Understanding What Workers Compensation Entails

Accidents sometimes happen at the workplace. It could be a fire explosion, machinery accidents, slip or fall, car accidents or even eye injury due to exposure to harmful chemicals or intense light. What happens if you get involved in an accident while giving it your all at work? That’s where workers’ compensation comes in.

It’s like your personal safety net, that can help you ensure you get the compensation you deserve when bad things happen at work. What does workers compensation entail? We asked Attleboro-based lawyer, Joe Lemus to walk us through workers compensation including what it covers, eligibility and many more to guide you in knowing your rights and responsibilities.

So, What Exactly is Workers’ Comp?

Workers compensation is like a kind of insurance your employer usually pays to cover medical expenses and lost wages if you get hurt or ill because of the nature of the job. The employee is not expected to contribute to the cost of compensation. It’s a no-fault system, which means you don’t have to prove who was at fault for the accident.

This is the main difference compared to regular personal injury lawsuits. “Workers compensation is mandated by the state government and the requirements vary from state to state except for Texas where employers are not required to maintain a worker’s compensation,” Joe Lemus explained.

What does Workers’ Comp Cover?

Also regarded as “workman’s comp”, workers’ compensation mainly covers:

• Medical expenses: This includes doctor’s visits, hospital stays, surgeries, medications, and physical therapy.
• Lost wages: If you’re unable to work due to your injury or illness, workers’ comp can provide temporary disability benefits to replace your lost income.
• Vocational rehabilitation: If your injury prevents you from returning to your previous job, workers’ comp may help you with job training or retraining to find a new career.
• Permanent disability benefits: For severe injuries that result in permanent disabilities, workers’ comp can provide long-term benefits.
• Death benefits: In the tragic event of a work-related death, workers’ comp provides benefits to the deceased employee’s family.
• Survivor Benefits: In the tragic event of a work-related death, workers’ comp provides benefits to the deceased employee’s family.

Who is Eligible for Workers’ Comp?

Generally, most employees who work for employers with a certain number of employees are eligible for workers’ compensation. However, there are some exceptions, such as independent contractors and certain types of temporary workers. However, there are some exceptions depending on the state while some states have different requirements for some industries. Categories of those that can be exempted include:

• Contractor Exemption: In some cases, independent contractors may not be eligible for workers’ compensation benefits. However, this can vary by state.
• Subcontractor Liability: If you’re a subcontractor working on a project, your employer may be responsible for providing workers’ compensation coverage.
• Small businesses: in some states, small businesses are excluded from paying workers compensations.
• Family Members: Employees who are family members of the business owner may be exempt from coverage in some cases.
• Temporary Workers: Short-term or temporary workers may not be eligible for workers’ compensation, depending on the circumstances.
• State requirements: some states, for instance, farm laborer’s and real estate agents are not eligible for workers compensations in Arkansas.

That is why it’s important to consult with an attorney or your state’s workers’ compensation agency for specific information.

Workers Compensation Coverage 

The two types of worker’s compensation coverage include Coverage A and Coverage B.

Coverage A 

Coverage A is the part of a workers’ compensation policy that deals with the mandatory benefits provided to injured or ill employees as required by state law. It includes:

• Medical expenses related to work injuries or illnesses.
• Wage replacement through temporary or permanent disability benefits.
• Rehabilitation services for workers who need retraining or help to return to work.
• Death benefits for families of workers who die due to a work-related incident.

This coverage is no-fault, meaning employees receive benefits regardless of who is at fault for the injury (as long as it occurred while performing job duties).

Coverage B 

Coverage B goes beyond Coverage A by paying an amount that exceeds the minimum requirements. Joe Lemus says with a good attorney in your arsenal, you can get the employer to pay above the requirements especially when the injury is brought about by the employer’s negligence or misconduct. While you might still choose a no-fault contract, you can choose to sue your employer as many states have granted employees the right to sue in some strict circumstances.

How does Workers’ Comp Work?

If you’re injured on the job, you should report the accident to your employer as soon as possible. Your employer will then file a claim with their insurance company. The insurance company will investigate the claim and determine if you’re eligible for benefits. If you’re approved, they will start paying the benefits you’re entitled to.

“You might need to do your homework by familiarizing yourself with your state’s workers’ compensation laws to understand your rights and the benefits you may be entitled to,” says Joe Lemus.

If you’re having difficulty with your workers’ compensation claim or if your claim is denied, you can appeal with your state’s Department of Industrial Accidents(DIA) which is in charge of the worker’s compensation. You may also want to consult with a workers’ compensation attorney. They can help you navigate the legal process and protect your rights.