How Workers Compensation Works

Filing a Workers Compensation Claim
Workers compensation covers repetitive stress injuries like carpal tunnel syndrome.
Workers compensation covers repetitive stress injuries like carpal tunnel syndrome.
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Most employees are covered under workers compensation law. In some states, certain people are exempt such as company owners, businesses with five or fewer employees, agricultural workers, domestic workers and independent contractors. These companies may still be required to carry general liability insurance.

For those who are covered, workers compensation covers injuries sustained at work and illnesses or effects suffered from long-term exposure to hazardous or strenuous conditions. These can range from a broken arm resulting from a fall, to hearing loss from drilling in a quarry, to carpal tunnel syndrome from stress caused by typing. Above all, the illness or injury has to be something that was caused by the job or that can be attributed to the conditions of employment.

The Coming and Going rule means that injuries sustained during the commute to or from work aren’t covered, but other transportation-related injuries may be covered such as running errands for an employer and traveling or transporting goods in the course of employment.

If you are injured on the job, it’s good to consult an attorney who specializes in workers compensation cases, especially if you think that your claim might be challenged by the insurance company or your employer. Many attorneys offer free consultations, and some are even required by state law to operate on contingency, meaning that you won’t have to pay any attorney’s fees unless you obtain a favorable settlement.

Though it’s important to consult a lawyer, it’s also essential to file a claim with your employer as soon as the injury occurs. Your employer will offer you an employee claim form to complete. The employer or the insurance company may contest the claim, which would result in a court hearing. Monetary compensation is generally one-half to two-thirds of normal compensation, but this amount is tax free, which means that you will likely end up with a level of income close to your pre-injury level. And as stated before, all of your medical expenses will be covered.

Sometimes workers, especially those on long-term disability, are offered a settlement. Accepting one of these settlements may be advantageous, but it’s important to consider whether there may be unforeseen medical costs in the future. If so, it’s likely better to stick with your current compensation plan.

An essential part of the workers compensation process is the independent medical examination (IME). A doctor chosen by the insurance company performs this exam and reports the results to the insurance company, which uses the report to help form its compensation offer. Be observant when undergoing one of these exams. Come prepared with a list of questions, and write down notes afterward about the doctor’s comments.

An independent medical examination helps the insurance company in determining its compensation offer.

If for any reason you are unhappy with your workers compensation package, your power to sue is limited -- remember the compensation bargain. However, you can still appeal to the state workers compensation board, and an attorney can help you in this process.