability can claim benefits indefinitely, but these benefits will be jeopardized if the individual does return to work.


This article was provided by Sandy Wallace, aspiring lawyer with an interest in social issues. If you need legal representation or advice concerning workers compensation, Sandy recommends seeking legal counsel.




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